Abstract：
Sexuality and sexual intimacy are important aspects of cancer survivorship. In head and neck cancer (HNC), concerns around sexual health, sexuality and sexual intimacy are infrequently raised or addressed in standard HNC consultations, either before embarking on treatment or during survivorship. The changing demographic of HNC patients, largely due to the increasing proportion of patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPVOPSCC), has driven renewed interest in some specific survivorship issues, including sexual behaviours and lifestyles, which may account for both the primary mode of HPV transmission and the younger and less comorbid population affected by this disease. While HNC survivors may have many complex needs in the short and longer term, some patients may prioritise preserving sexual function above other more HNC-specific issues, such as swallowing and xerostomia. Beyond HPVOPSCC, there is evidence to suggest that impairment of sexual health is a pervasive survivorship issue across all HNC cancer types, and this narrative review article highlights publications reporting quantitative assessments of sexual health outcomes in HNC patients. There are also limited studies evaluating whether current sexual health models of care are adequate for HNC patients or whether new or adapted models are needed. Future research will also need to define the impact of our treatments on the sexuality and sexual intimacy concerns of specific HNC cohorts with more granularity to enhance pre- and post-treatment counselling.
摘要：
性和性亲密是癌症生存的重要方面。在头颈癌（HNC）中，对性健康的担忧，性和性亲密很少在标准的HNC咨询中提出或解决，在开始治疗之前或在生存期间。HNC患者的人口结构变化，很大程度上是由于人乳头瘤病毒相关口咽鳞状细胞癌（HPVOPSCC）患者的比例增加，引起了人们对一些特定生存问题的新兴趣，包括性行为和生活方式,这可能是HPV传播的主要方式以及受这种疾病影响的较年轻和较少共病的人群。虽然HNC幸存者在短期和长期内可能有许多复杂的需求，一些患者可能优先考虑保留性功能，而不是其他更多的HNC特异性问题，如吞咽和口干症。超越HPVOPSCC,有证据表明，性健康受损是所有HNC癌症类型中普遍存在的生存问题，这篇叙述性综述文章重点介绍了报告HNC患者性健康结局定量评估的出版物。也有有限的研究评估当前的性健康护理模式是否适合HNC患者，或者是否需要新的或适应的模式。未来的研究还需要确定我们的治疗方法对特定HNC队列的性行为和性亲密关系的影响，并具有更多的粒度，以增强治疗前和治疗后的咨询。
