期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 31, 期 5, 页码 1043-1051出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-21-1305
关键词
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资金
- University of North Carolina Lineberger Comprehensive Cancer Center Developmental Grant
- NCI [R01 CA 204258, F31 CA260787]
- University of North Carolina Lineberger Cancer Control Education Program [T32 CA057726]
This study found that young women with cancer who used fertility preservation techniques after diagnosis may face increased financial hardship. More legislation is needed to ensure insurance coverage and improve access to fertility preservation for these individuals.
Background: Financial hardship among adolescents and young adults (AYA) with cancer who receive gonadotoxic treatments may be exacerbated by the use of fertility services. This study examined whether AYA women with cancer who used fertility preservation had increased financial hardship. Methods: AYA women with cancer in North Carolina and California completed a survey in 2018-2019. Cancer-related financial hardship was compared between women who cryopreserved oocytes or embryos for fertility preservation after cancer diagnosis (n = 65) and women who received gonadotoxic treatment and reported discussing fertility with their provider, but did not use fertility preservation (n = 491). Multivariable log-binomial regression was used to estimate prevalence ratios and 95% confidence Results: Women were a median age of 33 years at diagnosis and 7 years from diagnosis at the time of survey. Women who used fertility preservation were primarily ages 25 to 34 years at diagnosis (65%), non-Hispanic White (72%), and had at least a Bachelor's degree (85%). In adjusted analysis, use of fertility preservation was associated with 1.50 times the prevalence of material financial hardship (95% CI: 1.08-2.09). The magnitude of hardship was also substantially higher among women who used fertility preservation: 12% reported debt of >=$25,000 versus 5% in the referent group. Conclusions: This study provides new evidence that cryo- preserving oocytes or embryos after cancer diagnosis for future family building is associated with increased financial vulnerability. Impact: More legislation that mandates insurance coverage to mitigate hardships stemming from iatrogenic infertility could improve access to fertility preservation for young women with cancer.
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