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Oncofertility research pitfall? Recall bias in young adult cancer survivors

Open AccessPublished:December 29, 2022DOI:https://doi.org/10.1016/j.xfre.2022.12.007
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      ABSTRACT

      Objective

      To assess recall bias by evaluating how well female cancer survivors remember details regarding their cancer diagnosis, treatment, and fertility preservation (FP) counseling.
      Oncofertility literature cites recall bias as a pitfall of retrospective surveys (1,2), but limited data exist to quantify this bias (3).

      Design

      Retrospective secondary analysis of cross-sectional survey data

      Setting

      Single academic medical center

      Patients

      Female oncology patients of reproductive age, 18-44 years old, at least 6 months past their last chemotherapy treatment

      Interventions

      Not applicable

      Main Outcome Measures

      Recall of details surrounding cancer diagnosis and chemotherapy regimens, recall of FP counseling and ovarian reserve testing, and rates of chart-documented FP counseling

      Result(s)

      In total, 117 patients completed the survey, with 112 verified via chart review. When asked to report chemotherapy regimen, 57% (64 of the 112) reported “I don’t know/prefer not to say.” Regarding FP, 80% (90 of the 112) denied being offered counseling. Of the 37 (33%) who had documented FP conversations, 13 (35%) did not recall mention of fertility. Only 2 of 8 patients with ovarian reserve testing recalled this being performed at their initial visit. Multivariable logistic regression revealed older age was significantly associated with not being offered FP (OR 0.87, p=0.02).

      Conclusion

      Our results confirm that accuracy of oncology patients’ reporting is limited by poor recall, particularly regarding their specific chemotherapy regimen. More than 1 in 3 patients documented to have been offered FP counseling do not recall this discussion. Importantly, only one-third of cancer survivors had chart-documented FP counseling. Increased efforts are needed to ensure adequate follow-up beyond the initial visit.

      Keywords