Gynecologic radiation oncology patients report unmet needs regarding sexual health communication with providers

Abstract

Purpose

Following radiation therapy (RT), women with gynecologic malignancies report high rates of sexual dysfunction, but little is known regarding sexual health communication between these patients and health-care providers. This study assessed these patients’ beliefs/attitudes toward providers’ sexual history taking.

Methods

Surveys were administered to women who presented for follow-up care for gynecologic cancers in an academic radiation oncology department. The surveys assessed patient sexual health beliefs and inquiry preferences. Sexual functioning was assessed using the Female Sexual Function Index (FSFI). Ordered logistic regressions were performed to assess for correlations between survey responses, FSFI, and demographic characteristics.

Results

Seventy-five subjects participated. Most (89.8%) had FSFI scores indicating sexual dysfunction. Most patients agreed that sexual function is an important component of overall health (78.7%) and that providers should inquire regularly (62.8%). Few (12.0%) reported embarrassment around provider discussions. Most (62.7%) preferred discussion with female providers, especially married patients (p = 0.03). Half (53.4%) agreed that sexual problems are an unavoidable part of aging, a view that was more common as education level decreased (p = 0.01). Most (62.7%) patients agreed that providers should regularly ask about their sexual history, with patients having significant differences in education level. Patients with low FSFI scores were less likely to report inquiry from their OB/Gyn (p = 0.03).

Conclusions

Gynecologic cancer radiotherapy patients want to discuss sexual health, but report suboptimal provider inquiry. Patient views and experiences varied based on marital status, education level, and FSFI score. This work highlights the need for improved sexual health communication between cancer patients and providers.

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Funding

Investigator support for MBB was provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development BIRCWH Career Development Award # K12 HD001438. Institutional support for use of the REDCap application was provided through CTSA, National Center for Advancing Translational Sciences Grant UL1TR000433.

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Correspondence to Shruti Jolly.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Chapman, C.H., Heath, G., Fairchild, P. et al. Gynecologic radiation oncology patients report unmet needs regarding sexual health communication with providers. J Cancer Res Clin Oncol 145, 495–502 (2019). https://doi.org/10.1007/s00432-018-2813-3

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Keywords

  • Sexual dysfunction
  • Sexual history taking
  • Radiation therapy
  • Gynecological cancer