Study Objective

Adolescent and young adult (AYA) women undergoing cancer treatment face unique reproductive health risks. This study aimed to assess the prevalence of sexual health counseling and contraception use in the oncology setting, and to identify patient factors associated with these outcomes.

Design

Retrospective chart review.

Setting

Yale New Haven Hospital from 2013 to 2018.

Participants

Female patients 15-25 years of age receiving cancer treatment, excluding those treated with surgery only.

Interventions

None.

Main Outcome Measures

Outcomes of documented sexual health counseling and contraception use were assessed for frequency. Associations between patient factors and these outcomes were assessed using Pearson χ² and Fisher exact tests, and multivariate logistic regression was used to identify predictors of these outcomes.

Results

In this cohort (n = 157), the median age was 20.5 years, and the most common diagnoses were hematologic (40.8%) and thyroid (31.2%) malignancies. Of the patients, 33.1% were documented as receiving sexual health counseling, and 48.4% used contraception. Younger patients (15-20 years of age) were less likely to receive counseling (OR 0.31, 95% CI 0.14-0.70, P = .005). Receiving counseling (OR 3.36, 95% CI 1.35-8.34, P = .009) and sexual activity (OR 4.18, 95% CI 1.80-9.68, P = .001) were significantly associated with contraception use.

Conclusions

Sexual health counseling was documented infrequently during oncologic care for AYA women, especially for younger patients. However, such conversations were associated with a higher likelihood of contraception use. There is a need to improve rates of counseling in this high-risk setting, in which adolescents may be more vulnerable with regard to sexual health.

中文翻译：

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接受癌症治疗的青少年和年轻成年女性患者的避孕咨询和使用：回顾性分析

学习目的

接受癌症治疗的青少年 (AYA) 妇女面临独特的生殖健康风险。本研究旨在评估肿瘤学环境中性健康咨询和避孕措施的普及率，并确定与这些结果相关的患者因素。

设计

回顾性图表审查。

环境

耶鲁纽黑文医院从 2013 年到 2018 年。

参与者

接受癌症治疗的 15-25 岁女性患者，不包括仅接受手术治疗的女性患者。

干预

没有任何。

主要观察指标

对记录在案的性健康咨询和避孕措施的结果进行频率评估。患者因素而这些结果之间的关系应用皮尔逊χ评估²个Fisher精确检验，并使用多变量logistic回归以确定这些结果的预测因子。

结果

在该队列 (n = 157) 中，中位年龄为 20.5 岁，最常见的诊断是血液系统 (40.8%) 和甲状腺 (31.2%) 恶性肿瘤。在这些患者中，33.1% 的患者接受过性健康咨询，48.4% 的患者使用了避孕措施。年轻患者（15-20 岁）接受咨询的可能性较小（OR 0.31，95% CI 0.14-0.70，P  = .005）。接受咨询（OR 3.36，95% CI 1.35-8.34，P  = .009 ）和性活动（OR 4.18，95% CI 1.80-9.68，P  = .001）与避孕使用显着相关。

结论

在 AYA 女性的肿瘤护理期间，很少记录性健康咨询，尤其是年轻患者。然而，此类对话与更高的避孕使用可能性有关。需要提高在这种高风险环境中的咨询率，在这种环境中，青少年在性健康方面可能更容易受到伤害。