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Defining and Measuring Reproductive Concerns of Female Cancer Survivors
Affiliations of authors: University of California, Irvine, Center for Health Policy Research, Department of Medicine, College of Medicine, Irvine, CA (LW, ADA); Epidemiology Division, University of California, Irvine, College of Medicine, Irvine, CA (RH); William H. Baker Professor of Gynecology, Harvard Medical School, Boston, MA (RB); New England Trophoblastic Disease Center, Trophoblastic Tumor Registry, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Gillette Center for Women's Cancers, Brigham and Women Hospital, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA (RB, DPG, MB); Department of Health Evaluation Sciences, Penn State-Milton S. Hershey Medical Center, College of Medicine, Hershey, PA (BCK); Department of Medicine, University of California, Irvine, CA (KO); Gestational Trophoblastic Disease Centre, Charing Cross Hospital, Imperial College London, UK (EN, MJS); Yorkshire Cancer Research Professor of Clinical Oncology, University of Sheffield, Sheffield, UK (BH); Institute for Health Services Research and Policy Studies, Northwestern University and Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Evanston, IL (DC)
Correspondence to: Lari Wenzel, PhD, University of California, Irvine, Center for Health Policy Research, Department of Medicine, College of Medicine, 111 Academy Way, Ste. 220, Irvine, CA 92697–5800 (e-mail: lwenzel{at}uci.edu).
Although women diagnosed with cancer during their childbearing years are at significant risk for infertility, we know little about the relationship between infertility and long-term quality of life (QOL). To examine these relationships, we assessed psychosocial and reproductive concerns and QOL in 231 female cancer survivors. Greater reproductive concerns were significantly associated with lower QOL on numerous dimensions (P<.001). In a multiple regression model, social support, gynecologic problems, and reproductive concerns accounted for 63% of the variance in QOL scores. Women who reported wanting to conceive after cancer, but were not able to, reported significantly more reproductive concerns than those who were able to reproduce after cancer (P<.001). These preliminary data suggest that at least for vulnerable subgroups, the issue of reproductive concerns is worthy of additional investigation to assist cancer survivors living with the threat or reality of infertility.
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