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Patient-provider communication about sexual concerns in cancer: a systematic review

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Abstract

Purpose

Cancer survivors’ needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer.

Methods

Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000–2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study.

Results

Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients’ sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience.

Conclusions

Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed.

Implications for Cancer Survivors

Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.

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Notes

  1. The term “discuss” was entered as a Boolean phrase as “discuss*” which searched for any word beginning with this item stem. The terms “sexual behavior,” “sexuality,” “communication,” and “neoplasms” were also included in relevant searches as a MESH term and/or subject heading in addition to their appearance in the title or abstract.

  2. The Scheer study presented a prevalence rate using patient chart review (100 %) and patient self-report survey (53 %), both of which were included in the mean prevalence calculation.

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Acknowledgments

Jennifer Barsky Reese was supported by a Mentored Research Scholar Grant (MRSG-14-031-01-CPPB) from the American Cancer Society and by P30 CA006927 from the National Cancer Institute. The funding agencies had no role in the conduct of this study. We wish to thank Karenann Jurecki and Beth Lewis in the Fox Chase Talbot Research Library for their assistance with the searches.

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Authors and Affiliations

  1. Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA

    Jennifer Barsky Reese & Kristen Sorice

  2. Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex, 9th Floor, Philadelphia, PA, 19122, USA

    Jennifer Barsky Reese & Stephen J. Lepore

  3. Department of Medicine, Johns Hopkins School of Medicine, 2024 E. Monument St., Baltimore, MD, 21205, USA

    Mary Catherine Beach

  4. Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, DUMC 90399, Durham, NC, 27708, USA

    Laura S. Porter

  5. Dana-Farber Cancer Institute, 450 Brookline Avenue, DA-2016A, Boston, MA, 02215, USA

    James A. Tulsky

  6. Department of Clinical Genetics, Fox Chase Cancer Center, 333 Cottman Ave, 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA

    Mary B. Daly

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  1. Jennifer Barsky Reese
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Reese, J.B., Sorice, K., Beach, M.C. et al. Patient-provider communication about sexual concerns in cancer: a systematic review. J Cancer Surviv 11, 175–188 (2017). https://doi.org/10.1007/s11764-016-0577-9

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