Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 – Key considerations for clinical care Joint with the Society of Gynecologic Oncology

Abstract

With increasing trends in both cancer diagnosis and survivorship, a growing number of individuals impacted by cancer need high-quality contraceptive counseling. Individuals with cancer and cancer survivors have individualized needs with respect to sexual activity, fertility desires, and contraceptive preferences. Clinicians should provide person-centered contraceptive care that supports individual autonomy in decision-making, is tailored to the individual’s expressed preferences and values, and includes cancer-specific considerations. While pregnancy prevention is generally recommended during cancer treatment, pregnancy may occur before or during treatment and require person-centered counseling. No test reliably rules out pregnancy potential in cancer survivors; clinicians should offer to discuss contraception with individuals who are pregnancy-capable before cancer treatment. Clinicians should counsel individuals about common risks and complications that may impact contraceptive choice, as cancer and chemotherapy can cause (1) vascular injury, which can increase the risk of venous thromboembolism, (2) anemia, and (3) bone loss increasing the risk of fractures. Clinicians should counsel individuals with cancer that it is safe for them to use emergency contraception. Clinicians should be aware that individuals experiencing intimate partner violence and other marginalized populations, including adolescents and young adults and gender-diverse individuals, have unique needs requiring a person-centered approach to contraceptive care complicated by cancer. Access to the full spectrum of contraceptive methods should be prioritized for individuals with cancer and cancer survivors, accommodating individual preferences and health status. This document is part 1 of a three-part series that updates the Society of Family Planning’s 2012 Cancer and contraception clinical guidance. Its companion documents, Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 2 – Breast, ovarian, uterine, and cervical cancer and Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 – Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers, build upon this document and focus on actionable, clinical recommendations.