Risks of Sexual Dysfunction Higher for Survivors of Gynecologic Cancers

Survivors of gynecologic cancers may have an elevated risk of sexual dysfunction during the first 1 to 5 years after their cancer diagnosis, compared with cancer-free members of the general population. These results of a population-based cohort study were published in the journal Supportive Care in Cancer.

The study included cancer survivors with records in the Utah Cancer Registry whose first primary gynecologic cancer was diagnosed between 1997 and 2012. Survivors were matched with 22,693 cancer-free women from the general population for analyses involving various possible diagnoses of sexual dysfunction. Matching for analyses was based on characteristics of population cohorts categorized by cancer type (ovarian, endometrial, or cervical).

The researchers additionally aimed to identify risk factors for sexual dysfunction in analyses that involved multiple demographic and clinical characteristics. Analyses were adjusted for confounding factors.

Among survivors of gynecologic cancer, approximately 6.6% had diagnoses involving sexual dysfunction during the first 1 to 5 years after a cancer diagnosis. Relative to members of cancer-free cohorts, risks of sexual dysfunction were higher for survivors of gynecologic cancer for dyspareunia (hazard ratio [HR], 3.27; 95% CI, 2.63-4.06), vaginal dryness/atrophic vaginitis (HR, 2.63; 95% CI, 2.21-3.12), and overall sexual dysfunction (HR, 2.51; 95% CI, 2.16-2.93) 1 to 5 years after cancer diagnosis.

In analyses based on cancer type, compared with cancer-free women, risk of overall sexual dysfunction was higher in survivors of ovarian cancer (HR, 2.76; 95% CI, 2.02-3.76), survivors of cervical cancer (HR, 2.72; 95% CI, 1.89-3.92), and survivors of endometrial cancer (HR, 2.35; 95% CI, 1.88-2.92).

Certain clinical or treatment characteristics were also associated with greater risks of sexual dysfunction for survivors of gynecologic cancer. These included having regionally advanced cancer (vs localized), use of chemotherapy, and use of radiation therapy. By cancer type, use of radiation therapy was associated with higher risks of sexual dysfunction for survivors of ovarian and endometrial cancers, and chemotherapy was associated with a higher risk of sexual dysfunction for survivors of ovarian cancer.

Lack of orgasm was not diagnosed in any of the cancer survivors, and diagnoses of decreased libido, lack of arousal, or other forms of sexual dysfunction were rare in cancer survivors. Additionally, after more than 5 years following cancer diagnosis, risks of sexual dysfunction diagnoses were not higher among cancer survivors than in the cancer-free cohorts. However, the researchers noted that rates of sexual dysfunction diagnoses appeared lower in this study than in patient reports in the literature.

“In conclusion, gynecological cancer patients had a higher risk of sexual dysfunction than women without gynecological cancer; however, the incidence identified in our study was very low in comparison to patient reports,” the researchers wrote in their report.

Reference

Chang CP, Wilson CM, Rowe K, et al. Sexual dysfunction among gynecologic cancer survivors in a population-based cohort study. Support Care Cancer. 2022;31(1):51. doi:10.1007/s00520-022-07469-6