Factors associated with non-receipt of fertility counseling during cervical cancer treatment: Insights from the ACHIEVE study.

Abstract

e17530 Background: The American Society of Clinical Oncology recommends that all individuals of reproductive age with cancer receive fertility counseling. However, implementation in routine practice remains inconsistent. Few studies have examined factors associated with non-receipt of fertility counseling among cervical cancer survivors. Methods: We examined factors associated with non-receipt of fertility counseling during cervical cancer treatment using baseline data from the study Assessing Cervical Cancer Healthcare Inequities in Diverse Populations: the ACHIEVE Study. The ACHIEVE Study recruits cervical cancer survivors, diagnosed between 2021-2025, from population-based National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program registries in New Jersey and Los Angeles. Analyses were limited to reproductive-aged participants (21-49 years-old). We assessed differences in fertility counseling receipt across sociodemographic and healthcare factors using t-tests and Fisher’s exact tests. Results: Of the 111 participants included in this study, 23.4% reported non-receipt of fertility counseling during treatment. Those diagnosed between 40-49 years-old had the highest percentage of non-receipt of fertility counseling (58%) compared to participants aged 20-29 years-old (7%) and 30-39 years-old (35%) (p = 0.18). Non-Hispanic White survivors were more likely than non-Hispanic Black survivors to not receive fertility counseling (58% vs. 8%; p = 1). When compared to participants who received fertility counseling, those who did not receive fertility counseling more frequently reported healthcare discrimination (72% vs. 50%; p = 0.07) and low (vs. high) patient-centered communication (19.2% vs. 11.8%; p = 0.34; not significant). Conclusions: Findings underscore the need to better understand how sociodemographic factors and healthcare barriers shape fertility counseling practices during cervical cancer treatment. Interventions to standardize fertility counseling and address healthcare barriers in cancer care are needed to ensure equitable onco-fertility services and outcomes.