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Multicenter Study
. 2021 Aug;10(15):5110-5119.
doi: 10.1002/cam4.4077. Epub 2021 Jun 15.

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

Natasha N Frederick  1   2 , Kristin Bingen  3 , Sharon L Bober  4 , Brooke Cherven  5   6 , Xinxin Xu  7 , Gwendolyn P Quinn  8 , Lingyun Ji  9 , David R Freyer  10   11
Affiliations
Multicenter Study

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

Natasha N Frederick et al. Cancer Med. 2021 Aug.

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.

Keywords: adolescent and young adult; sexual and reproductive health in cancer; sexual health education; sexual health in pediatric oncology.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Frequency of clinician conversations with AYAs on specific sexual health topics. These data include physicians and APPs combined
See this image and copyright information in PMC

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