Cherven Brooke O, Demedis Jenna, Frederick Natasha N
Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA.
Emory University School of Medicine, Atlanta, GA.
J Clin Oncol. 2024 Feb 20;42(6):717-724. doi: 10.1200/JCO.23.01390. Epub 2023 Oct 19.
Sexual health (SH), an integral aspect of overall health and quality of life, can be negatively affected by cancer and cancer treatment. SH is influenced by biological, psychological, social, and cultural factors, and, for adolescents and young adults (AYAs), developmental factors. The AYA population (age 15-39 years) is diverse in terms of psychosexual development, interpersonal relationships, and varying levels of independence, resulting in unique SH needs for this population. AYAs with cancer are particularly vulnerable to unmet SH needs related to contraception and infection prevention, sexual function, body image, and romantic/sexual relationships. Sexual dysfunction during and after cancer treatment is reported by 30%-100% of AYA cancer survivors. Clinical guidelines recommend discussing SH and screening for dysfunction but currently lack specifics regarding psychosexual interventions and strategies for incorporating screening into clinical care. Research and clinical priorities include improved provider-AYA communication regarding SH, standardization of SH measures and screening tools, infrastructure to support the SH needs of AYAs across pediatric and adult clinical environments, and engagement of sexual and gender minority AYAs in research. As the field of SH in cancer evolves, interventions need to be tailored to the developmental needs that are unique to AYAs and address the multidimensional aspects of SH.
性健康是整体健康和生活质量的一个组成部分，可能会受到癌症和癌症治疗的负面影响。性健康受到生物、心理、社会和文化因素的影响，对于青少年和青年（AYAs）来说，还受到发育因素的影响。青少年和青年人群（15至39岁）在性心理发展、人际关系和不同程度的独立性方面存在差异，导致该人群有独特的性健康需求。患有癌症的青少年和青年特别容易出现与避孕和感染预防、性功能、身体形象以及浪漫/性关系相关的未满足的性健康需求。30%至100%的青少年和青年癌症幸存者报告在癌症治疗期间及之后出现性功能障碍。临床指南建议讨论性健康并筛查功能障碍，但目前缺乏关于性心理干预以及将筛查纳入临床护理的具体策略。研究和临床重点包括改善医疗服务提供者与青少年和青年之间关于性健康的沟通、性健康测量和筛查工具的标准化、支持儿科和成人临床环境中青少年和青年性健康需求的基础设施，以及让性少数和性别少数青少年和青年参与研究。随着癌症性健康领域的发展，干预措施需要针对青少年和青年特有的发育需求进行调整，并解决性健康的多维度问题。
