Oncofertility Knowledge and Communication: Comparison Between Medical and Surgical Oncologists and Breast Cancer Patients in Academic Chinese Centers.

Steven R. Lindheim,Rui Li,Ewelina Biskup,Leslie Coker Appiah,Hongwei Zhang,Yun Sun,Yao Lu,John P. Zucal,Zhaochen Xin

doi:10.3389/fsurg.2021.681614

Abstract

Background: As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country.Objective: This study aimed to identify gaps in knowledge and communication as well as referrals in the previous year regarding oncofertility among medical and surgical oncologists and breast cancer patients (BCPs) in Chinese academic settings to target areas of needed improvement.Materials and Methods: A WeChat online questionnaire was designed, distributed, and compared between medical and surgical oncology specialists and reproductive age BCPs in academic teaching settings in Shanghai.Results: Sixty-one medical and surgical oncologists and 125 BCPs responded to the survey. 63.3% of oncologists were familiar with the term “oncofertility” compared to 25.6% of BCPs (p < 0.001). Oncologists were more likely to correctly know the costs associated with treatment (59.0 vs. 32.0%, p < 0.001); patient did not have to be married to undergo oncofertility treatment (50.8 vs. 24.8%, p < 0.001). Both oncologists and BCPs were similarly unlikely to know when patients could utilize cryopreserved tissue in the future (37.7 vs. 22.2%, p = 0.056). While oncologists reported they discussed all oncofertility options (41.0%) and offered psychological counseling (98.4%), significantly fewer BCPs reported receiving information on all options and offered counseling (3.2%, p < 0.001 and 85.6%, p < 0.01). Knowledge of oncofertility was the most important predictor for providing and receiving counseling from oncologists [OR = 6.44 (95% CI = 1.59–26.1, p = 0.009] and BCPs (OR = 3.73 95% CI: = 1.36–10.2, p = 0.011). Overall, 57.4% of oncologists referred <10 patients and none referred more than 25 patients in the past year.Conclusion: Data suggests a significant knowledge gap and ineffective communication/comprehension exists between academic Chinese oncologists and BCPs. Continued education and raised awareness are needed to optimize utilization of oncofertility services in China.

Highlights

Cancer incidence and mortality continue to increase world-wide, despite rather stable rates over the last decade in the Western countries [1]
Multiple logistic regression indicated that knowing what oncofertility was (OR = 3.73, 95% confidence intervals (95% CIs) = 1.36, 10.2) and greater knowledge of oncofertility, were associated with greater odds of discussing oncofertility with oncologists
Our study revealed that slightly less than two-thirds of academic Chinese medical and surgical oncologists knew what the term oncofertility meant, though more than three quarters discussed at least some type of fertility preservation option

Summary

Introduction

Cancer incidence and mortality continue to increase world-wide, despite rather stable rates over the last decade in the Western countries [1] This positions cancer as one of the top global burden diseases [2]. While cancer is mostly a disease of the elderly, there remains a large number of cancer types in young adults and adolescents, e.g., breast and colon cancer which includes nearly 400,000 reproductive age adults and 23,000 pre- and post-adolescents [4] Mortality rates both globally and in China have decreased due to advancements in treatment regimens [1, 5], leading to a rise in the number of cancer survivors in pre- and reproductive age [6, 7]. As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country

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Discussion

Conclusion