There are estimated to be two million new cancer cases in the United States in 2023. Of those, approximately 95,000 are expected to occur in the pediatric, adolescent, and young adult population. Due to early detection and newer targeted agents, five-year survival rates have significantly improved to 84% for this population with an estimated 100,000 survivors of reproductive age annually.
With survivors living longer, it is estimated that up to three-fourths will experience long-term adverse sequelae of cancer therapies, termed late effects. The cancer care paradigm has thus shifted to include a focus on quality of life in survivorship including screening for late effects, prevention of long-term sequelae, and implementation of evidence-based guidelines for symptom management.
Reproductive late effects in survivorship are an often underdiagnosed and undertreated consequence of cancer therapy. These late effects include gonadal injury resulting in sub- and infertility, genital graft versus host disease after stem cell transplant, radiation induced uterine and vaginal injury, sexual dysfunction, and an increased risk of breast and cervical cancer after certain treatments.
National and international guidelines exist to mitigate risk to fertility and improve reproductive health outcomes in survivorship. However, despite established guidelines, implementation is not standardized. Barriers include provider knowledge and bias, cost, and the lack availaable fertility preservation services at academic and community medical centers.
A standardized, comprehensive approach for fertility preservation and reproductive late effects care is necessary to address current low fertility preservation referral and uptake patterns to resolve inequities in care. This presentation on Best Practices in Pediatric, Adolescent, and Young Adult Oncofertility seeks to present strategies to improve outcomes for this population with an equity lens.
**Don’t have time to watch the full recording? Check out this 7-minute Lightning Lesson for a condensed version focusing on the major highlights and takeaways.
Landmark Articles
Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update.
Male Pediatric, Adolescent, and Young Adult Reproductive Survivorship.
Female Reproductive Health in Pediatric, Adolescent, and Young Adult Cancer Survivors.
