背景:性功能障碍是许多成人发病的癌症治疗的重要并发症。然而,对成年儿童癌症幸存者(CCSs)性功能障碍的了解相对较少。研究受到排除特定癌症的限制(例如,中枢神经系统[CNS]肿瘤)和缺乏有效的措施,这使得很难理解CCS中性功能障碍的性质和患病率。
方法:共有249名成人CCS(18-65岁)参加了REACH项目,前瞻性队列研究,并完成了身心健康措施,包括性功能障碍.女性性功能指数6得分≤19或国际勃起功能指数5得分≤21的参与者被归类为性功能障碍。分析了性功能障碍与人口统计学之间的关系,疾病,治疗,和健康变量。
结果:共有78名参与者(32%)经历了临床上显著的性功能障碍。在单变量分析中,性功能障碍与中枢神经系统肿瘤诊断显著相关(比值比[OR],2.56)和手术(OR,1.96)以及疲劳等健康变量(OR,3.00),睡眠不足(或,2.84),疼痛(或,2.04),抑郁症(或,2.64),身体健康状况不佳(或,2.45),和不良的心理健康(或者,2.21).调整后的分析发现,中枢神经系统肿瘤诊断(p=.001)和健康变量(p=.025)对CCS中的性功能障碍有重要贡献。
结论:大约三分之一的成人CCS报告临床上显著的性功能障碍,这强调了重大的筛查和治疗需求。然而,因为针对成人癌症幸存者制定了可用的措施,有必要进行专门针对成人CCS的性健康措施的研究,以更好地识别该弱势群体的性健康问题。
BACKGROUND: Sexual dysfunction is a significant complication of treatment for many adult-onset cancers. However, comparatively less is known about sexual dysfunction in adult childhood cancer survivors (CCSs). Research has been limited by the exclusion of specific cancers (e.g., central nervous system [CNS] tumors) and the lack of validated measures, which makes it difficult to understand the nature and prevalence of sexual dysfunction in CCSs.
METHODS: A total of 249 adult CCSs (aged 18-65 years) enrolled in Project REACH, a prospective cohort
study, and completed measures of physical and mental health, including sexual dysfunction. Participants scoring ≤19 on the Female Sexual Function Index 6 or ≤21 on the International Index of Erectile Function 5 were classified as experiencing sexual dysfunction. Analyses examined the relationships between sexual dysfunction and demographic, disease, treatment, and health variables.
RESULTS: A total of 78 participants (32%) experienced clinically significant sexual dysfunction. In univariate analysis, sexual dysfunction was significantly associated with CNS tumor diagnosis (odds ratio [OR], 2.56) and surgery (OR, 1.96) as well as with health variables such as fatigue (OR, 3.00), poor sleep (OR, 2.84), pain (OR, 2.04), depression (OR, 2.64), poor physical health (OR, 2.45), and poor mental health (OR, 2.21). Adjusted analyses found that CNS tumor diagnosis (p = .001) and health variables (p = .025) contribute significantly to sexual dysfunction in CCSs.
CONCLUSIONS: Approximately one third of adult CCSs report clinically significant sexual dysfunction, which underscores a significant screening and treatment need. However, because available measures were developed for survivors of adult cancers, research to create a sexual health measure specifically for adult CCSs is necessary to better identify the sexual health concerns of this vulnerable population.