Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1063, USA.
Department of Health Sciences, James Madison University, 235 Martin Luther King Jr Way, Harrisburg, VA, 22807, USA.
Support Care Cancer. 2018 Aug;26(8):2605-2613. doi: 10.1007/s00520-018-4098-0. Epub 2018 Feb 17.
This study aims (1) to estimate percentages of partnered women who are sexually active over the first 2 years post-breast cancer diagnosis; (2) to identify factors related to sexual inactivity; and (3) to evaluate separately, among both sexually active and inactive survivors, the relation between sexual problems and treatment-related variables, symptoms, and psychosocial factors.
Longitudinal observational study of breast cancer survivors recruited within 8 months of cancer diagnosis and followed for 18 months. The main outcome measures were (1) being sexually active/inactive in the past month and (2) sexual problems assessed with the four-item sexual problem domain of the Quality of Life in Adult Cancer Survivors (QLACS) scale.
At baseline, 52.4% of women reported being sexually active in the past month. This percentage increased to 60.7% 18 months later. In multivariable repeated-measures analyses, age, past chemotherapy, depressive symptoms, and lower perceived attractiveness were related to inactivity. Sexually inactive women reported more problems on the QLACS than sexually active women. In stratified multivariable analyses, depressive symptoms were related to greater sexual problems for both sexually active and inactive women, as was vaginal dryness. Among the sexually active women, younger age at diagnosis, less illness intrusiveness, and lower perceived attractiveness were related to more problems.
Research has shown that sexual functioning/sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers. Future studies should examine how such topics are handled by clinicians in their interactions with survivors.
本研究旨在：(1) 估计乳腺癌诊断后 2 年内有性生活的伴侣女性的百分比；(2) 确定与无性生活相关的因素；(3) 分别评估在有性生活和无性生活的幸存者中，性问题与治疗相关变量、症状和心理社会因素之间的关系。
在癌症诊断后 8 个月内招募的乳腺癌幸存者进行纵向观察性研究，并随访 18 个月。主要观察指标为：(1) 过去一个月是否有性生活；(2) 用成人癌症幸存者生活质量四项目性问题领域量表(QLACS)评估性问题。
基线时，52.4%的女性报告过去一个月有性生活。这一比例在 18 个月后增加到 60.7%。在多变量重复测量分析中，年龄、过去化疗、抑郁症状和较低的感知吸引力与无性生活相关。无性生活的女性比有性生活的女性在 QLACS 上报告更多的问题。在分层多变量分析中，抑郁症状与有性生活和无性生活的女性的性问题更严重有关，阴道干燥也是如此。在有性生活的女性中，诊断时年龄较小、疾病侵入性较小和感知吸引力较低与更多的问题相关。
研究表明，性功能/性健康是许多癌症幸存者生活质量的关键方面，但往往未被医疗保健提供者关注。未来的研究应探讨临床医生在与幸存者互动时如何处理这些问题。
