Comprehensive assessment of sexual function in male survivors of childhood cancer: A report from the Childhood Cancer Survivor Study Journal Article


Authors: Marchak, J. G.; Seidel, K. D.; Cherven, B. O.; Klosky, J. L.; Ritenour, C. W. M.; Leisenring, W. M.; Sklar, C. A.; Ford, J. S.; Krull, K. R.; Robison, L. L.; Armstrong, G. T.; Meacham, L. R.
Article Title: Comprehensive assessment of sexual function in male survivors of childhood cancer: A report from the Childhood Cancer Survivor Study
Abstract: Background: Assessment of sexual dysfunction among adult male survivors of childhood cancer has primarily been limited to erectile dysfunction. This study aimed to characterize sexual functioning more comprehensively among a large population of male survivors of childhood cancer. Methods: Male survivors (N = 1595, 22.0–59.4 years, median age, 37.8 years) and siblings (N = 269, 21.5–60.8 years, median age, 38.9 years) from the Childhood Cancer Survivor Study completed the Sexual Functioning Questionnaire (SFQ) to assess interest, desire, arousal, satisfaction, activity, orgasm, masturbation, relationship, and problems. Poor sexual functioning was defined as SFQ Total scores >2 standard deviations below siblings' mean. Multivariable logistic regression identified risk factors for poor sexual function. Results: Survivors (8.3%) were more likely to report poor sexual functioning as compared to siblings (4.9%, odds ratio [OR], 1.9; 95% confidence interval [CI], 1.1–3.4) and reported lower SFQ total scores (p <.001) and lower means on seven subscales. Poor sexual functioning among survivors was associated with older age (40–49 years: OR, 3.81; 95% CI, 1.78–8.18; 50–59 years: OR, 6.45; 95% CI, 2.28–18.30), not being married (OR, 4.39; 95% CI, 2.66–7.26), lower education (OR, 3.07; 95% CI, 1.32–7.14), learning/memory problems (OR, 1.83; 95% CI, 1.02–3.27), and high-dose cranial (≥40 Gy: OR, 3.45; 95% CI, 1.58–7.51) or high-dose testicular (≥10 Gy: OR, 4.16; 95% CI, 1.66–10.39) radiation. Conclusions: Adult male survivors report poor sexual functioning at twice the rate expected before age 60 years. High-dose cranial or testicular radiation, as well as social and cognitive factors, contributes to risk. Improved awareness of sexual dysfunction prevalence and risk factors in male childhood cancer survivors can help clinicians better assess and treat those at highest risk. © 2025 American Cancer Society.
Keywords: adult; cancer chemotherapy; child; middle aged; young adult; major clinical study; cancer recurrence; radiation dose; follow up; neoplasm; neoplasms; sexual satisfaction; cohort analysis; risk factors; attitude to health; cyclophosphamide; risk factor; childhood cancer; survivor; cancer survivor; survivors; questionnaire; depression; sexual dysfunction; education; epidemiology; memory disorder; employment status; marriage; sexual function; ethnicity; sexual behavior; race; etiology; cancer survivors; psychosexual disorder; sexual dysfunctions, psychological; sexual dysfunction, physiological; complication; learning disorder; arousal; sexual relationship; childhood cancer survivor; health knowledge; megavoltage radiation; masturbation; orgasm; sexual functioning; humans; human; male; article; genital system disease assessment; disease assessment; surveys and questionnaires; mens health questionnaire; sexual functioning questionnaire
Journal Title: Cancer
Volume: 131
Issue: 14
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2025-07-15
Start Page: e35967
Language: English
DOI: 10.1002/cncr.35967
PUBMED: 40614134
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Charles A Sklar
    323 Sklar