Are there differences in characteristics of breast and gynecologic oncology patients who utilize a sexual health clinic? A pilot study in addressing inclusion

Abstract

<h3>Objectives:</h3> Our primary objective is to describe the characteristics of breast and gynecology-oncology patients who utilize a sexual health clinic compared to women with breast and gynecology-oncologic malignancies in the Program in Women's Oncology clinic. <h3>Methods:</h3> This is a Retrospective study at the Program in Women's Oncology (PWO) and all participants attending the Women's Intimacy and Sexual Health (WISH) clinic from December 2016 to October 2019. Women who were seen in the PWO were identified using the Tumor Registry during a 3-month period in 2018. This captured all new and existing patients within the 3-month period. Study data was collected on age, sex, gender, sexual orientation, race, ethnicity, primary spoken language, marital status, and existing partner at time of treatment with PWO and/or WISH, insurance status, cancer type, stage, and treatment history. Statistical analysis chi-square for significance. <h3>Results:</h3> A total of 624 subjects were reviewed. Of these,138 from the PWO and 78 from WISH clinic met inclusion criteria. There were 496 subjects excluded due to having a diagnosis other than breast or gynecologic malignancy, a diagnosis of benign breast and/or gynecologic malignancy, and non-invasive disease such as cervical intraepithelial neoplasia. All subjects identify as female, with the vast majority being heterosexual. Of the demographic categories analyzed, there are significant differences between the WISH and overall women's cancer group in terms of race (p=0.048), marital status (p=0.0046), existing partner (p=0.00), insurance type (p=0.032), and stage of cancer (p=0.041). There are fewer WISH participants who identify as Black (WISH 1.3%, PWO 7.2%), without notable difference in all other race categories and no difference in ethnicity makeup. A lower percentage of WISH participants report marital status as widowed (WISH 1.3%, PWO 18.8%), had an existing partner during duration of treatment (WISH 3.8%, PWO 34.1%), and have insurance plan that is Medicare with Supplemental coverage (WISH 0%, PWO 17.4%). There are no differences in primary language spoken, ethnicity, type of cancer, and stage or recurrence of cancer. <h3>Conclusions:</h3> Sexual health continues to be an ongoing area of need for patients with breast and gynecologic cancers, especially during survivorship for improved quality of life. The results of this study indicate disproportionate under-utilization of WISH by certain groups: women who identify as Black, do not have a partner, are widowed, have recurrent and stage IV cancer. A further exploration of barriers to why these group are underrepresented is warranted.