{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:47:04Z","timestamp":1777484824285,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["4K00CA284291"],"award-info":[{"award-number":["4K00CA284291"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Julia Stal also received funding from the University of Southern California (USC) Center for the Changing Family for this research.","award":["P30CA014089"],"award-info":[{"award-number":["P30CA014089"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,2,19]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Clinical practice organizations have developed evidence-based guidelines to structure oncofertility care delivery and mitigate fertility impairment after cancer. However, fertility care remains a leading unmet need for adolescents and young adults (AYAs) with cancer, and implementation of guidelines in practice is poorly understood. This study aims to identify intervention opportunities to improve the delivery of guideline-concordant oncofertility counseling for AYAs with cancer from the perspectives of oncologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Oncologists who treat AYAs with cancer at risk for infertility at an NCI-designated Comprehensive Cancer Center in California were recruited to participate in a virtual, semi-structured qualitative interview. Opportunities for interventions were identified following a thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data\/thematic saturation was achieved through 12 interviews with oncologists (66.7% female, 41.7% White and 41.7% Asian, in practice for an average of 14.3 years). To increase delivery of guideline-concordant oncofertility counseling for AYAs with cancer, oncologists reported opportunities for: (1) enhancements to electronic care systems (e.g., reminders to discuss fertility with young patients, automatic referrals for fertility-related care, expedited oncofertility consults); (2) dedicated personnel and time (e.g., appointing a specific person to discuss fertility, allocating dedicated time to discuss fertility); and (3) oncologist education (e.g., related to financial considerations, fertility preservation, availability of oncofertility-related resources within the care setting, patient preferences and experiences).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study identified oncologists\u2019 perspectives on opportunities for interventions to improve guideline-concordant oncofertility counseling for AYAs with cancer, providing actionable insights into targets for change across both provider- and system-level domains. Notably, identified interventions depend upon institutional commitments to prioritize oncofertility. Without systemic efforts to improve care, oncofertility will likely remain a prominent unmet need for AYAs with cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261433282","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T19:20:16Z","timestamp":1773256816000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intervention Opportunities to Increase the Delivery of Guideline-Concordant Fertility Discussions for Adolescents and Young Adults With Cancer"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-7388","authenticated-orcid":false,"given":"Julia","family":"Stal","sequence":"first","affiliation":[{"name":"Dana-Farber Cancer Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5916-6503","authenticated-orcid":false,"given":"Charleen I.","family":"Roche","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena Y.","family":"Yi","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5280-990X","authenticated-orcid":false,"given":"David R.","family":"Freyer","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Children\u2019s Hospital Los Angeles"},{"name":"University of Southern California"},{"name":"USC Norris Comprehensive Cancer Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer W.","family":"Mack","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute"},{"name":"Dana-Farber Cancer Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann H.","family":"Partridge","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute"},{"name":"Harvard Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-3730","authenticated-orcid":false,"given":"Kimberly A.","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_3_8_2_2","volume-title":"Adolescents and young adults with cancer","author":"National Cancer Institute","unstructured":"National Cancer Institute. Adolescents and young adults with cancer. https:\/\/www.cancer.gov\/types\/aya. Accessed February 27, 2025."},{"key":"e_1_3_8_3_2","volume-title":"Cancer stat facts: Cancer among adolescents and young adults (AYAs) (ages 15\u201339)","author":"National Cancer Institute Surveillance Epidemiology and End Results Program (NCI SEER)","unstructured":"National Cancer Institute Surveillance Epidemiology and End Results Program (NCI SEER). Cancer stat facts: Cancer among adolescents and young adults (AYAs) (ages 15\u201339). National Cancer Institute. https:\/\/seer.cancer.gov\/statfacts\/html\/aya.html. Accessed October 11, 2024."},{"key":"e_1_3_8_4_2","volume-title":"Late effects of cancer treatment","author":"National Cancer Institute","unstructured":"National Cancer Institute. Late effects of cancer treatment. https:\/\/www.cancer.gov\/about-cancer\/coping\/survivorship\/late-effects. Accessed February 27, 2025."},{"key":"e_1_3_8_5_2","volume-title":"Fertility issues in girls and women with cancer","author":"National Cancer Institute","unstructured":"National Cancer Institute. Fertility issues in girls and women with cancer. National Institute of Health. https:\/\/www.cancer.gov\/about-cancer\/treatment\/side-effects\/fertility-women. Accessed September 19, 2024."},{"key":"e_1_3_8_6_2","volume-title":"Fertility issues in boys and men with cancer","author":"National Cancer Institute","unstructured":"National Cancer Institute. Fertility issues in boys and men with cancer. National Cancer Institute. https:\/\/www.cancer.gov\/about-cancer\/treatment\/side-effects\/fertility-men. 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