From Discussion to Action: Mapping the Oncofertility Referral Gap in Indian Breast Cancer Care

There is an increase in the incidence of breast cancer in young Indian women. With better oncological care leading to improved survival rates, fertility preservation (FP) has become an important part.

A cross-sectional survey done across oncologists in India. The questionnaire included questions on their demographics and questions on knowledge of oncofertility, attitude toward discussing FP, and their current clinical practices. We used descriptive statistics to analyze the data using SPSS software.

A total of 123 oncologists completed the questionnaire. Most of them were surgical oncologists (68.3%). The majority (55%) had 3-10 years of experience, working in metropolitan areas (60%), and at teaching hospitals (58%). Their knowledge of oncofertility was assessed to be good. They also had a very positive attitude, with 89% being comfortable in discussing FP with their patients. However, we found a big gap, with nearly half (47%) of the oncologists saying that less than 25% of their patients ask questions pertaining to fertility. Only 22.8% of the oncologists had successfully referred at least one patient for a fertility consultation. This shows a large gap between knowledge of oncologists and actual discussion and final outcomes.

Indian oncologists appear to have a sound knowledge and a positive attitude; however, there is a major gap between their awareness and what happens in practice. The main problem seems to be patient's perspective with patients not willing or not able to pursue these options, even when they are made aware about them.