RESUMO
Objective: To determine the current level of knowledge about hormonal contraception among young women so they may be better informed about the risks and various choices available to them regarding hormonal contraception (HC). Methods: In an online survey-based study, data was analyzed from the anonymous responses of 675 female participants aged 18-30 years in various academic programs at two post-secondary institutions in Kingston, Ontario. Surveys explored demographics, use/type/duration of hormonal contraception, and knowledge of HC and thrombosis. Kruskal Wallis test and Spearman Correlation were used to determine differences in knowledge level about contraceptives across age groups, education levels, as well as use/type/duration of HC. Results: 476 participants were users of HC (264 > 1 year) and 199 were non-HC users. 370 participants have a high school diploma. The knowledge level of HC risks was associated with duration of use and overall knowledge of thrombosis and HC. The knowledge level of thrombosis was correlated with duration of use, education level, and age. Participants with higher level of education or those that have been using HC for 5 years or longer had an increased knowledge surrounding thrombosis. Participants aged 24 and older had a higher knowledge of thrombosis than that of participants younger than 24. Overall, the data was used to generate a simple infographic to further educate women in this regard. Conclusion: Misconceptions remain among young women concerning benefits and risks of HC which can be addressed by formal education.
RESUMO
Thrombosis is one of the leading causes of death in cancer. Cancer-induced hypercoagulable state contributes to thrombosis and is often overlooked. Prostate cancer may not be of high thrombogenic potential compared with other cancers, but its high prevalence brings it into focus. Pathological evidence for venous thromboembolisms (VTEs) in prostate cancer exists. Factors such as age, comorbidities, and therapies increase the VTE risk further. There is a need to systematically identify the risk of VTE in regard to patient-, cancer-, and treatment-related factors to risk stratify patients for better-targeted and individualized strategies to prevent VTE. Sensitive tests to enable such risk assessment are urgently required. There is sufficient evidence for the utility of thromboelastography (TEG) in cancer, but it is not yet part of the clinic and there is only limited data on the use of TEG in prostate cancer. One study revealed that compared with age-matched controls, 68.8% of prostate cancer patients demonstrated hypercoagulable TEG parameters. The absence of clinical guidelines is a limiting factor in TEG use in the cancer population. Cancer heterogeneity and the unique cancer-specific microenvironment in each patient, as well as determining the hypercoagulable state in each patient, are added limitations. The way forward is to combine efforts to design large multicenter studies to investigate the utility and clinical effectiveness of TEG in cancer and establish longitudinal studies to understand the link between hypercoagulable state and development of thrombosis. There is also a need to study low thrombogenic cancers as well as high thrombogenic ones. Awareness among clinicians and understanding of test applicability and interpretation are needed. Finally, expert discussion is critical to identify the investigation priorities.
