Psychosexual Functioning Among Adult Female Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Abstract

A B S T R A C T PurposeChildhood cancer survivors may be at risk for impaired psychosexual functioning as a direct result of their cancer or its treatments, psychosocial difficulties, and/or diminished quality of life. Patients and MethodsTwo thousand one hundred seventy-eight female adult survivors of childhood cancer and 408 female siblings from the Childhood Cancer Survivor Study (CCSS) completed a self-report questionnaire about their psychosexual functioning and quality of life. On average, participants were age 29 years (range, 18 to 51 years) at the time of the survey, had been diagnosed with cancer at a median age of 8.5 years (range, 0 to 20) and were most commonly diagnosed with leukemia (33.2%) and Hodgkin lymphoma (15.4%). ResultsMultivariable analyses suggested that after controlling for sociodemographic differences, survivors reported significantly lower sexual functioning (mean difference [MnD], Ϫ0.2; P ϭ .01), lower sexual interest (MnD, Ϫ0.2; P Ͻ .01), lower sexual desire (MnD, Ϫ0.3; P Ͻ .01), lower sexual arousal (MnD, Ϫ0.3; P Ͻ .01), lower sexual satisfaction (MnD, Ϫ0.2; P ϭ .01), and lower sexual activity (MnD, Ϫ0.1; P ϭ .02) compared with siblings. Risk factors for poorer psychosexual functioning among survivors included older age at assessment, ovarian failure at a younger age, treatment with cranial radiation, and cancer diagnosis during adolescence. ConclusionDecreased sexual functioning among female survivors of childhood cancers seems to be unrelated to emotional factors and is likely to be an underaddressed issue. Several risk factors among survivors have been identified that assist in defining high-risk subgroups who may benefit from targeted screening and interventions.

Pediatric and Teen Ovarian Tissue Removed for Cryopreservation Contains Follicles Irrespective of Age, Disease Diagnosis, Treatment History, and Specimen Processing Methods

“…2 Although more children and teens are surviving their cancer diagnoses and living into adulthood, recent data from the Childhood Cancer Survivor Study (CCSS) identifies gonadal failure as a long-term health concern. 3,4 Indeed, the CCSS reported that 6.3% of childhood survivors experience acute ovarian failure immediately after treatment, and 8% experience premature ovarian failure at some point after the end of treatment. 5,6 Preservation and restoration of fertility are key aspects for enhancing quality of life in this population, and studies have found that 60% of survivors desire to rear biological children and >65% of childhood or young adult cancer survivors have used or want information about infertility and options for having children.…”

Marital Status in Moroccan Long-term Childhood Cancer Survivors

“…Childhood Cancer Survivor Study found that adult female survivors of childhood cancer reported lower sexual functioning, lower sexual interest, lower sexual desire, lower sexual satisfaction and lower sexual activity compared with siblings [4]. By respect to Moroccan culture, we didn't have any question about sexuality.…”

“…The category with the lowest probability of marriage were patients with CNS tumors, cranial radiation, impaired processing efficiency, and short stature. There is no difference in divorce patterns between survivors and their peers [4].…”

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

“…Radiation affecting ovarian and uterine functions has been linked to pregnancy complications including infertility, spontaneous abortion, acute ovarian failure, low birth weight and stillbirth. Also, sexual malfunction among female survivors of childhood cancers was partially related to cranial radiation treatment [21].…”