Critical appraisal:Chung JP, Lao TT, Li TC 2017
Chung JP, Lao TT, Li TC. Evaluation of the awareness of, attitude to, and knowledge about fertility preservation in cancer patients among clinical practitioners in Hong Kong. Hong Kong Med J 2017 Dec;23(6):556-61 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29123075.
- What is the level of awareness among health professionals of the need to discuss the risk of infertility with cancer patients?
cross sectional study
To study the awareness of, attitude to, and knowledge about fertility preservation among clinicians in Hong Kong
conducted between June and December 2016
Eligible subjects identified from the Specialist Register of Medical Council of Hong Kong.
To be eligible: clinicians worked in public hospitals and specialised in the field of Clinical Oncology, Haematology, Obstetrics and Gynaecology, Paediatrics, and Surgery.
Potential candidates were selected by convenience sampling from each specialty from various hospitals and their work addresses identified via the electronic staff directory or organisational chart provided by the Hospital Authority intranet. The study questionnaire was mailed to them internally.
Response rates for specific specialties were: 55.3% (68/123) for obstetricians and gynaecologists, 37.5% (48/128) for surgeons (general/breast/urology), 18.5% (22/119) for paediatricians, and 16.5% (16/97) for haematologists or clinical oncologists.
Up to 85.0% (142/167) of respondents cared for cancer patients in their daily practice and 76.0% (127/167) dealt with treatments that may threaten fertility.
Views on the demand for the fertility preservation service
Factors considered when making a decision about fertility preservation
Difficulties encountered in discussing fertility issues with their patients
Need for a dedicated fertility preservation clinic
Only 45.6% (73/160) were familiar with FP - 3 most familiar means were sperm freezing (66.3%, 108/163), followed by oocyte freezing (65.0%, 106/163) and embryo freezing (50.3%, 82/163) - the results include a table that breaks down awareness and familiarity across the specialties that may be relevant.
68.3% (112/164) had never referred a patient for fertility preservation - of the 52 respondents who had, 88.5% (46/52)
had referred <5 patients and 11.5% had referred >5 patients over the past 12 months.
Sperm cryopreservation was the most commonly referred fertility preservation method.
90.7% (146/161) would consider referral of a patient to a fertility specialist for fertility preservation if it
delayed treatment by 1 week, 83.2% (134/161) if the delay was <2 weeks, 41.6% (67/161) for <4 weeks, and 6.2% (10/161) for <8 weeks.
76.5% (117/153) agree that fertility preservation should be available as a public service.
Top 5 difficulties encountered by clinicians in discussing fertility preservation were: no time before commencement
of gonadotoxic treatment (60.6%, 97/160), high risk of cancer recurrence (53.8%, 86/160) or poor prognosis, financial constraints (46.9%, 75/160), treating the cancer as top priority (38.8%, 62/160), and not being aware of any place or person to whom their patients could be referred to (35.0%, 56/160).
Didn't ask how important, or knowledge about risk of infertility...
|High risk of bias||Comments: Self-selection bias.|
I've said include but it doesn't acutally loook at their knwoeldge of risk of infertility, but it does ask about awareness of FP which is the flip side of the coin...
- Chung JP, Lao TT, Li TC. Evaluation of the awareness of, attitude to, and knowledge about fertility preservation in cancer patients among clinical practitioners in Hong Kong. Hong Kong Med J 2017 Dec;23(6):556-61 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29123075.
- Assigned to
- Topic area
- Guidelines:COSA:Cancer fertility preservation guidelines/Discussing risk
- Clinical question
Section below only relevant for Cancer Council Project Officer