(009) Comparing the Sexual Lives of Adolescents and Young Adults (AYA) With and Without a History of Cancer

Abstract

Abstract Introduction Studies have consistently described poor sexual outcomes for AYA cancer survivors – nearly half of which report some level of negative subjective impact of cancer on their sexual lives (Wettergren et al., 2016, Geue et al., 2015). Available data typically comes from long-term survivors, indicating a chronicity of sexual problems that persist long after treatment and recovery. Among AYA survivors, there remains a major unmet need for sexuality-based supportive care, which will likely have to be tailored to the social/developmental needs of a younger population. Objective 1) Compare a sample of AYA survivors to age- and partner-matched peers across a wide variety of sexual outcomes, including behavior, function, affect, and cognition. 2) Explore variables associated with maintenance of sexual problems within the AYA survivor population, i.e., potential intervention targets. Methods Women ages 18-39 with a history of cancer (31% hematologic, 18% breast, 16% gynecologic, 14% thyroid, 20% other) were matched with healthy controls based on age (within 5 years) and partner status (single vs. partnered) (total N=272). Survivors were diagnosed at age 26 (SD=7.88, range 2 to 39 years). 71% of survivors who reported knowing stage at diagnosis (stage 0-2, 54%). At the time of survey, 79% were partnered. We conducted independent samples t-tests to compare scores on sexual behavior (PROMIS), function (PROMIS), distress (Female Sexual Distress Scale [FSDS]), self-efficacy (Sexual Self-Efficacy Scale for Females), and sexual self schema (SSS), hypothesizing that survivors would have poorer sexual outcomes. Results Age at first intercourse and number of partners were comparable across groups. Survivors were more likely to report having children than controls [X2 (1, N = 192) = 5.63, p =.02]. Survivors evidenced a less varied behavioral repertoire (past 30 days) [t(262)=-2.64, p=.01] and engaged in vaginal intercourse significantly less often [t(205)=-1.97, p=.05]; this effect was more pronounced among partnered survivors. Despite lower frequency of intercourse, survivors reported using lubricant more often than the controls [t(211)=2.04, p=.04]. Survivors reported poorer sexual interest [t(281)=-4.89, p<.01], lubrication [t(281)=-4.12, p<.001], orgasm [t(279)=-2.65, p=.01], and satisfaction [t(278)=-3.07, p<.01]. Sexual affect and cognition were also poorer for survivors; they tended to have higher sexual distress [t(269)=5.05, p<.01], more embarrassed/conservative sexual self schema [t(268)=2.22, p=.03], and lower sexual self-efficacy [t(286)=-4.94, p<.01]. Conclusions Young adult survivors of cancer experience more sexual problems than peers, including a more restricted sexual repertoire, less frequent sexual behaviors, poorer sexual function, as well as more negative emotion and cognition regarding their sexuality. There has been insufficient attention to the unique needs and experiences of younger survivors. Disclosure No