No abstract

Research has established that childhood cancer treatments can place survivors at risk for reproductive health problems, yet little is known about pediatric survivors' perceptions of their risk for infertility and worry about future family planning. The purpose of this study was to explore factors that affect awareness of risk for and worry about infertility among female pediatric cancer survivors aged 10 to 21 (N=48) and their parents (N=41) following exposure to treatments associated with reproductive late effects. The majority of female childhood cancer survivors (71%) and their parents (95%) reported worry about infertility following gonadotoxic therapy. Cross-sectional data indicated that survivors' awareness of risk for and worry about infertility increase during adolescence, whereas parents' awareness of risk and worry generally remain constant throughout their daughters' development. Survivor worry about infertility was predicted by a variety of factors, yet parent worry about infertility was only associated with increased gonadotoxic radiation exposure. Overall, these findings reinforce the necessity of developmentally appropriate education about reproductive health risks and fertility preservation options across the continuum of pediatric oncology care from diagnosis to survivorship.

The highest risk factors for low BMD were male gender, exposure to TBI, cranial, or craniospinal radiation, and gonadal dysfunction. Survivors receiving methotrexate or HCT therapy have the lowest risk for low BMD among those screened. Future studies should investigate risk of low BMD for survivors receiving HCT without radiation exposure.