Exploring the reproductive and sexual health concerns of young adults with cancer.

Abstract

e24176 Background: Young adults (YA) with cancer face unique challenges due to their developmental stage at the time of diagnosis/treatment. In the limited number of studies that have looked at reproductive and sexual health among YA being treated for cancer, YA expressed a need for increased communication and guidance in these areas. There is inadequate insight into the extent of sexual and reproductive concerns YA have and the substance of related counseling patients have received in the past, if any. As survivorship rates improve in this age group the need to address reproductive and sexual health as a part of comprehensive cancer care increases. Methods: This was a cross sectional study via a one time survey created on REDCap. Eligibility included diagnosis of malignancy (lymphoma, leukemia, breast cancer, or testicular cancer) between ages 18-39, less than 5 years from therapy completion. Eligible participants were identified via an i2b2 filter on Epic. Enrolled participants completed an online survey that focused on their concerns surrounding sexual health, fertility, contraception, the HPV vaccine, and any counseling they received in those areas. Questions regarding patient demographics, diagnostic, and treatment information were included. Results: The survey was completed by 23 patients (126 eligible, 52 contacted after permission given by the primary oncologist). Patients were 52% female, 73% non-Hispanic/Latino. 57% were between ages 18-24 at diagnosis and the most common cancer for females and males were lymphoma and testicular cancer respectively. 57% of patients stated they had questions about sexual activity during their cancer diagnosis and treatment, 35% recalled having a discussion with a provider. 60% of patients said cancer affected their sex life, with over 80% of those stating it was a net negative effect. 82% of patients had questions about fertility, and 87% had a discussion with a provider. 24% had questions about contraception with 43% having a discussion. 43% of patients were unsure if there was any conversation about the HPV vaccine. Conclusions: YA cancer patients seem to have many questions surrounding sexual and reproductive health. The biggest discrepancy between questions had and conversations had was specifically in the area of sexual health. Future research should delve into the content of the questions and how providers can better address sexual health in a standard manner. Most patients who had questions concerning fertility report they did have some discussion, although satisfaction varies. The majority of patients said cancer negatively affected their sex life, but it is yet to be determined if this affects overall quality of life and if providers can help. The lack of HPV vaccine counseling should be further explored.[Table: see text]