Discussions regarding reproductive and sexual health among young adult survivors of cancer.
Bibliographic record
Abstract
9588 Background: Infertility and sexual dysfunction can result from many cancer treatments and may become a source of significant distress for young adult cancer survivors. Our aims were to 1) characterize the frequency in which reproductive and sexual health discussions occur in a population-based cohort of young cancer patients and 2) identify clinical factors associated with such discussions. Methods: Patients aged 20 to 39 years who were diagnosed with solid tumors from 2006 to 2008, evaluated at any 1 of 5 regional cancer centers in British Columbia, Canada and alive at 2 or more years after their initial diagnosis were included. Demographics, tumor and treatment characteristics, and information on patient-physician conversations were analyzed. Using regression models, we explored the relationships between clinical factors and whether or not discussions had occurred. Results: A total of 397 patients were identified: median age was 35 years (IQR 31-38), 28% were men, 88% had ECOG 0, and 73% reported being in a relationship. Tumor sites included breast (50%), testicular (27%), gynecological (17%), and colorectal (6%). A significant proportion of patients received chemotherapy and radiation that posed the potential risk of infertility or sexual dysfunction. However, only 224 (56%) and 24 (6%) of individuals had a discussion about reproductive and sexual health, respectively, within the first month of their diagnosis. At 6 months, an additional 25 (6%) and 16 (4%) patients had discussed these concerns with their physicians. Age, gender, ECOG, relationship status, and type of chemotherapy and radiation were not correlated with whether or not discussions had occurred (all p>0.05). In regression models, tumor site was associated with differences in reproductive and sexual health discussions between patients and physicians (Table). Conclusions: Among young adult survivors of cancer, fertility and particularly sexual function are inadequately addressed during discussions near the time of initial cancer diagnosis. [Table: see text]
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".