Confidence in knowledge discussing fertility changes with cancer treatment

Abstract

e20540 Purpose: Infertility can be a devastating side effect of cancer treatment in younger women, but approximately one third of young women fail to recall a discussion of such issues with their oncologist prior to cancer treatment. Oncologists may not discuss these issues because they lack confidence in their knowledge of treatment-associated fertility issues and fertility preserving options. We sought to determine oncologists’ confidence in their knowledge of fertility issues and the factors associated with greater confidence. Methods: A national sample of MedOnc, HemOnc, RadOnc, and GynOnc physicians was randomly drawn from the AMA Master File. Mailed recruitment letters provided a link to an on-line survey of fertility issues in cancer treatment. Only practicing oncologists who reported treating > 5 women/yr aged 21–45 were eligible to participate. Physicians were asked 8 questions regarding their confidence in knowledge of fertility changes with cancer treatments and fertility-sparing options. Responses on a 5pt likert scale ranged from 1=not at all confident to 5= very confident and a summary scale was created from participants’ answers. Multiple linear regression was conducted to determine the socio-demographic characteristics, practice settings and attitudes regarding discussing fertility issues that were associated with confidence in knowledge scores. Results: 336/1702 eligible participants responded (20%). Avg years in practice was 15.7, mean age was 48.5 and 75.2% were male. A majority were community-based (60%). Average score on confidence in knowledge scale was 2.9 (SD 0.80) with Cronbach α= 0.84. Higher confidence in knowledge scores were associated with Gyn-Onc sub-specialty, access to educational resources regarding fertility and cancer, and greater sense of responsibility to discuss fertility preservation options (p<.001). Age, sex, and practice setting were not associated with confidence in knowledge. Conclusions: This is the first nationally representative survey regarding confidence in knowledge among oncologists regarding fertility and female cancer treatments. Whether confidence in knowledge is a cause or result of resource access and sense of responsibility to discuss fertility issues should be explored in future research. No significant financial relationships to disclose.