Sexual quality of life of adolescents and young adult breast cancer survivors

Abstract

Background: With increasing survival rates of adolescents and young adults (AYAs) with breast cancer, health-related quality of life (HRQoL) becomes more important. An important aspect of HRQoL is sexual QoL. This study examined long-term sexual QoL of AYA breast cancer survivors, compared sexual QoL scores with that of other AYA cancer survivors, and identified factors associated with long-term sexual QoL of AYA breast cancer survivors.

Materials and methods: Data of the SURVAYA study were utilized for secondary analyses. Sexual QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). Descriptive statistics were used to describe sexual QoL of AYA cancer survivors. Linear regression models were constructed to examine the effect of cancer type on sexual QoL and to identify factors associated with sexual QoL.

Results: Of the 4010 AYA cancer survivors, 944 had breast cancer. Mean sexual QoL scores of AYA breast cancer survivors ranged from 34.5 to 60.0 for functional domains and from 25.2 to 41.5 for symptom-orientated domains. AYA breast cancer survivors reported significantly lower sexual QoL compared to AYA survivors of other cancer types on all domains. Age, time since diagnosis, relationship status, educational level, chemotherapy, hormonal therapy, breast surgery, body image, and coping were associated with sexual QoL of AYA breast cancer survivors.

Conclusions: AYA breast cancer survivors experience decreased sexual QoL in the long term (5-20 years) after diagnosis and worse score compared to AYA survivors of other cancer types, indicating a clear need to invest in supportive care interventions for those at risk, to enhance sexual well-being.

Keywords: adolescents and young adults (AYAs); breast cancer; health-related quality of life (HRQoL); sexual quality of life (QoL); survivorship.

Figure 1

Long-term sexual QoL of AYA cancer survivors; individual questions. Bar charts of EORTC QLQ-SURV100 questions of AYA breast cancer survivors (n) (A) and AYA survivors of other cancer types (n) (B). S101: Have you had problems being sexually intimate? S102: Has sexual activity been enjoyable for you? S103: Have you had problems becoming sexually aroused? S104: Have you felt uncomfortable about the idea of being sexually intimate? S105 (women only): Have you experienced a dry vagina during sexual activity? S107: Have you avoided having sex? S108: Have you been interested in sex? S109: Have you been sexually active? AYA, adolescents and young adult; EORTC QLQ-SURV100, European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire.

Figure 2

Regression models for the comparison of sexual QoL between AYA breast cancer survivors and AYA survivors of other cancer types. For functional scales, higher scores represent higher QoL; for symptom scales, higher scores indicate more severe symptoms. Green represents an increase in scores and purple, a decrease in scores. AYA breast cancer survivors were chosen as the reference category. AYA, adolescents and young adult; QoL, quality of life.

Figure 3

Regression models for the comparison of sexual QoL between AYA breast cancer survivors and female AYA survivors of other cancer types. For functional scales, higher scores represent higher QoL; for symptom scales, higher scores indicate more severe symptoms. Green represents an increase in scores and purple, a decrease in scores. AYA breast cancer survivors were chosen as the reference category. AYA, adolescents and young adult; QoL, quality of life.