title: Cancer negatively impacts on sexual function in adolescents and young adults: The AYA HOPE study.
abstract: OBJECTIVE
  This cohort study examined the impact of cancer on sexual function and intimate relationships in adolescents and young adults (AYAs). We also explored factors predicting an increased likelihood that cancer had negatively affected these outcomes.
  
  
  METHODS
  Participants (n = 465, ages 15-39) in the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study completed two surveys approximately 1 and 2 years post-cancer diagnosis. We used multivariable logistic regression to determine factors negatively affected by perceptions of sexual function at 2 years post-diagnosis.
  
  
  RESULTS
  Forty-nine percent of AYAs reported negative effects on sexual function at 1 year post-cancer diagnosis and 70% of those persisted in their negative perceptions 2 years after diagnosis. Those reporting a negative impact at 2 years were more likely to be 25 years or older (OR, 2.53; 95% CI, 1.44-4.42), currently not raising children (OR, 1.81; 95% CI, 1.06-3.08), experiencing fatigue (OR, 0.99; 95% CI, 0.975-0.998) and more likely to report that their diagnosis has had a negative effect on physical appearance (OR, 3.08; 95% CI, 1.97-4.81). Clinical factors and mental health were not significant predictors of negative effects on sexual function.
  
  
  CONCLUSIONS
  Many AYAs diagnosed with cancer experience a persistent negative impact on sexual life up to 2 years following diagnosis. The findings underscore the need to develop routine protocols to assess sexual function in AYAs with cancer and to provide comprehensive management in the clinical setting. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.|Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Wettergren
authors.affiliation: Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Kent
authors.affiliation: Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
authors.affiliation: University of Michigan, School of Social Work, Ann Arbor, MI, USA.
authors.forename: Brad
authors.initials: B
authors.lastname: Zebrack
authors.affiliation: Department of Epidemiology, University of Iowa, Iowa City, IA, USA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.affiliation: Children's Hospital of Michigan, Detroit, MI, USA.
authors.forename: Mara B
authors.initials: MB
authors.lastname: Rubenstein
authors.affiliation: Division of Hematology and Oncology, UC Davis Comprehensive Cancer Center, CA, USA.
authors.forename: Theresa H M
authors.initials: THM
authors.lastname: Keegan
authors.affiliation: Epidemiology Program/Louisiana Tumor Registry, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
authors.forename: Xiao-Cheng
authors.initials: XC
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Biostatistics, University of Texas Health Sciences Center, San Antonio, TX, USA.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Parsons
authors.affiliation: Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Ashley Wilder
authors.initials: AW
authors.lastname: Smith
authors.affiliation: The AYA HOPE Study Collaborative Group, National Cancer Institute, Bethesda, MD, USA.
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000073116:Cancer Survivors / Q000523:psychology*; D015331:Cohort Studies; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy; D010549:Personal Satisfaction; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000523:psychology*; D055815:Young Adult
keywords: cancer; complications; oncology; sexuality; survivors; young adults