The National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List as a screening tool for sexual problems in adults with cancer.

295 Background: Cancer diagnosis and treatment adversely affect sexuality, which often remains unaddressed. Few clinic-based, easily administrable tools exist to identify sexual problems in patients with cancer. The National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List (NDT) is frequently used to measure distress in oncology clinics. This study explored the prevalence and associative factors for sexual problems and their overlap with reported distress in cancer patients using NDT screening data. Methods: This retrospective cohort study included adults with cancer receiving oncology care at the University of Alabama at Birmingham from March 2017 through April 2023. Participants completed a lay navigator-administered NDT around their first visit. Participants reported their distress levels in a score of 0 (no distress) and 10 (extreme distress) and checked their problems from a 42-item Problem List, sexual problems being one of them. Distress was categorized as mild (0-3), moderate (4-7), and severe (8-10) distress. Patient age, sex, race, tumor type, and stage were captured. Frequencies of reported sexual problems were calculated and compared by patient characteristics and reported distress using Cohen’s d (0.2 small, 0.5 medium, 0.8 large effect) or Cramer’s V (0.1 small, 0.3 medium, 0.5 large effect) effect sizes. Results: Of patients completing an NDT survey (N=2821), 62% were female, 22% were Black, and 30% had a diagnosis of breast cancer. A total of 4% (n=99) expressed sexual problems. Compared to those reporting no sexual concerns, patients who reported sexual concerns were younger (median age 56 [interquartile range, IQR: 48-66] vs. 64 [IQR: 57-72], d=0.6) and more often had a breast cancer diagnosis (45% vs. 29%, V: 0.10), (V=0.2). Participants reporting sexual problems more often reported moderate to severe distress than those who did not (64% vs. 34%, V=0.1). Conclusions: Though the percentage of participants reporting sexual problems was low compared to historical data on sexual dysfunction in patients with cancer, the NCCN Distress Thermometer and Problem List could be a helpful screening tool for identifying sexual problems in adults with cancer. Sexual problems reported by patients with cancer differed by age, cancer types, and distress levels. More research is needed to understand best practices for capturing and responding to sexual concerns in patients with cancer during clinical encounters.