Sexual inactivity in young adult survivors of childhood cancer: a Project REACH study.
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PURPOSE: Young adult childhood cancer survivors (YACCS) experience impairing late effects of treatment, including disruptions to sexual activity and function. Although research has begun examining sexual dysfunction in sexually active survivors, little is known about sexually inactive YACCS. Research focused on the needs of sexually inactive YACCS is necessary for the development of comprehensive sexual health screening and interventions. METHODS: Three hundred twenty-one YACCS (ages 18-39) enrolled in Project REACH, a prospective cohort study, completed measures of physical and mental health, including sexual dysfunction. Analyses examined relationships between sexual inactivity and demographic, cancer, physical, psychological, and social variables. RESULTS: Eighty-four (26%) participants were classified as sexually inactive. In univariate analysis, sexual inactivity was significantly positively associated with female sex, younger age (18-28), cancer diagnosis before age 10, central nervous system (CNS) tumor, lack of chemotherapy history, poor mental quality of life, being unmarried, and living with parents. Adjusted analyses found female sex (OR = 2.28), diagnosis before age 10 (OR = 3.25), CNS tumor (OR = 3.09), poor mental QoL (OR = 2.11), and living with parents (OR = 2.97) were significantly associated with increased odds of sexual inactivity. CONCLUSIONS: Almost one third of YACCS are sexually inactive; this is concerning, as existing sexual health measures were not designed for this vulnerable group. Creating measures that capture the needs of sexually inactive YACCS is imperative, as even those sexually inactive by choice may have sexual health late effects that impact health more broadly. IMPLICATIONS FOR CANCER SURVIVORS: Barriers to screening sexually inactive survivors mean a large proportion of YACCS may experience concerns that are not being addressed.