Patient-reported sexual health outcomes and quality of life in younger versus older breast and gynecologic cancer survivors.

Abstract

422 Background: Although the National Comprehensive Cancer Network recommends assessment of sexual dysfunction, these symptoms remain understudied, especially among older adults. Unlike existing research focus on prostate cancer and male sexual function, we aim to determine the impact of self-reported sexual health symptoms among breast and gynecological cancer survivors. Methods: This retrospective observational study utilized clinical survey data from an academic survivorship clinic between 2020 and 2025. Descriptive statistics characterize the study population based on age group. Outcomes was assessed using the validated Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction Measures Brief Profiles. Bivariate analyses were conducted to compare symptom burden across age groups. Statistical significance was defined as a two-sided p-value <0.05. Results: There were 342 breast (n=314) and gynecologic (n=28) survivors, median age was 55 years (IQR, 32–77). Patients were predominantly women (99.4%), White (88.5%), non-Hispanic (90.0%), and aged 45–64 years (54.1%); 26.0% were ≥65 years old. Overall, 40% of patients reported sexual health concerns. Survivors aged 44 and younger, reported more sexual health concerns compared to others. More than 50% of those having concerns met criteria for sexual dysfunction (n=128), there were no significant age-related differences in sexual interest, desire, or activity. Among patients reporting no sexual activity within the previous 30 days (n=51), most common reasons were lack of interest (n=39) and vaginal dryness or pain (n=21). Among those sexually active (n=60), 24% reported dissatisfaction with their sex life, with no significant differences by age. Conclusions: Sexual health problems are prevalent among survivors of any age, affecting their quality of life. Screening and creation of sexual health programs and interventions, are needed in the care of breast and gynecological cancer survivors. Clinical characteristics of sample population by age group. <44 (n=68) 45 - 64 (n=185) 65 - 74 (n=68) 75+(n=21) p-value Primary Cancer 0.574 Breast 66 (97.06%) 169 (91.35%) 62 (91.18%) 17 (80.95%) Gynecological 2 (2.94%) 16 (8.65%) 6 (8.82%) 4 (19.05%) Metastatic Disease 11 (16.18%) 31 (16.76%) 6 (8.82%) 6 (28.57%) 0.261 Active Treatment 34 (50.75%) 87 (47.80%) 29 (44.62%) 10 (47.62%) 0.919 # of Oncology visits within the past year 0.021 1-4 times 25 (26.76%) 110 (60.11%) 40 (58.82%) 15 (71.43%) 4 or more times 41 (60.29%) 71 (38.80%) 26 (38.24%) 6 (28.57%) Survivors with sexual health concerns 40/65 (61.54%) 75/181 (41.44%) 10/62 (16.13%) 3/19 (15.79%) 0.000 Survivors experiencing stress related to their sexual health concerns* 30/40 (75.00%) 38/75 (50.67%) 5/10 (50.00%) 2/3 (66.67%) 0.071 *Includes individuals who answered "yes" to having sexual health concerns.