MedicalResearch.com Interview with:
Pooja Rao, MD, MSCE
Division of Pediatric Hematology/Oncology
Milton S. Hershey Medical Center
Penn State College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment.
Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.
MedicalResearch.com: What should readers take away from your report?
Response: As nearly all chemotherapy agents used to treat acute leukemia in childhood and adolescence can cause potential harm to a developing fetus, our findings highlight the need for standardized pregnancy screening practices for adolescent patients being treated for cancer. Within the pediatric oncology community, there are no standardized guidelines for pregnancy screening. This lack of standard screening recommendations may contribute to the inadequate pregnancy screening observed in our study.
Furthermore, the low pregnancy testing rates may indicate pediatric oncology providers’ hesitancy to discuss sexual health with their adolescent patients. Studies indicate adolescents with chronic illnesses, including those with cancer, engage in sexual behaviors which may not be recognized by their health care practitioners. As adolescent oncology patients see their oncology providers frequently throughout their cancer treatment, this doctor-patient relationship is well suited for discussions about sexual health. Such discussions may identify high-risk sexual behaviors that could put patients at risk for pregnancy, in addition to sexually transmitted infections, intimate partner violence, and nonconsensual sexual activity.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We hope that our study findings initiate discussion in the healthcare community of the clear need for routine pregnancy screening practices for adolescent patients who will receive chemotherapy and CT scans. Furthermore, we believe that standardized guidelines for pregnancy screening in adolescents should be implemented given that many chemotherapy agents are teratogenic. These discussions should occur at the level of the healthcare institution and cooperative oncology treatment groups.
As mentioned earlier, the lack of standard pregnancy screening recommendations may contribute to the inadequate pregnancy screening observed in our study. We observed variation in pregnancy screening, not just between the different groups of adolescents we studied, but also by hospital center. Future work should focus on exploring the factors responsible for hospital-level variation in pregnancy screening, such as academic hospital status, hospital volume, affiliation with an adult hospital, and hospital environment.
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Low Rates of Pregnancy Screening in Adolescents Prior to Teratogenic Exposures in a National Sample of Children’s Hospital
Pooja Rao MD, MSCE,Yimei Li PhD,Kelly D. Getz PhD, MPH,Tamara P. Miller MD, MSCE, Yuan-Shung Huang MS, Jennifer J. Wilkes MD, MSCE, Alix E. Seif MD, MPH, Rochelle Bagatell MD, Brian T. Fisher DO, MSCE, Clarisa Gracia MD, MSCE, Richard Aplenc MD, PhD
First published: 12 September 2016Full publication history
DOI: 10.1002/cncr.30225View/save citation
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