Let's Talk About Sex: A Systematic Review of What Childhood Cancer Patients and Survivors Really Want to Know About Sex.

BACKGROUND

Childhood cancer treatment often leads to persistent, complex psychosexual late effects, which impact survivors' sexual function, body image, and relational development. Despite these pervasive and serious consequences, sexual health communication remains consistently neglected across the cancer care continuum for childhood cancer patients and survivors.

AIMS: This systematic review synthesies empirical evidence to determine childhood cancer patients and survivors' specific preferences for sexual health communication: What, how, when, where, and with whom do they want to discuss sexuality and sexual health.

METHODS

Adhering to PRISMA, a systematic search across six major databases identified 12 articles focusing on childhood cancer patients and survivors (diagnosed 0-18 years). Data on patient-reported communication needs was extracted and analysed using an integrative thematic synthesis approach.

RESULTS

What: childhood cancer patients and survivors specifically require discussions about sexuality to cover psychosocial issues (body image, romantic relationships, sexual identity), extending beyond physical function or fertility alone. Who: Successful communication relies on healthcare provider competence, rapport, and trust. How and Where: Healthcare providers should proactively initiate, normalise, and destigmatise conversations. Support should be delivered in a private, one-on-one setting, and be tailored, and age appropriate. When: Conversations about sexual health should be continuous throughout the cancer trajectory, starting at diagnosis and continuing into survivorship.

CONCLUSIONS

Childhood cancer patients and survivors possess clear, actionable and multifaceted needs highlighting a critical failure in survivorship care. These findings suggest that clinical guidelines could be enhanced by integrating these patient-reported outcomes to ensure comprehensive, preventive psychosexual support for this vulnerable population.