Factors Associated with Hormonal Contraception Choice Among Female Cancer Survivors Open Access

Black, Gabrielle (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/gt54kp50g?locale=en


Cancer survivors of reproductive age are a unique population with specific contraceptive needs. This study aims to examine contraceptive use among cancer survivors to women who have not had cancer and to determine what characteristics of cancer survivors are associated with the decision to use hormonal contraception. Female cancer survivors (n= 1,282) aged 22–45 years, who were diagnosed in Georgia from 1990 to 2009, between ages 20–35 years and at least 2 years post diagnosis, and comparison women with no history of cancer (n= 1,073) completed an interview about their contraceptive and reproductive histories, including type of contraception used. Adjusted logistic regression models were fit to examine hormonal contraceptive use in the past 12 months among cancer survivors and comparison women. Multiple logistic regression models were fit to access the association between sociodemographic and survivorship characteristic and hormonal contraception use in the past 12 months among cancer survivors. After adjusting for confounding by age at interview and race, cancer survivors were less likely to use hormonal contraception in the past 12 months compared to the comparison women (Adjusted Odds Ratio [aOR:] 0.59, 95% confidence interval [CI]:0.48-0.73). In unadjusted models, factors associated with a higher use of hormonal contraception in the past 12 months in cancer survivors included being <30 at diagnosis (Odds Ratio [OR]: 2.53, 95% CI: 1.83-3.45; referent: >30 at diagnosis), achieving desired family size prior to diagnosis (OR:1.58, 95% CI: 1.07-2.31), and having children after the cancer diagnosis (OR: 1.38, 95% CI: 1.01-1.88). Factors associated with a lower use of hormonal contraception in the past 12 months were receiving chemotherapy (OR: 0.56, 95% CI: 0.34-0.62), receiving radiation (OR: 0.58, 95% CI: 0.43-0.78), having children before cancer diagnosis (OR: 0.44, 95% CI: 0.32-0.61), being obese (OR: 0.60, 95% CI:0.41-0.89; referent: underweight/normal), and black race (OR: 0.34, 95% CI: 0.27-0.59; referent: white). Cancer survivors may benefit from contraceptive counseling addressing concerns with the use of certain methods.

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