Introduction:

Sexual health (SH) is compromised by cancer diagnosis and treatment.  Prevalence rates of sexual dysfunction are up to 90% in prostate/gynecological, 73% in breast, 30% in colorectal, and 20% in non-breast/non-pelvic cancers. Adjustment after cancer treatment requires individualized, patient-centered approaches to navigate changes in sexual function. Increasing evidence calls upon a biopsychosocial approach to holistically address the medical, psychological, and interpersonal aspects of SH. Multidisciplinary SH clinics in oncology settings are uniquely positioned to address the complexities of cancer-related SH concerns. As such, we formed the Canadian Oncology Sexual Health Initiative (COSHI) which is comprised of a multi-disciplinary group of SH experts with the following goals:

• Develop a SH virtual resource repository for participating Cancer Centres
• Develop standardized treatment protocols and access for SH across Canada
• Develop a series of cancer-type-specific guidelines for SH treatment
• Establish a national SH database, inclusive of clinical and patient reported outcomes (PROs)

Methods:

The authors contacted selected Canadian clinicians to participate in the development of COSHI. Purposeful effort was made to ensure regional and multi-disciplinary representation. All clinicians contacted agreed to be “site-champions” for COSHI. In 6/2021 a meeting was held to define the scope, mission, and governance of COSHI. A 360° survey was distributed to 13 participating Cancer Centres to characterize SH care in oncology in Canada.  Responses were collated and descriptive results reported.

Results:

12/13 institutions responded to the survey. All sites reported some form of SH care (i.e., printed handouts, virtual resources, dedicated practitioners or clinics). 7 sites have cancer-specific clinics (gyne, prostate, colorectal); 3 sites offer SH care for all cancers; and 5 sites offer SH education classes. 9 sites have in-person clinics and 4 offer virtual services. MDs (urologists) deliver SH care at 9 sites, RNs at 6, and psychologists at 5.

At least some SH-related PROs are collected at 8 sites. 4 sites have the SH service integrated into usual care, 6 sites allowed for patient self-referral, 2 sites require oncologist or other healthcare professional referral; 8 sites reported that SH was a "gap in care" and all reported limited to no community-based SH resources.

Conclusion:

All clinicians polled agreed that SH is a critical aspect of holistic cancer care. Most reported that SH was a gap in patient care, and respective sites would benefit from having additional resources available. When asked “Where would you like to see the SH programing in your institution in the next 5 years,” 5/10 clinicians identified issues surrounding referrals as a key opportunity for improvement. Content accessibility was a second theme in the responses – having options for virtual resources that are updated to reflect recent advances in therapeutic options, improved access to educational materials for both patients and their partners, as well as having greater access to psychosocial interventions through course or group-based options. The survey confirms gaps, discrepancies, or absence of SH care across selected Canadian Cancer Centres. Results underscore the need for an organization such as COSHI with goals to improve SH care across Canada.

Funding: N/A