A 360-degree view of sexual health services at selected institutions across Canada: The need for the Canadian Oncology Sexual Health Initiative (COSHI)
Sydney Sparanese1,2, Ryan Flannigan1,2, Andrew Matthew3, Celestia S. Higano1,2, Eugenia Wu2, Steven Guirguis3, Monita Sundar2.
1Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada; 2Prostate Cancer Supportive Care Program, Vancouver Prostate Centre, Vancouver, BC, Canada; 3Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
Introduction: Sexual health (SH) is compromised by cancer diagnosis and treatment. Prevalence rates of sexual dysfunction are 90% in prostate/gynecological, 73% in breast, 30% in colorectal, and 20% in non-breast/non-pelvic cancers. SH clinics in oncology settings are the exception in Canada. As such, we formed the Canadian Oncology Sexual Health Initiative (COSHI), which is comprised of a multidisciplinary group of SH experts with the following goals:
Methods: The authors contacted selected Canadian clinicians to participate in the development of COSHI. Purposeful effort was made to ensure regional and multidisciplinary representation. Every clinician contacted agreed to be “site-champions” for COSHI. In June 2021, a meeting was held to define the scope, mission, and governance of COSHI. A 360° survey was distributed to 12 participating cancer centers to characterize SH care in oncology in Canada. Responses were collated and descriptive results reported.
Results: Eleven of 12 institutions responded to the survey. All sites reported some form of SH care: seven have cancer-specific clinics (gyne, prostate, colorectal); two offer SH care for all cancers; and four offer SH education classes. Seven sites have in-person clinics and two offer virtual services. MDs (urologists) deliver SH care at nine sites, RNs at six, and psychologists at three. At least some SH-related PROs are collected at seven sites. Eight sites reported that SH was a "gap in care" and all reported limited to no community-based SH resources.
Conclusions: The 360° survey confirms gaps, discrepancies, or absence of SH care across selected Canadian cancer centers. Results underscore the need for an organization such as COSHI, with its goals to improve SH care across Canada.
