Pediatric oncology clinician communication about sexual health with adolescents and young adults: A report from the children's oncology group

• Authors: Natasha N Frederick, Connecticut Children’s Medical Center; Kristin Bingen, Medical College of Wisconsin; Sharon L Bober, Dana‐Farber Cancer Institute; Brooke Cherven, Emory University; Xinxin Xu, Children’s Oncology Group, Monrovia CA; Gwendolyn P Quinn, New York University; Lingyun Ji, University of Southern California; David R Freyer, Children’s Hospital Los Angeles
• Journal Title: CANCER MEDICINE
• Volume: Volume 10, Number 15
• Publisher: WILEY | 2021-06-15, Pages 5110-5119
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1002/cam4.4077
• Subjects: Health Sciences, Oncology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; adolescent and young adult; sexual and reproductive health in cancer; sexual health education; sexual health in pediatric oncology; CHILDHOOD-CANCER SURVIVORS; FERTILITY PRESERVATION; ROMANTIC RELATIONSHIPS; BARRIERS; WOMEN; CARE; BEHAVIOR; PARENTS; PEOPLE; IMPACT

Abstract

Background: Sexual health (SH) is an important concern for adolescents and young adults (AYAs). This study determined current SH communication practices, barriers, and additional resources needed among pediatric oncology clinicians who treat AYAs. Methods: A cross-sectional survey was developed by the Children's Oncology Group (COG) AYA Committee and sent to pediatric oncologists (n = 1,987; 85.9%) and advanced practice providers (APPs, n = 326; 14.1%) at 226 COG institutions. Responses were tabulated and compared using tests of proportion and trend. Results: The sample comprised 602 respondents from 168 institutions and was proportionally representative (468 oncologists [77.7%], 76 APPs [12.6%], 58 unidentified [9.6%]; institutional and provider response rates 74.3% and 26.2%, respectively). Almost half of respondents (41.7%) reported no/small role in SH care. Medical topics were discussed most often, including contraception (67.2%), puberty (43.5%), and sexual activity (37.5%). Topics never/rarely discussed included gender identity (64.5%), sexual orientation (53.7%), and sexual function (50.3%). Frequently cited communication barriers included lack of time, low priority, perceived patient discomfort, and the presence of a parent/guardian. Respondents endorsed the need for further education/resources on sexual function (66.1%), gender identity/sexual orientation (59.5%), and body image (46.6%). Preferred education modalities included dissemination of published guidelines (64.7%), skills training modules (62.9%), and webinars (45.3%). By provider type, responses were similar overall but differed for perception of role, barriers identified, and resources desired. Conclusions: Many pediatric oncology clinicians play minimal roles in SH care of AYAs and most SH topics are rarely discussed. Provider-directed education/training interventions have potential for improving SH care of AYA cancer patients.