Patient Discussion About Sexual Health With Health Care Providers After Cancer-A National Survey.
BACKGROUND
A discussion about sexuality should become a routine part of the personalized care pathway for patients with cancer.


OBJECTIVE
To assess rates of patient discussion about sexuality with health care providers after cancer.


METHODS
We used data from the representative French nationwide 2012 VICAN survey, which included 4,349 adults 18 to 82 years old who were still alive 2 years after diagnosis at 12 cancer sites.


METHODS
Self-reported rates of discussion about sexuality with health care providers were assessed, and associated factors were tested after systematic adjustment for a sexual health indicator (created from six items of the Relationship and Sexuality Scale).


RESULTS
Of 4,181 respondents to the question on a discussion about sexuality, 54.7% reported that nobody had proposed a discussion to them, 21.9% did not want any discussion, and 23.4% had had a discussion. Women had less discussion about sexuality with health care providers (11.1% vs 36.7% of men, P < .001) and were more likely to request a discussion at their own initiative (62.9% vs 48.0% of men, P < .001). Discussion about sexuality was more frequent with patients with prostate (56.3%) and cervical (39.6%) cancer, but increasing age was associated with a greater reluctance to discuss this issue (odds ratio = 1.17, 95% CI = 1.04-1.2). The likelihood of discussion increased with severe sexual problems, radiotherapy, general sequelae, having an information-seeker profile, previous professional psychological help, and initial treatment in private centers. Patients initially wishing for psychological help were more likely to desire a discussion about sexuality.


CONCLUSIONS
Sexuality receives little attention in French patients with cancer. Inequalities in the discussion about sexuality were observed in relation to the type of care center where the patient was initially managed. Information on supportive interventions, including more systematic referral for professional psychological help, should be developed to facilitate discussion and should be offered to all patients, irrespective of severity of sexual problems, age, sex, cancer site, and care center.
Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille; ORS PACA, Observatoire régional de la santé Provence Alpes Côte d'Azur, Marseille, France.
Ali
A
Ben Charif
Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille.
Anne-Déborah
AD
Bouhnik
IMBE UMR7263, Aix Marseille Université, CNRS, IRD, Avignon Université, Marseille, France; Department of Obstetrics, Gynecology and Reproductive Medicine, AP-HM, La Conception Hospital, Marseille, France.
Blandine
B
Courbiere
Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille; ORS PACA, Observatoire régional de la santé Provence Alpes Côte d'Azur, Marseille, France.
Dominique
D
Rey
GRePS, Psychology Institute, Lyon 2 University, Bron, France.
Marie
M
Préau
Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille; ORS PACA, Observatoire régional de la santé Provence Alpes Côte d'Azur, Marseille, France.
Marc-Karim
MK
Bendiane
Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille.
Patrick
P
Peretti-Watel
Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille; APHM, Hôpital de la Timone, Service Biostatistique et Technologies de l'Information et de la Communication, Marseille, France. Electronic address: julien.mancini@univ-amu.fr.
Julien
J
Mancini
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006282:Health Personnel / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D016017:Odds Ratio; D010353:Patient Education as Topic; D011369:Professional-Patient Relations; D060728:Reproductive Health / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology; D019529:Sexuality / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
Cancer; Health care Providers; Oncology; Patient Information; Sexual Health; VICAN