Physicians’ practice of discussing fertility preservation with cancer patients and the associated attitudes and barriers
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The aim of this study is to describe physicians’ clinical practice of discussing fertility issues with cancer patients and determine the factors associated with such discussion.
In this cross-sectional study, a nationwide Internet survey was conducted among physicians who provided daily medical care to cancer patients at hospitals or clinics. Participants answered a questionnaire assessing characteristics, discussion practices, attitudes, and barriers regarding fertility preservation.
Among the 180 participants, 42% discussed fertility issues with patients daily, and 30% had experience in referring patients to fertility preservation specialists. A multivariate logistic regression analysis showed that those who agreed or strongly agreed with the statements “physicians are responsible for discussing fertility preservation” (OR = 2.04, 95% CI 1.14–3.63, p < 0.05) and “patients who have an exceedingly aggressive disease and need immediate cancer treatment should not be told about fertility issues” (OR =1.84, 95% CI 1.09–3.10, p < 0.05) were nearly twice as likely to discuss fertility issues with patients.
Compared to Western countries, fertility issues are less likely to be discussed in Japan. To increase opportunities for patients to discuss fertility issues, the ASCO guidelines should be widely understood. Additionally, these results suggest that physicians who are more likely to discuss fertility issues might feel more conflicted about whether they in fact should discuss such issues with patients with poor prognosis or insufficient time for cancer treatment.
KeywordsCancer survivor Fertility Discussion Barrier Attitude
This study was supported by a Health Labour Sciences Research Grant (H26-016) from the Ministry of Health, Labour and Welfare.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
The need for informed consent was waived by the Institutional Review Board and Ethics Committee of the National Cancer Center of Japan, but we explained to them the research purpose, procedure, privacy protection, and right to voluntary participation.
Informed consent was obtained from all individual participants included in the study.
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