Use of emergency contraception among female young adult cancer survivors

Abstract

Objective: 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.

Design: 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.

Setting: Not applicable.

Patient(s): A total of 616 female cancer survivors aged 18-40.

Intervention(s): None.

Main outcome measure(s): Self-reported emergency contraception use.

Result(s): 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.

Conclusion(s): 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.

Keywords: Emergency contraception; cancer survivorship; family planning; young adult cancer survivors.