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Quinn GP, Block RG, Clayman ML, Kelvin J, Arvey SR, Lee JH, Reinecke J, Sehovic I, Jacobsen PB, Reed D, Gonzalez L, Vadaparampil ST, Laronga C, Lee MC, Pow-Sang J, Eggly S, Franklin A, Shah B, Fulp WJ, Hayes-Lattin B. If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients' medical records. J Oncol Pract 2014; 11:137-44. [PMID: 25549654 DOI: 10.1200/jop.2014.000786] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The adolescent and young adult (AYA) population is underserved because of unique late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers. METHODS All centers reviewed randomized records within the top four AYA disease sites (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible records included those of patients: diagnosed in 2011, with no prior receipt of gonadotoxic therapy; age 18 to 45 years; with no multiple primary cancers; and for whom record was not second opinion. Quality Oncology Practice Initiative methods were used to evaluate documentation of discussion of risk of infertility, discussion of FP options, and referral to a fertility specialist. RESULTS Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P = .030 and .004, respectively) and those with breast cancer (P = .021 and < .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P = .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P < .001, < .001, and .002, respectively) and those who already had children (all P < .001). CONCLUSION The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation.
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Affiliation(s)
- Gwendolyn P Quinn
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Rebecca G Block
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Marla L Clayman
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Joanne Kelvin
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Sarah R Arvey
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Ji-Hyun Lee
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Joyce Reinecke
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Ivana Sehovic
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Paul B Jacobsen
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Damon Reed
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Luis Gonzalez
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Susan T Vadaparampil
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Christine Laronga
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - M Catherine Lee
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Julio Pow-Sang
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Susan Eggly
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Anna Franklin
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Bijal Shah
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - William J Fulp
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Brandon Hayes-Lattin
- Moffitt Cancer Center; Morsani College of Medicine, University of South Florida, Tampa, FL; Oregon Health & Science University, Portland, OR; Northwestern University, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York, NY; LIVESTRONG Foundation, Austin; The University of Texas MD Anderson Cancer Center, Houston, TX; and Karmanos Cancer Institute, Wayne State University, Detroit, MI
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