Volume 109, Issue 6, Pages 1114–1120.e1
Alexa C.O. Medica, M.D., Shaylyn S. Stark, MPH, Tracy N. Hadnott, M.D., Andrew C. Dietz, M.D., M.S.C.R., Sally A.D. Romero, Ph.D., M.P.H., Loki Natarajan, Ph.D., Elena Martinez, Ph.D., Brian W. Whitcomb, Ph.D., H. Irene Su, M.D., M.S.C.E.
To test whether emergency contraception use in reproductive-aged cancer survivors is higher than in the general U.S. population and evaluate factors associated with use among survivors.
A retrospective cohort study compared emergency contraception use between cancer survivors in the Reproductive Window Study on ovarian function after cancer and in the general population in the 2006–2010 National Survey for Family Growth. In a cross-sectional analysis of survivors, multivariable models were used to test associations between participant characteristics and emergency contraception use.
A total of 616 female cancer survivors aged 18–40.
Main Outcome Measure(s)
Self-reported emergency contraception use.
The mean age of survivors was 33.4 ± 4.7, at a mean 7.5 years since diagnosis. Breast cancer (22%), Hodgkin lymphoma (18%), and leukemia (8%) were the most common cancers. Since diagnosis, 156 (25.3%) used emergency contraception, 60% because of not otherwise using contraception. Age-adjusted prevalence of use was higher in survivors than in the general population (28.3% [95% confidence interval (CI) 24.7–31.9] vs. 12.0% [95% CI 11.1–12.9]). In multivariable analysis among survivors, nonwhite race (prevalence ratio [PR] 1.3, 95% CI 1.0–1.8), breast cancer (PR 0.6, 95% CI 0.4–1.0), partnered relationship (PR 0.6, 95% CI 0.5–0.9), and older age (age 36–40 vs. 31–35; PR 0.7, 95% CI 0.5–1.0) were associated with emergency contraception.
Female young adult cancer survivors were significantly more likely to use emergency contraception compared with the general population. Populations including nonwhite survivors have a higher risk, suggesting differences in family planning care. Strategies to improve contraception and decrease the need for emergency contraception are needed.