(174) Sexual Health in Young Adult Survivors of Childhood Cancer: A Project REACH Study
Authors: Chevalier L , Bice B , Bober S , Recklitis C 
Published: May 2023

Abstract

Introduction
Sexual health, a key component of general well-being, relies on the successful interplay of physical, psychological, and social development. Although we know cancer treatment early in life disrupts many of these processes, it remains unclear exactly how treatment leads to sexual dysfunction in young adult childhood cancer survivors (YACCS). Our previous research found that approximately one third of YACCS report two or more sexual dysfunction symptoms using five sexual health items on a larger health-related quality of life survey. This research suggests that sexual dysfunction is related to late effects (e.g., fatigue) but not specific cancer treatments (e.g., chemotherapy). However, additional research using validated sexual health measures is required to understand these relationships more fully.

Objective
To build on previous research by examining the relationship between cancer treatment and sexual dysfunction in YACCS using validated sexual health measures.

Methods
252 YACCS enrolled in Project REACH, a prospective cohort study, completed self-report measures on sexual functioning, psychological distress, and physical functioning. To examine proportion of participants experiencing clinically significant sexual dysfunction, participants were classified as a sexual dysfunction “case” if they scored ≥ 19 on the Female Sexual Function Index (FSFI-6) or ≥ 24 on the International Index of Erectile Function (IIEF). Relationships between sexual dysfunction, cancer type, cancer treatment, psychological distress (Brief Symptom Inventory-18; BSI-18), and health-related quality of life (i.e., Short Form-12; SF-12) were examined.

Results
Almost half (43%) of participants were classified as a sexual dysfunction case, with females significantly more likely (51%) to be a case than males (34%, p=.007). Brain tumor survivors were significantly more likely to be a case (53%) than participants with other types of cancers (36%, p=.009). Participants with a history of bone marrow transplant (BMT) were more likely to be a case (61%) than those without (41%, p=0.061), although this finding was only marginally significant. There were no significant differences in case vs. non-case by age, time since diagnosis, chemotherapy, radiation, or surgery. Sexual dysfunction cases reported significantly worse anxiety and depression (BSI-18) and overall mental and physical health (SF-12) than non-cases.

Conclusions
Our findings extend previous research by confirming that YACCS, particularly female YACCS, have significant sexual dysfunction according to validated sexual health measures. Findings also confirm strong ties between sexual dysfunction and other common late-effects (e.g., anxiety). Unlike previous research, our current findings link a history of brain cancer and BMT to more significant sexual dysfunction. Additional research is required to understand whether higher rates of sexual dysfunction are related to the more significant disruptions to physical, psychological, and social development during treatment in these two groups. Nevertheless, findings suggest that sexual health screening and treatment is clearly warranted in YACCS, particularly with those who have experienced brain cancer or BMT.

Disclosure
No