More than 32,000 newly diagnosed young cancer patients in the USA could face challenges accessing fertility preservation treatment each year due to the overturning of Roe v Wade.
Since many essential cancer treatments often impair fertility, young cancer patients often rely on freezing their eggs, sperm, and embryos in hopes of starting a family in the future. The American Cancer Society warns in a paper in the Lancet Oncology that the decision by the Supreme Court of the United States (SCOTUS) to overturn Roe v Wade could impose new restrictions on genetic testing and the storage and disposal of embryos, which could affect tens of thousands of these patients in the 22 states where abortion is now, or likely to be banned.
'Accurate information about the adverse consequences of reproductive legislation on access to fertility preservation care for adolescent and young adult patients with cancer needs to be fully understood by policymakers,' said Dr Xuesong Han, the study's senior author and scientific director and health services researcher at the American Cancer Society in Atlanta, Georgia.
However, these concerns remain hypothetical. Although the SCOTUS' ruling explicitly restricts abortion, how states define abortion and whether legal personhood statuses are conferred to fetuses or embryos, as seen in Georgia (see BioNews 1154), have significant legal implications that will impact fertility preservation treatments (see BioNews 1158).
The researchers identified and collected demographic and clinical data from 123,591 individuals between the ages of 15-44 years old that were newly diagnosed with cancer from a 2018 United States cancer registry. Of these, approximately 85,085 were deemed likely to need fertility preservation treatment.
Among those that needed fertility preservation treatment, 32,008 patients lived in 22 states where abortion was already restricted or became restricted as of 6 August 2022, while the remaining 53,077 lived in 29 states where abortions remain legal.
Those living in abortion-restricted states, and most disproportionately impacted by abortion restrictions, were more likely to be non-Hispanic White and live in non-metropolitan areas in the poorest counties than those living in states where abortions remain legal.
According to the study's findings, fertility preservation is essential for more than two-thirds of young newly diagnosed cancer patients. Although patients could seek out fertility preservation treatments in less restrictive states, the authors warn that this could have wider consequences.
Furthermore, the study's authors note that the SCOTUS ruling may hinder the trust and quality of patient-provider relationships. They also note that cancer patients seeking fertility preservation treatments and the medical staff carrying out those treatments could potentially face financial, civil, and criminal penalties.
Sources and References
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Continued access to fertility preservation critical for adolescent and young adult cancer patients, following SCOTUS decision
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Dobbs v Jackson and access to fertility care among newly diagnosed adolescents and young adults with cancer in the USA
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Amid nationwide abortion debate, American Cancer Society warns fertility preservation for cancer patients could be at risk in the future
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