John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
Shivani Rao , Ju-Whei Lee , Sinan Hashim , Howard A. Zaren , Erika K. Radeke , David Cella , Michael Jordan Fisch , Lynne I. Wagner
Background: Cancer diagnosis and therapeutic interventions are associated with altered reproductive health including sexuality. Despite pertinence to quality of life, cancer management frequently precludes periodic assessments of sexual health. Methods: The EROS trial is a clustered randomized trial performed at 17 NCI Community Oncology Research Program (NCORP) sites (including 8 NCORP sites and 9 Minority/Underserved NCORP sites) from 2016-2023. Eligible subjects included reproductively capable women aged 15-55 with new cancer diagnosis. We report on an embedded observational study pertaining to oncosexuality. Perceived importance of patient’s sexuality maintenance was assessed for clinicians and patients on a 10-point Likert scale (1 = Not important; 10 = Extremely important). Mean and standard deviation were computed for value discrepancy (pairwise clinician-patient differential) by arm assignment and timepoint (baseline, 3-, 6-, 12- and 24-months). One-sample t-test was conducted with Bonferroni’s adjustment to evaluate cell mean of the value discrepancy against zero (α = 0.02). A mixed effect model analyzed intervention effect on value discrepancy over time, adjusting for baseline covariates (α = 0.05). Results: Mean patient importance rating within the intervention arm ranged from 8.39 (SD = 2.39) at baseline to 7.84 (SD = 2.86) at 24-month assessment; paired clinician value varied from 8.17 (SD = 2.57) to 7.77 (SD = 2.92), respectively. Within non-intervention arm, mean patient importance rating varied from 8.23 (SD = 1.95) at baseline to 8.68 (SD = 1.67) at 24-month assessment; paired clinician value ranged from 7.93 (SD = 1.86) to 8.15 (SD = 1.70). Mean clinician-patient value differentials with respect to arm assignment and timepoint were not significantly different from zero. A significant arm-by-timepoint interaction effect was noted (p = 0.0417). Post-hoc simple main effect analysis exhibited no intervention effect at any assessment timepoint. Conclusions: Data indicate high concordance of sexuality importance within oncologic clinicians and patients over the 2 years. Findings necessitate investigation to ensure management of sexual health matches level of importance to the cancer survivor. Clinical trial information: NCT01806129.
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