Primary care visits are higher amongst adults who report sexual dysfunction concerns after cancer treatment

Sexual health concerns are prevalent ongoing effects after cancer treatment. This study examined the association between sexual dysfunction and physician use among adult cancer survivors in Nova Scotia, Canada. We identified all adult survivors of breast, prostate, colorectal, melanoma, and hematological cancers, and all young adult cancer survivors of any invasive cancer, who were diagnosed between 2012 and 2014 from the Nova Scotia Cancer Registry (NSCR). Sexual dysfunction concerns were obtained from the Cancer Transitions Survey using a single question ("How much was this a concern for you?"). This national survey, administered in 2016, explored the experiences of cancer survivors 1-3 years post-cancer treatment. Survey responses were linked to the NSCR and administrative health databases to capture healthcare utilization. Multivariable Poisson and negative binomial regression models examined the association between sexual dysfunction and the number of primary care and oncology specialist visits, respectively, during follow-up care. 823 respondents were included in this study (46% male, 54% female). Nearly one-third (32.4%) of respondents indicated sexual dysfunction was a big or moderate concern at the time of survey completion. During routine follow-up, cancer survivors with self-reported sexual dysfunction had a 9% higher rate of primary care visits compared to those without sexual dysfunction (IRR 1.09, 95% CI 1.06-1.13, p < 0.0001). No significant association was observed between self-reported sexual dysfunction and oncology visits. These findings highlight a potentially important role for primary care providers in addressing sexual health concerns in their cancer survivor patients. Primary care providers should be supported with appropriate resources and training to optimize survivors' sexual health and recovery after cancer.