Talking about sexual health during survivorship: understanding what shapes breast cancer survivors’ willingness to communicate with providers

Mollie Rose Canzona, Carla L. Fisher, Kevin B. Wright, Christy J.W. Ledford

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: Breast cancer survivor (BCS)–provider communication about sexual health (SH) is often absent or inadequate. Patients report wanting providers to broach the topic, but providers cite barriers to initiating discussions. While the health care community works to address barriers, it is unrealistic to rely solely on provider initiation of SH conversations. This research investigates willingness to communicate about sexual health (WTCSH) to better understand what may interfere with survivors’ ability to self-advocate and receive care for these concerns. Methods: (N = 305) BCSs completed online surveys. Hierarchical multiple regression determined the relationship between Sexual Quality of Life—Female (SQOL—F), which measures psychological and social dimensions of SH and WTCSH. Interviews were then conducted with forty BCSs. The constant comparative method was used to thematically analyze the transcripts. Results: The mean SQOL score was 53.4 out of 100. No statistically significant differences in SQOL or WTCSH were found by age or survivorship length. The positive relationship between WTCSH and SQOL was significant, F (6,266) = 4.92, p <.000, adj. R2 =.080). Five themes illustrated factors that shape WTCSH: (1) comfort discussing SH; (2) perception of demographic similarity/discordance; (3) patient-centered communication; (4) belief that SH is (un)treatable, and (5) ability to access timely/coordinated care. Conclusions: Findings establish the significance of SH concerns and provide an in-depth understanding of intrapersonal, interpersonal, and organizational issues informing WTCSH. Implications for Cancer Survivors: Age and gender dynamics, perceptions of provider SQOL messaging, and futility influence survivor openness. Addressing these areas may encourage disclosure among women who would otherwise continue to suffer in silence.

Original languageEnglish (US)
Pages (from-to)932-942
Number of pages11
JournalJournal of Cancer Survivorship
Issue number6
StatePublished - Dec 1 2019
Externally publishedYes


  • Breast cancer
  • Oncology
  • Patient-provider communication
  • Sexual health
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)


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