Abstract
OBJECTIVE: Infertility can be a devastating side effect of cancer treatment in younger women, but ∼1/3 of young women fail to recall discussion of these issues with their oncologists prior to treatment. Oncologists may not discuss these issues because they lack confidence in their knowledge of treatment-associated fertility issues. We sought to determine oncologists' confidence in their knowledge of fertility issues and the factors associated with greater confidence. DESIGN: National Survey of US Oncologists. MATERIALS AND METHODS: A random national sample of Med/Onc, Hem/Onc, Rad/Onc, and Gyn/Onc physicians was drawn from the AMA Master File. Oncologists treating >5 women/yr aged 21-45 were eligible to participate. Recruitment letters and emails provided a link to an on-line survey that included 8 questions regarding their confidence in knowledge of fertility issues related to cancer. Responses were based on a 5pt likert scale from which a summary scale was created (Cronbach α= 0.84). Multiple linear regression was conducted to determine the factors associated with confidence in their knowledge of fertility issues. RESULTS: 326/1702 eligible participants responded. Mean age was 48.5 and 75.2% were male. The majority of clinicians were community-based (60%). Average score on confidence in knowledge scale was 23.8 (SD 6.4, range 8-40). Higher scores were associated with Gyn-Onc sub-specialty, access to educational resources regarding fertility and cancer, and perceiving discussion of fertility preservation options as their responsibility (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. Our results suggest that providing relevant resources to oncologists and creating a sense of responsibility to discuss fertility issues may increase knowledge and improve communication of these important issues.
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