title: Psychosexual functioning among adult female survivors of childhood cancer: a report from the childhood cancer survivor study.
abstract: OBJECTIVE
  Childhood 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.
  
  
  METHODS
  Two 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%).
  
  
  RESULTS
  Multivariable analyses suggested that after controlling for sociodemographic differences, survivors reported significantly lower sexual functioning (mean difference [MnD], -0.2; P = .01), lower sexual interest (MnD, -0.2; P < .01), lower sexual desire (MnD, -0.3; P < .01), lower sexual arousal (MnD, -0.3; P < .01), lower sexual satisfaction (MnD, -0.2; P = .01), and lower sexual activity (MnD, -0.1; P = .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.
  
  
  CONCLUSIONS
  Decreased 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.
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN. fordj@mskcc.org.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Ford
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Toana
authors.initials: T
authors.lastname: Kawashima
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: John
authors.initials: J
authors.lastname: Whitton
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Caroline
authors.initials: C
authors.lastname: Laverdière
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Stovall
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Lonnie
authors.initials: L
authors.lastname: Zeltzer
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Jennifer S. Ford and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY; Toana Kawashima, John Whitton, and Wendy Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Caroline Laverdière, University of Montreal, Montreal, Quebec, Canada; Marilyn Stovall, The University of Texas MD Anderson Cancer Center, Houston, TX; Lonnie Zeltzer, University of California, Los Angeles, Los Angeles, CA; and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000175:diagnosis / Q000523:psychology; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology*; D035781:Siblings; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
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