Abstract PS1-02-11: The Unbridged Gap in Sexual Health Counseling: A Global Oncology Trainee Perspective

Abstract Background Clinical guidelines recommend addressing sexual health (SH) as part of routine oncology practice, yet only 20-29% of patients with breast cancer (BC) report receiving SH counseling. SH remains mostly excluded from formal medical training. This study explored the current knowledge, attitudes, and barriers to SH counseling among oncology trainees working in breast oncology settings globally. Methods A cross-sectional study was conducted among medical oncology residents/fellows, breast and gynecology surgical fellows, and radiation oncology residents. Anonymous self-administered surveys were distributed via social media platforms, including X, LinkedIn, WhatsApp, and email. Surveys collected demographics, self-reported SH knowledge, practices, and barriers to SH counseling. Data were analyzed using descriptive statistics. Results Among 46 oncology trainees, 52% were male, and 48% female, with the majority aged 31-35 years (48%). Most were in advanced training levels (PGY4-6), and 91% were in medical oncology. Respondents were trained in the US (70%), Middle East (17%), Europe (9%), and Asia (4%). A majority (89%) reported limited knowledge of SH dysfunction during cancer treatment. Table 1 summarizes self-reported confidence in managing SH concerns. SH was infrequently assessed; 48% reported they rarely addressed it, and only 26% indicated they usually/always did. 65% indicated that SH counseling is their responsibility. Biases were common:70% were more likely to discuss SH with younger patients (<50), and 52% with those with early-stage BC. When asked to select all appropriate times to address SH, 72% chose active/post-treatment, 43% at diagnosis, 41% during survivorship, and only 15% throughout care. 46% of trainees were moderately concerned about prescribing vaginal estrogen to patients with BC on endocrine therapy; 33% had prescribed vaginal estrogen, and 37% had prescribed erectile dysfunction medication. Overall, 94% reported insufficient SH training, with around 60% receiving no training to counsel females, males, or transgender patients with BC. 81% supported individualizing SH discussions, 68% felt patients value them, 50% feared offending patients by initiating them. Awareness of institutional SH resources was low with many unsure of availability of pelvic floor therapy 50%, sex therapy 59%, and behavioral therapy 50%. Commonly reported barriers to SH counseling included lack of training 85% and time 65%, followed by cultural sensitivity, provider discomfort, and perceived lack of effective treatment. Importantly, 83% supported more SH education, with seminars 83%, shadowing SH experts 50%, online courses 50%, and simulation-based training 26%. Conclusion Oncology trainees worldwide treating BC report inadequate training in SH, low confidence, and limited awareness of available resources. Formal education and social media engagement may help bridge the counseling gap. Citation Format: M. Alharbi, K. Ahuja, Z. Shah, J. Mussel, S. Gandhi, A. AbuSanad, V. Gupta, L. S. Agrawal, A. M. Roy. The Unbridged Gap in Sexual Health Counseling: A Global Oncology Trainee Perspective [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-02-11.