# Project 1: Fertility and Cancer Care Delivery for Adolescents and Young Adults

> **NIH NIH P01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $357,873

## Abstract

ABSTRACT – Project 1, Fertility and Cancer Care Delivery in AYAs
 Future fertility is a critical concern for many adolescents and young adults (AYAs) with cancer. National
guidelines universally recommend fertility counseling for AYA cancer patients before potentially gonadotoxic
treatment begins. However, prior studies have shown that patients often do not receive fertility counseling.
With the long-term goal of examining how fertility counseling may enhance cancer treatment adherence and
outcomes, this study will investigate: 1) potential disparities in receipt of fertility counseling and access to
fertility preservation strategies; and, 2) how fertility concerns impact the receipt of recommended cancer
treatments for AYAs with breast cancer, testicular cancer, or lymphoma.
 Limited access to specialists and unconscious biases in provider referrals may result in demographic,
socioeconomic, and disease-related disparities in receipt of fertility counseling and preservation services.
When routinely provided, referrals to fertility specialists can be rapid and preservation strategies can be
completed within a few weeks. AYAs whose fertility-related concerns are not addressed though counseling
and/or fertility preservation strategies may spend more time seeking fertility information or making medical
appointments on their own. They may avoid or postpone potentially gonadotoxic therapies, increasing their
risk of treatment delays or non-initiation or non-persistence of cancer therapies compared to patients whose
fertility-related concerns are addressed. Our study will investigate how gaps in delivery of fertility counseling
may have an impact beyond meeting patients’ reproductive goals, by contributing to suboptimal cancer
treatments for AYAs. While several small studies have partially assessed these issues in young women with
breast cancer, they remain unstudied in AYAs with most other cancers.
 In this P01, we plan to survey approximately 5,000 AYA cancer survivors. For this Project, we will collect
information on fertility concerns, receipt of fertility counseling, use of fertility preservation techniques, and
factors that may influence use of fertility services. Survey participants will be AYA cancer patients 2–10 years
after a cancer diagnosis from the University of North Carolina Cancer Information & Population Health
Resource (CIPHR), Kaiser Permanente Northern California (KPNC), and Kaiser Permanente Southern
California (KPSC). These settings provide the opportunity to link survey data with electronic health records or
administrative claims data that document receipt of cancer treatment.
 This study will identify disparities in fertility counseling delivery and use of fertility preservation strategies,
informing development of interventions to improve fertility-focused AYA care, including those that target patient
and clinician comfort with the use of reproductive technologies. This project adds a critical element to our
larger program addre...

## Key facts

- **NIH application ID:** 9855900
- **Project number:** 1P01CA233432-01A1
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Hazel B Nichols
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $357,873
- **Award type:** 1
- **Project period:** 2020-09-15 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9855900

## Citation

> US National Institutes of Health, RePORTER application 9855900, Project 1: Fertility and Cancer Care Delivery for Adolescents and Young Adults (1P01CA233432-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9855900. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*