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• W2751871901 abstract "Rates of contraception and use of highly effective methods in young, female cancer survivors are lower than those of the general reproductive-aged female population. Patient-important factors in contraceptive decision-making in young female cancer survivors are needed to develop interventions, but remain unknown. We examined associations between self-reported reasons for contraceptive choice and method used. Cross sectional study. Participants were 18-41 year old female survivors of cancers diagnosed at ages 15-35, and had completed primary cancer treatment at enrollment in the Window study on ovarian function. 480 women at risk of unintended pregnancy were included, excluding those pursuing pregnancy, with no heterosexual intercourse in the prior year, and/or hysterectomy. Participants completed online questionnaires, including contraception questions derived from the National Survey for Family Growth and the Behavioral Risk Factor Surveillance System. Fisher’s Exact test was used to examine the association between self-reported primary reason for contraceptive choice and use of highly effective (WHO Tiers I/II) versus less effective (WHO Tiers III/IV) methods. Post-hoc pairwise comparisons used Chi-square or Fisher’s Exact tests. The mean age of participants was 33.2+4.9 years with 7.6+5.4 years since cancer diagnosis. 83.9% of participants used contraception, including 146 (36.3%), 94 (23.4%), 118 (29.5%), and 44 (11.0%) using WHO Tier I, II, III, and IV methods, respectively. Women using highly effective methods were more likely to cite ease of use, favorable cost, contraceptive efficacy, or menstrual pattern as the primary reason for contraceptive choice, compared with women who used less effective methods (Table). Women who used Tier III/IV methods were more likely to cite ease of obtaining method or lack of hormones as influencing their choice. Side effects, STI prevention, and partner preference were not associated with method. Among women who did not use contraception, common primary reasons for non-use were perceived infertility (32.6%) and desired future pregnancy (9.5%). Significant proportions of young cancer survivors are not using contraception or using less effective methods, increasing risks of unintended pregnancy. Self-reported reasons for contraceptive choice differs between women who use methods of higher versus lower efficacy. These factors may inform development of interventions to improve highly effective contraception use in this population.Tabled 1Self-reported primary reason for contraceptive choice by World Health Organization (WHO) TierTier I/II Method (n = 240)Tier III/IV Method (n = 162)Easy to obtain*8 (3.3)21 (13.0)Easy to use*50 (20.8)12 (7.4)Favorable cost/insurance coverage*9 (3.8)1 (0.6)Contraceptive efficacy*62 (25.8)9 (5.6)Favorable side effect profile23 (9.6)23 (14.2)Lack of hormones*50 (20.8)77 (47.5)Menstrual cycle changes*16 (6.7)0Partner preference5 (2.1)3 (1.9)Sexually transmitted infection (STI) prevention5 (2.1)3 (1.9)None of the above12 (5.0)13 (8.0)Tier I: sterilization, intrauterine devices, implants. Tier II: combined hormonal contraceptives,progestin only contraceptives,lactation amenorrhea method. Tier III: condoms, diaphragm, fertility awareness. Tier IV: withdrawal, spermicide Open table in a new tab" @default.
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• W2751871901 date "2017-09-01" @default.
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• W2751871901 title "Contraceptive choice among young cancer survivors: what do patients value?" @default.
• W2751871901 doi "https://doi.org/10.1016/j.fertnstert.2017.07.373" @default.
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