Abstract
There is a growing concern about the fertility preservation for adult cancer patients of reproductive age. Very little literature exists about fertility preservation of cancer survivors in Chinese text. This study is first to describe the knowledge level, attitude, and practice behaviors among physicians concerning fertility preservation in adult cancer patients in China. A cross-sectional survey with 30-item was conducted to assess Chinese oncology physicians’ knowledge, attitude, and behaviors regarding fertility issues. Of 360 oncology physicians, 206 (57.2%) submitted valid questionnaires. With possible overall scores for knowledge and attitude of 9 and 15, respectively, physicians’ responses to the questionnaires were 3.91 ± 1.67 and 12.29 ± 1.23. Only 49.5% of physicians routinely informed their cancer patients of childbearing age about the risk of infertility with cancer treatment. The knowledge score of the men physicians was 2-fold that of the women. Physicians aged 20–29 years were significantly more likely than other age groups to prioritize cancer treatment over fertility concerns. Men physicians were significantly more comfortable than the women discussing fertility preservation issues and cooperating with fertility specialists. The oncology physicians in China had limited knowledge of fertility preservation and rarely discussed these issues with their patients, although their attitude was positive. Results suggest that oncology physicians would welcome an in-house fertility-related training program.Key MessagesThis is the first study to address the topic of fertility preservation as it relates to the care that oncologists provide to cancer patients in China. These results revealed the importance of providing fertility-related training program to oncology physicians. Moreover, this study should provide useful information for other Asian countries, and highlight both the similarities and differences between China and Western countries concerning the reproductive rights of patients. This study should encourage international cooperation with institutions of scientific research and education.
Highlights
MethodsThe survival rates of patients with cancer have increased significantly with improvements in detection and treatments, allowing greater attention to their long-term quality of life
In patients whose treatments may lead to infertility, the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) have recommended the cryopreservation of sperm and embryos or oocytes in men and women, respectively, as standard strategies for fertility preservation (FP) [1, 5]
Physicians were required to rate the possibility of medical disputes that may be caused by insufficient information about FP
Summary
MethodsThe survival rates of patients with cancer have increased significantly with improvements in detection and treatments, allowing greater attention to their long-term quality of life. The ability to produce children is widely considered to be important for cancer survivors of reproductive age [1]. The fertility of cancer patients can be affected by various factors, including age, cancer type, and cancer treatment [2, 3]. An adverse outcome of cancer treatment may be temporary or permanent azoospermia [4], and women may become unable to produce mature ovum, or suffer premature ovarian failure [2]. In patients whose treatments may lead to infertility, the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) have recommended the cryopreservation of sperm and embryos or oocytes in men and women, respectively, as standard strategies for fertility preservation (FP) [1, 5]. Cancer survivors who have preserved their fertility are better ability to cope with their cancer [8], whereas patients without hope of a child often experience anxiety, depression, and grief [9, 10]
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