06 June 2024
New research published in the Internal Medicine Journal, a publication of the Royal Australasian College of Physicians, reveals that only 17.3% of chemoimmunotherapy cycles screened patients for pregnancy up to 90 days before their treatment began.
The study included 304 women between 18-51 years of age over the course of five years, assessing the uptake of pregnancy screening and contraception counselling prior to their chemoimmunotherapy (CIT) treatment at a cancer treatment centre in Sydney.
Lead researcher, Professor Nada Hamad says this study reveals the urgent need for guidelines to require pregnancy testing for women of childbearing age prior to cancer treatment.
“We saw a concerning low rate of women of childbearing potential being screened for pregnancy, and this has major implications for treatment and care. Prior to the 416 cycles of CIT in the 304 women of childbearing potential, pregnancy screening only occurred 72 times.
“A missed positive pregnancy test could result in foetal complications, accidental miscarriage and other health issues, but we can avoid this risk altogether through a simple pregnancy test just prior to undergoing a CIT cycle during routine bloods tests already collected.
“Potential pregnancy is often deprioritised by both patients and their clinicians, as the cancer diagnosis takes precedence.
“Chemotherapy can impact menstrual cycles and make ovulation unpredictable, so it’s important physicians screen their patients with childbearing potential because a positive pregnancy test has significant treatment implications.
“Ensuring there are guidelines in place to screen for pregnancy prior to CIT treatment cycles would be hugely beneficial to support implementation of screening to ensure an unrecognised pregnancy is not missed.
“When women were tested for pregnancy, the median time between the test and the beginning of a treatment cycle was about three weeks, which is a significant gap in which there would be time to conceive.
“We also know that symptoms of pregnancy can overlap with symptoms of treatment, including nausea, vomiting and fatigue.
“We should also ensure women have access to contraception counselling to make sure women of childbearing potential have all the information they need to make informed decisions about family planning.
“We found that only 18.8% of women had documentation of past or present contraception details, and none had contraception counselling documented.
“We also know that an overwhelming majority of women of childbearing potential with malignancy – 80% – see contraception as very important and want to be able to talk about it with their oncologist or haematologist.
“It’s time for us to prioritise women’s reproductive rights throughout cancer diagnosis and treatment, and ensure we also look after their reproductive health,” says Professor Hamad.