Sexual health in women and sexual-gender-minority patients with cancer: A nationwide survey on healthcare professional awareness and attitude on behalf of MITO and AIRO-gynecology group

Amelia Barcellini; Chiara Cassani; Giulia Fontana; Ester Orlandi; Gabriella Macchia; Giorgia Mangili; Sandro Pignata; Laura Deborah Locati; Rossella E Nappi

doi:10.1016/j.jcpo.2024.100556

Sexual health in women and sexual-gender-minority patients with cancer: A nationwide survey on healthcare professional awareness and attitude on behalf of MITO and AIRO-gynecology group

J Cancer Policy. 2024 Dec 30:43:100556. doi: 10.1016/j.jcpo.2024.100556. Online ahead of print.

Authors

Amelia Barcellini¹, Chiara Cassani², Giulia Fontana³, Ester Orlandi⁴, Gabriella Macchia⁵, Giorgia Mangili⁶, Sandro Pignata⁷, Laura Deborah Locati⁸, Rossella E Nappi⁹

Affiliations

¹ Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy.
² Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Unit of Obstetrics and Gynecology, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy. Electronic address: chiara.cassani@unipv.it.
³ Clinical Department, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy.
⁴ Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
⁵ Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy.
⁶ Unit of Gynaecology and Obstetrics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁷ Department of Urology and Gynecology, Istituto Nazionale Tumori, IRCCS-Fondazione G. Pascale Napoli, Naples, Italy.
⁸ Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.
⁹ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy.

PMID: 39742993
DOI: 10.1016/j.jcpo.2024.100556

Abstract

Background: Compared to male patients, sexual health remains poorly studied in women and sexual gender minority (SGM) patients with cancers.

Material and methods: An online survey was developed by a multidisciplinary team to assess the awareness and attitude of Italian oncological providers facing sexual health during or after cancer treatment. On behalf of the respective scientific committees, the questionnaire was sent to Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies group (MITO) and to Italian Association of Radiation Oncology (AIRO) Group. Four dedicated sections analyzed participants' demographic data, clinical context, communication and assessment practices, possible barriers, and treatment approaches.

Results: A total of 184 clinicians responded to the survey for an overall response rate of 20.8 %. Patient's gender identity and sexual orientation were not routinely assessed, and several barriers were recorded. There was a high attitude to talk about the iatrogenic potential of sexual dysfunction with patients, even if up to 39.7 % of the respondents declared average/extreme difficulty in facing this issue. Radiation and medical oncologists more frequently refer patients to dedicated specialists to manage iatrogenic sexual dysfunctions.

Conclusions: Sexual health is a key component of comprehensive care for female and SGM patients during their oncological journey. Despite the high attitude to talk about iatrogenic sexual dysfunctions in Italian providers, the present study highlighted the need for specific training and guidelines on sex-related health issues encountered by women and SGM patients.

Policy summary: Despite the recognized need for specialized care, there remain significant gap and barriers in knowledge regarding sexual health management in women and SGM patients. Our study highlights the urgent need to enhance healthcare provider training, equipping them with the necessary tools to recognize, discuss, and treat this type of toxicity, which has a significant impact on the social well-being and quality of life of long-term survivors.

Keywords: Cancer survivorship; Minority; Sexual health; Sexual toxicity; Women's well-being.