Infertility, anxiety, and depression among adolescents and young adults with cancer: the Mexico Cancer Survivorship Registry.
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BACKGROUND: In 2020, 24,000 new cancer cases were diagnosed among adolescents and young adults (AYAs) in Mexico. Cancer-related infertility affects 30%-75% of AYAs and is associated with poor quality of life, relationship satisfaction, and self-worth. This study examines the association between infertility, anxiety, and depression among AYA cancer survivors in Mexico. METHODS: Data for AYAs (ages 15-39) in the Registro de Supervivientes de Cancer (Cancer Survivor Registry) developed by the Instituto Nacional de Cancerología in Mexico was utilized. A self-report survey was conducted during 2014-2018. Logistic regression models were used to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). RESULTS: AYA cancer survivors (N = 1168) had a median age of 31 (interquartile range: 25-36), were predominantly women (75%), and 42% had a college education or higher. The most common cancers were breast (33%), lymphoma (12%), cervical (10%), and testicular (9%) with the majority being Stage III (19%) tumors. Approximately 1 in 8 AYAs (12%) reported infertility. Across men and women, after adjusting for age at diagnosis, time since the end of treatment, education level, geographical region, stage, treatment type, and cancer type, AYAs who reported infertility were more likely to experience depression (OR 1.52, 95% CI: 1.02-2.26) symptoms than those who did not report infertility. There was no association between infertility and anxiety among all AYA cancer survivors combined. CONCLUSIONS: Infertility is associated with depression symptoms among AYA Mexican cancer survivors. Mexican AYA cancer survivors experiencing infertility may need additional support to address unmet care needs.