Sexual dysfunction in young adult survivors of childhood cancer – A population-based study

Kirsi Jahnukainen,Lisa Ljungman,Claudia Lampic,Ove Axelsson,Päivi M Lähteenmäki,Lena Wettergren,Kristina Fagerkvist,Emma Hovén

doi:10.1016/j.ejca.2021.06.014

Abstract

ObjectiveTo determine the prevalence of sexual dysfunction and to identify the factors associated with sexual dysfunction in young adult childhood cancer survivors. MethodsAll survivors of childhood cancer (aged 19–40 years) in Sweden were invited to this population-based study, and 2546 men and women (59%) participated. Sexual function was examined with the PROMIS Sexual Function and Satisfaction Measure. Logistic regression was used to assess the differences between survivors and a general population sample (n = 819) and to identify the factors associated with sexual dysfunction in survivors. ResultsSexual dysfunction in at least one domain was reported by 57% of female and 35% of male survivors. Among females, dysfunction was most common for Sexual interest (36%), Orgasm – ability (32%) and Vulvar discomfort – labial (19%). Among males, dysfunction was most common for the domains satisfaction with sex life (20%), Sexual interest (14%) and Erectile function (9%). Compared with the general population, male survivors more frequently reported sexual dysfunction in ≥2 domains (OR = 1.67, 95% CI: 1.03–2.71), with an increased likelihood of dysfunction regarding Orgasm – ability (OR = 1.82; 95% CI: 1.01–3.28) and Erectile function (OR = 2.30; 95% CI: 1.18–4.49). Female survivors reported more dysfunction regarding Orgasm – pleasure (9% versus 5%, OR = 1.86; 95% CI: 1.11–3.13). A more intensive cancer treatment, emotional distress and body image disturbance were associated with sexual dysfunction in survivors. ConclusionsThe findings underscore the need for routine assessment of sexual health in follow-up care of childhood cancer survivors and highlight that those treated with more intensive cancer treatment and who experience concurrent psychological concerns may benefit from targeted screening and interventions.

Highlights

With an increased 5-year survival rate approaching 80%, the population of long-term childhood cancer survivors is growing [1]
Dysfunction was most common in the domains Sexual interest, Table 2 Prevalence of sexual dysfunctiona by sex in survivors and comparison group; differences between groups were adjusted for sociodemographics
In line with a previous study [11], our results indicate that childhood cancer can have adverse effects on certain domains of sexual functioning, and that this is more evident in male survivors

Summary

Introduction

With an increased 5-year survival rate approaching 80%, the population of long-term childhood cancer survivors is growing [1]. In Europe, there are about 500,000 people living with a childhood cancer experience [2]. This is a group known to be at risk of physical and psychological late effects [3,4], and many survivors suffer from chronic health conditions [4]. Despite being acknowledged as an integral part of health and quality of life [5,6], data on the effect of childhood cancer on sexual health in young adult survivors are limited. Sexual dysfunction in childhood cancer survivors can be secondary to physical, psychological and social implications related to the cancer experience [7,8]. Previous studies suggest that both male [9e12] and female [13,14] survivors experience more sexual dysfunction than siblings and peers in similar ages

Results

Discussion

Conclusion