Columbia University Irving Medical Center, New York, NY
Amita Kulkarni, Seema Bhoj, Corbyn Mbock Nchako, Muhammad Danyal Ahsan, Melissa Kristen Frey
Background: Patients with BRCA1/2 pathogenic variants have an elevated risk for several malignancies including breast and ovarian cancer. Recommended risk-reducing treatments and surgeries can cause sexual dysfunction. Yet, sexual health is often under-addressed among this population. The goal of this initiative was to assess the feasibility and acceptability of implementing universal sexual health screening among BRCA1/2 patients in the outpatient setting. Methods: From 1/2022-6/2022, all patients with BRCA1/2 pathogenic variants in an outpatient Gynecologic Oncology clinic were asked to complete a sexual health symptom questionnaire at their visit. The self-administered screener was distributed by a medical assistant in the waiting room and included a validated single-item screener to assess for sexual dysfunction and questions regarding prior provider discussions about sexual health and how patients wanted to receive information on the topic. The screener was positive if a patient reported at least one symptom related to sexual dysfunction. Results: Thirty-six patients were given the sexual health screening and 100% completed it. The median age was 41 years (range 27-72) and 28 (78%) identified as White and 32 (89%) as non-Hispanic. Fourteen (39%) patients screened positive for sexual dysfunction and 25 (69%) reported never having previously discussed the topic of sexual health with a provider. Among the 14 patients that screened positive for sexual dysfunction, 6 (43%) preferred written educational resources about sexual health and 5 (36%) wanted a follow-up in-person visit. Vaginal dryness, lack of interest, and difficulty with orgasm were the most common patient concerns. Conclusions: Implementing a universal sexual dysfunction screening tool for patients with BRCA1/2 pathogenic variants in the outpatient setting is feasible and acceptable, with 100% participation. Further, over one third of patients screened positive for sexual dysfunction, the majority of whom had never discussed their symptoms with a provider. Future efforts are needed to evaluate scalable strategies to assess and improve sexual health among patients with hereditary cancer syndromes.
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