内容紹介
Summary
A national survey conducted in 2016 aimed to evaluate the current status and needs of the field of oncofertility and to consider optimized medical delivery systems. A total of 739 oncologists, excluding gynecological and urological specialists, were surveyed. Of these, 99.2% thought that providing information on fertility preservation was important. Of the surveyed oncologists, 48% were affiliated with facilities providing assisted reproductive technology, and 79.3% practiced in university hospitals. Of 238(32.2%)specialists who provided information on the risk of reproductive damage resulting from treatment in their facility, 163(44.9%)and 75(19.9%)practiced in university hospitals(n=363)and non-university hospitals(n=376), respectively. In contrast, 14.3% and 32.7% of oncologists who practiced in university hospitals and non-university hospitals, respectively, collaborated with local obstetricians and gynecologists. Among oncologists who use a gradually expanding regional oncofertility network, 0.6% practice in university hospitals and 2.7% practice in non-university hospitals. Patients were advised that the risk of infertility was 92.3% and the likelihood of fertility preservation was 66.9%. Furthermore, as an ideal way of providing information on preservation of fertility, 22.9% of oncologists collaborate with local gynecologists, and 26.3% do so at a public cancer and reproductive medical counseling center. In addition, 34.7% and 55.1% of oncologists at university and non-university hospitals, respectively, thought that implementation of a fertility preservation program at a public facility would be desirable. Although most oncologists recognize the importance of providing information on reproductive medicine, the support system for reproductive function and fertility in adolescent and young adult(AYA)generation cancer patients is limited because of the lack of agreement on patient referral. The limited number of referrals in turn limits data collection in the field of oncofertility. Grant: A Health and Labour Sciences Research Grant: H27-Cancer Control-Ippan,
要旨
2016年に実施したWEBアンケート調査により,本邦でのがん専門医の思春期・若年成人(AYA)世代がん患者に対する生殖機能低下や妊孕性温存に関する情報提供の現状,ニーズの把握と今後のがん・生殖医療提供体制の検討を目的とした。解析対象は,産科婦人科専門医と泌尿器科専門医を除外した739名とした。99.2%が妊孕性温存に関する情報提供は重要と考えていたが,自施設内で生殖機能に関する情報提供を実施している専門医は全体で32.2%,大学病院所属専門医と非大学病院所属専門医で,それぞれ44.9%,19.9%であった。また,近隣産婦人科施設との連携は,それぞれ14.3%と32.7%,地域ネットワークの活用は0.6%と2.7%と施設によって対照的な結果を示した。これは,回答者の所属施設で生殖補助医療(assisted reproductive technology: ART)実施施設が全体で48%,そのうち79.3%が大学病院所属専門医であることとも関係していると思われた。説明内容については,不妊発症可能性に関して92.3%,妊孕性温存方法に関しては66.9%であった。妊孕性温存に関する情報提供としては,全体で22.9%の専門医が近隣産婦人科施設との連携を考え,26.3%が公的ながん・生殖医療相談センター(公的機関)での実施が理想と考えていた。また,妊孕性温存実施に関しては大学病院,非大学病院で,それぞれ34.7%,55.1%が公的機関での実施が望ましいと考えていた。がん専門医は生殖医療に関する情報提供の重要性を認識しつつも,がん治療施設の特性によりAYA世代がん患者の生殖機能や妊孕性に関する支援体制において量的および質的に適切な情報提供の実施が妨げられている可能性が示唆された。
目次
A national survey conducted in 2016 aimed to evaluate the current status and needs of the field of oncofertility and to consider optimized medical delivery systems. A total of 739 oncologists, excluding gynecological and urological specialists, were surveyed. Of these, 99.2% thought that providing information on fertility preservation was important. Of the surveyed oncologists, 48% were affiliated with facilities providing assisted reproductive technology, and 79.3% practiced in university hospitals. Of 238(32.2%)specialists who provided information on the risk of reproductive damage resulting from treatment in their facility, 163(44.9%)and 75(19.9%)practiced in university hospitals(n=363)and non-university hospitals(n=376), respectively. In contrast, 14.3% and 32.7% of oncologists who practiced in university hospitals and non-university hospitals, respectively, collaborated with local obstetricians and gynecologists. Among oncologists who use a gradually expanding regional oncofertility network, 0.6% practice in university hospitals and 2.7% practice in non-university hospitals. Patients were advised that the risk of infertility was 92.3% and the likelihood of fertility preservation was 66.9%. Furthermore, as an ideal way of providing information on preservation of fertility, 22.9% of oncologists collaborate with local gynecologists, and 26.3% do so at a public cancer and reproductive medical counseling center. In addition, 34.7% and 55.1% of oncologists at university and non-university hospitals, respectively, thought that implementation of a fertility preservation program at a public facility would be desirable. Although most oncologists recognize the importance of providing information on reproductive medicine, the support system for reproductive function and fertility in adolescent and young adult(AYA)generation cancer patients is limited because of the lack of agreement on patient referral. The limited number of referrals in turn limits data collection in the field of oncofertility. Grant: A Health and Labour Sciences Research Grant: H27-Cancer Control-Ippan,
要旨
2016年に実施したWEBアンケート調査により,本邦でのがん専門医の思春期・若年成人(AYA)世代がん患者に対する生殖機能低下や妊孕性温存に関する情報提供の現状,ニーズの把握と今後のがん・生殖医療提供体制の検討を目的とした。解析対象は,産科婦人科専門医と泌尿器科専門医を除外した739名とした。99.2%が妊孕性温存に関する情報提供は重要と考えていたが,自施設内で生殖機能に関する情報提供を実施している専門医は全体で32.2%,大学病院所属専門医と非大学病院所属専門医で,それぞれ44.9%,19.9%であった。また,近隣産婦人科施設との連携は,それぞれ14.3%と32.7%,地域ネットワークの活用は0.6%と2.7%と施設によって対照的な結果を示した。これは,回答者の所属施設で生殖補助医療(assisted reproductive technology: ART)実施施設が全体で48%,そのうち79.3%が大学病院所属専門医であることとも関係していると思われた。説明内容については,不妊発症可能性に関して92.3%,妊孕性温存方法に関しては66.9%であった。妊孕性温存に関する情報提供としては,全体で22.9%の専門医が近隣産婦人科施設との連携を考え,26.3%が公的ながん・生殖医療相談センター(公的機関)での実施が理想と考えていた。また,妊孕性温存実施に関しては大学病院,非大学病院で,それぞれ34.7%,55.1%が公的機関での実施が望ましいと考えていた。がん専門医は生殖医療に関する情報提供の重要性を認識しつつも,がん治療施設の特性によりAYA世代がん患者の生殖機能や妊孕性に関する支援体制において量的および質的に適切な情報提供の実施が妨げられている可能性が示唆された。