Background Adolescents and young adult (AYA) women with cancer are at risk of heavy menstrual bleeding (HMB) due to thrombocytopenia, coagulopathy, and/or disruption of the hypothalamic‐pituitary‐gonadal axis. Currently, little is known about current practices to help prevent and treat HMB in AYA women with cancer. Methods We surveyed providers from 100 pediatric oncology centers. Face and content validity were assessed prior to distribution. Descriptive statistics, Chi‐squared and Fisher exact tests were used for analysis. Results Ninety‐four percent of respondents have recommended preventative menstrual suppression. More than half of respondents agreed that patients with the following types of cancers should receive preventative menstrual suppression: sarcomas, acute leukemias, lymphomas, and germ cell tumors. The most preferred form of menstrual suppression was GnRH agonists. Almost 95% of respondents felt that it is important to consider menstrual suppression and that a formal guideline about initiation of menstrual suppression would be helpful. Only 46% felt comfortable personally managing menstrual suppression. Conclusions The vast majority of pediatric oncologists who responded to this national survey have used preventative menstrual suppression and feel that it is important to consider in many types of AYA cancers. Although pediatric oncologists are most often managing menstrual suppression, they do not feel comfortable doing so and desire guidelines to help with management. Future studies to assess which patients require menstrual suppression and which menstrual suppression is best tolerated and efficacious is needed.
e21533 Background: Adolescents and young adult (AYA) females with cancer are at risk of heavy menstrual bleeding (HMB) due to thrombocytopenia, coagulopathy, and/or disruption of the hypothalamic-pituitary-gonadal axis. Options for temporary menstrual suppression (MS) include combined oral contraceptives (OCPs), progestin-only therapy, GnRH agonists, and intrauterine devices. Currently, little is known about current practices to help prevent and treat HMB in AYA women with cancer. Methods: We conducted a national cross-sectional internet-based survey of providers from 100 pediatric oncology centers. Institutions were randomly selected to allow for even representation by program size and geography. Face and content validity were assessed prior to distribution. Descriptive statistics were used to analyze respondent characteristics, attitudes, and practices for managing menstrual suppression. Chi-squared test or Fischer’s Exact test (for small cell sizes across groups) were used for analysis of categorical data. Kruskal-Wallis one-way ANOVA tests were used to compare means. Results: The majority of respondents (94%) have recommended preventative MS. MS in pediatric oncology patients is most often managed by oncology (61%) versus gynecology (22%) or adolescent medicine (12%). Greater than 50% of respondents agreed that patients with the following types of cancer should receive preventative MS: sarcomas, acute leukemias, lymphomas, and germ cell tumors. GnRH agonists were the most preferred method of MS (52%). Most respondents agreed that it is important to consider MS (94%), and that a formal guideline about initiation of MS would be helpful (95%). Less than half (46%) of participants felt comfortable personally managing MS. Conclusions: The vast majority of pediatric oncologists have used preventative MS, most commonly GnRH agonists, and feel that it is important to consider in the majority of AYA cancers. Although pediatric oncologists are most often managing MS, they do not feel comfortable doing so and desire guidelines to help with management.
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