Belgian Physicians' Perceptions of Sexual Health and Its Care in Cervical Cancer Survivors: An Exploratory Qualitative Interview Study.

Main Objective of the Study: To (1) identify Belgian physicians' perceptions of sexual health discussions with patients diagnosed with cervical cancer (CC), and (2) describe sexual health care provision from the physicians' perspective. Methods: This study was part of a larger exploratory qualitative study using semistructured one-on-one interviews. The present manuscript focuses on 16 Belgian physicians specialized in pelvic gynecologic oncology. Recruitment took place in five hospitals between September 2021 and January 2022. Participants had a median age of 45 years, 56% were female, half were gynecologists, and they provided follow-up care for a mean of 18 newly diagnosed CC patients annually. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic data analysis. COREQ and SRQR reporting guidelines were applied. Results: Three main themes emerged from the interviews. First, physicians reported substantial variability in when they initiate discussions about sexual health in CC care. This variability was shaped by a complex interplay of factors that could either prompt or dampen such conversations. Second, many physicians adopted a predominantly medical approach to sexual health concerns, while non-medical - psychosocial - aspects of sexual health were largely overlooked. Third, physicians identified several strategies to improve care. An interprofessional approach, with specialized roles for the oncology nurse and sexologist, was perceived as highly valuable. Participants emphasized the need for a structured sexual health care pathway as key overarching proposal. Conclusion: This study underscores a persistent gap between physicians' intention to address sexual health and their actual communication practices. Implicit triage, role ambiguity, and structural constraints contribute to inconsistent and reactive discussions. Physicians suggested that strengthening interprofessional collaboration - through the integration of oncology nurses and sexologists - together with the implementation of an oncologic sexual health care pathway, could enhance awareness, reduce physician-driven variability, and improve overall sexual health care for women with CC. They also advocated routine sexologist consultations at defined points throughout the disease trajectory and emphasized the importance of involving partners.