European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2026
Factors associated with reproductive concerns among adolescent and young adult cancer survivors: A cross-sectional study.
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Zhao Shuliang, Wang Xiao, Zhong Ting, Tang Dongyan, Li Ho Cheung William, Xia Wei, Chung Oi Kwan Joyce
Аннотация
PURPOSE: Cancer and its treatment-related effects may impair fertility and increase reproductive concerns (RCs) among adolescent and young adult (AYA) survivors at their peak reproductive years. To assess RCs in survivors and examine their associated factors and pathways.
METHODS: A cross-sectional study was conducted with 209 AYA cancer survivors aged 15-39 years from June 2023 to December 2024. Participants' RCs, cancer-related sexual and reproductive health knowledge, attitudes, and needs were measured. Multiple linear regression and structural equation modeling were performed.
RESULTS: Participants' mean RCs score was 70.17 ± 6.70. Regression showed that cancer-related sexual and reproductive health attitudes (B = 0.646, p < 0.001), needs (B = 0.516, p = 0.001) were positively associated with RCs. Awareness of fertility preservation options, including sperm donation (B = 2.034, p = 0.005) and testicular replacement (B = 2.224, p = 0.044), was also positively associated with RCs. Conversely, endorsement of artificial uterus technology (B = -3.032, p = 0.007), perceived impact of habitual sleep deprivation on fertility (B = -1.491, p = 0.030), and a history of hematologic malignancy (B = -6.256, p = 0.003) were negatively associated with RCs. Structural equation modeling showed that attitudes (β = 0.531, p < 0.001), knowledge (β = 0.201, p = 0.003), and needs (β = 0.295, p = 0.006) were significantly associated with RCs.
CONCLUSIONS: RCs among AYA cancer survivors are associated with sexual and reproductive health-related attitudes, knowledge, needs. Integrated education and supportive care may be relevant for addressing RCs in this population.
METHODS: A cross-sectional study was conducted with 209 AYA cancer survivors aged 15-39 years from June 2023 to December 2024. Participants' RCs, cancer-related sexual and reproductive health knowledge, attitudes, and needs were measured. Multiple linear regression and structural equation modeling were performed.
RESULTS: Participants' mean RCs score was 70.17 ± 6.70. Regression showed that cancer-related sexual and reproductive health attitudes (B = 0.646, p < 0.001), needs (B = 0.516, p = 0.001) were positively associated with RCs. Awareness of fertility preservation options, including sperm donation (B = 2.034, p = 0.005) and testicular replacement (B = 2.224, p = 0.044), was also positively associated with RCs. Conversely, endorsement of artificial uterus technology (B = -3.032, p = 0.007), perceived impact of habitual sleep deprivation on fertility (B = -1.491, p = 0.030), and a history of hematologic malignancy (B = -6.256, p = 0.003) were negatively associated with RCs. Structural equation modeling showed that attitudes (β = 0.531, p < 0.001), knowledge (β = 0.201, p = 0.003), and needs (β = 0.295, p = 0.006) were significantly associated with RCs.
CONCLUSIONS: RCs among AYA cancer survivors are associated with sexual and reproductive health-related attitudes, knowledge, needs. Integrated education and supportive care may be relevant for addressing RCs in this population.