5 Things to Know About Dobbs v Jackson & Teens with Cancer

Researchers' data shows the public & state legislators how reproductive laws may affect access to fertility care for adolescents & young adults with cancer.

1. Who’s Affected

Fertility refers to having the ability to conceive a biological child. Both young women and young men with certain types of cancer or who are getting treatment for cancer may have fertility problems. Fertility preservation treatment helps these young people be able to have a biological child later in life.

A recent research study found that more than 2 out of 3 adolescents and young adults who are newly diagnosed with cancer would require fertility preservation treatment.

Adolescents and young adults may want to talk with their doctors about getting treatment to preserve fertility when they've been newly diagnosed with a type of cancer that requires treatment with chemotherapy, radiotherapy, or other treatments that can damage the sexual organs (called gonadotoxic treatment).

Young people may also talk about preserving fertility when their diagnosis isn’t new, but a new treatment plan adds one of those treatments. People who may need such systemic treatments include those with any of these cancers:

Leukemia
Lymphoma
Bone, joint, or soft tissue sarcoma
Breast cancer in females
Cervical cancer
Ovarian cancer
Uterine cancer
Testicular cancer
Other cancers at a regional or distant stage

That means fertility preservation care is essential for more than 2 out of 3 adolescents and young adults who are newly diagnosed with cancer.

2. What’s Happened

The United States Supreme Court’s decision on Dobbs v Jackson reversed Roe v Wade and returned decisions about abortion services to each US state. In many states, abortion restrictions could limit fertility care. That leaves about 1 out of 4 adolescents or young adults with cancer who need fertility preservation living in a state where they may not be able to receive it. Fertility preservation treatment directly affects the ability to conceive a child after cancer treatment is completed.

Our hope is that our state-level data about access to reproductive care will prompt US decision-makers to make laws that ensure young people with cancer are able to access recommended cancer care and fertility preservation care.”

Xuesong Han, PhD

Scientific Director, Health Services Research

American Cancer Society

3. What Populations Are Most at Risk

In a recent study, among adolescents and young adults newly diagnosed with cancer who live in a state where fertility preservation treatment is at risk, 84% lived in high-poverty counties and 65% were girls or women. Texas, Ohio, and Georgia had the most young people with cancer at risk of not being able to get treatment to preserve fertility.

4. What’s at Risk

The court’s decision potentially interferes with fertility preservation that involves genetic testing, as well as the collection of eggs and sperm, and the creation, storage, and disposal of embryos, including those created in vitro.

5. Why We Studied the Need for Fertility Preservation in Adolescents and Young Adults with Cancer

“We took on this study because the public and our state legislators need accurate information to be able to understand the potential consequences of reproductive legislation on access to fertility care for young people with cancer,” Xuesong Han, PhD, says. She co-wrote a study published in The Lancet Oncology with her American Cancer Society (ACS) Surveillance and Health Equity research colleague, Robin Yabroff, PhD, along with two other researchers.

Ongoing monitoring of the health effects of the US Supreme Court’s decision and states’ decisions is warranted, the authors say.

“Our hope is that our state-level data about access to reproductive care will prompt US decision-makers to make laws that ensure young people with cancer are able to access recommended cancer care and fertility preservation care,” Han adds.