我们能谈谈性吗?BRCA1/2患者普遍性健康筛查的可行性

IF 3.3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Amita Kulkarni, Luiza Perez, Lauren Mitchell, Muhammad Danyal Ahsan, Jesse Brewer, Charlene Thomas, Eloise Chapman-Davis, Evelyn Cantillo, Kevin Holcomb, Shoshana Rosenberg, Melissa K Frey
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引用次数: 0

摘要

背景:降低BRCA1/2致病性变异个体卵巢癌风险的输卵管卵巢切除术可导致性功能障碍,但患者和提供者之间的性健康讨论仍然有限。目的:我们描述了普遍性健康筛查的可行性和BRCA1/2致病变异个体的性健康功能障碍率。方法:对2022年1月至2023年2月在妇科肿瘤门诊就诊的BRCA1/2致病变异患者进行性健康筛查。筛选者将一项有效的、单项性功能障碍评估与三个附加问题结合起来,探讨与医疗保健提供者的性健康讨论、对性健康信息的渴望以及传递信息的首选方法。结果:主要结果是完成性健康筛查的患者比例,次要结果包括性功能障碍率和患者特征对性功能障碍的影响。结果:103例患者中,100%完成了性健康筛查。中位年龄为42岁(25-84岁)。83例(81%)患者自认为是白人,32例(31%)患者有癌症病史,42例(41%)患者接受过降低风险的输卵管卵巢切除术,47例(46%)患者处于绝经前。37例(36%)患者性功能障碍筛查阳性。在输卵管卵巢切除术后过早绝经的患者中,6/15(40%)接受激素替代治疗的患者报告了性功能障碍,6/10(60%)未接受激素替代治疗的患者报告了性功能障碍(P = 0.43)。在所有患者中,38人(37%)以前从未与提供者讨论过性健康问题。基于任何测量的患者特征,性功能障碍率没有显著差异。临床意义:对携带BRCA1/2致病变异的个体进行普遍的性健康筛查是可行的,并且可能为高危患者提供更深入的讨论途径,这些患者之前可能没有与他们的医疗团队讨论过这个问题。优势和局限性:我们的研究发现,在临床环境中,在高危患者人群中实施性健康筛查工具是可行的。由于我们的研究对象规模小,多数为白人和非西班牙裔,且来自单一机构,因此可泛化性可能受到限制。结论:提供者应考虑对BRCA1/2致病变异患者实施标准化的性健康筛查。研究特色:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can we talk about sex? Feasibility of universal sexual health screening for BRCA1/2 patients.

Background: Risk-reducing salpingo-oophorectomy for ovarian cancer risk reduction in individuals with BRCA1/2 pathogenic variants can cause sexual dysfunction, yet sexual health discussions between patients and providers remain limited.

Aim: We describe the feasibility of universal sexual health screening and rates of sexual health dysfunction among individuals with BRCA1/2 pathogenic variants.

Methods: Patients with BRCA1/2 pathogenic variants presenting to an outpatient gynecologic oncology clinic from January 2022 to February 2023 were offered a sexual health screener. The screener combined a validated, single-item sexual dysfunction assessment with three additional questions exploring discussions of sexual health with healthcare providers, desire for information about sexual health, and preferred methods for delivery of information.

Outcomes: The primary outcome was the proportion of patients who completed the sexual health screener and the secondary outcomes included rate of sexual dysfunction and impact of patient characteristics on sexual dysfunction.

Results: Among 103 patients offered the sexual health screening, 100% completed it. Median age was 42 years (range 25-84). Eighty three (81%) patients self-identified as White, 32 (31%) patients had a history of cancer, 42 (41%) had undergone risk-reducing salpingo-oophorectomy, and 47 (46%) were pre-menopausal. Thirty seven (36%) patients screened positive for sexual dysfunction. Among patients with premature menopause following salpingo-oophorectomy, 6/15 (40%) on hormone replacement therapy reported sexual dysfunction versus 6/10 (60%) not on hormone replacement therapy (P = .43). Across all patients, 38 (37%) had never previously discussed sexual health concerns with a provider. There were no significant differences in sexual dysfunction rates based on any measured patient characteristics.

Clinical implications: Universal sexual health screening for individuals with BRCA1/2 pathogenic variants is feasible and may provide an avenue for more in-depth discussion with at-risk patients, who may not have previously discussed this issue with their medical team.

Strengths and limitations: Our study found that it was feasible to administer a sexual health screening tool among an at-risk patient population in a clinical setting. Generalizability may be limited due to the composition of our cohort, which was small, majority White and non-Hispanic, and from a single institution.

Conclusion: Providers should consider implementing standardized sexual health screening practices among patients with BRCA1/2 pathogenic variants.

Research highlights:

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来源期刊
Journal of Sexual Medicine
Journal of Sexual Medicine 医学-泌尿学与肾脏学
CiteScore
6.20
自引率
5.70%
发文量
826
审稿时长
2-4 weeks
期刊介绍: The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.
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