Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Fertility and sexual health in young-onset colorectal cancer: current practice around fertility discussion and preservation at an academic Australian cancer centre (146608)

Charlotte A O'Leary 1 , Harriet O'Rourke 1 , Mitchell Tan 1 , Benjamin Barzel 1 , Jeanne Tie 1 2 3 , Wanda Cui 1 3
  1. Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
  2. Division of Personalised Oncology, Walter and Eliza Hall Institute, Parkville, VIC, Australia
  3. Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia

Background

Incidence of young-onset colorectal cancer (YOCRC, diagnosed <50 years of age) is rising, with Australia amongst the highest incidence rates globally. The multimodal treatment for colorectal cancer may impact sexual and gonadal function. This study aims to explore practices regarding discussion of fertility/sexual health issues, utilisation of fertility preservation services and, in females, use of goserelin to preserve ovarian function during chemotherapy in YOCRC.

Methods

This retrospective study included new YOCRC patients aged <50 years who received systemic treatment at Peter MacCallum Cancer Centre between 1st December 2020 and 1st December 2024. Post-menopausal female patients were excluded.

Results

140 patients were included. 55 (39%) were females and 85 (61%) were males. The median age was 40 years (range 24 – 49). 75 patients (54%) had Stage I/II/III cancer and 64 (46%) had metastatic cancer. 22 female patients (42%) and 39 male patients (46%) had no previous children. A discussion regarding potential impacts of treatment on fertility and a discussion regarding sexual health was documented in 41 (50%) and 22 (27%) of the 85 male patients, respectively. Likewise, discussion regarding impacts on fertility and sexual health was documented in 25 (45%) and nine (16%) of the 55 female patients, respectively. 25 males (30%) were referred to fertility services; 24 underwent sperm cryopreservation. Nine females (16%) were referred to fertility services; seven underwent fertility preservation. Five females (9%) received goserelin.

Conclusion

Discussion regarding the potential impact of cancer treatments on fertility was documented in only half of YOCRC patients, and less than one quarter had a documented discussion regarding sexual health. One quarter of patients were referred to fertility services; the majority of those referred underwent fertility preservation. Goserelin use among female patients was low. More attention to reproductive and sexual health impacts of cancer treatments is needed in YOCRC patients.

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