National Advisory Unit for Late Effects After Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway.
J Sex Med. 2020 Jul;17(7):1359-1369. doi: 10.1016/j.jsxm.2020.03.010. Epub 2020 Apr 23.
Most studies of cervical cancer (CC) survivors describe sexual inactivity in relation to treatment modalities, but few consider that inactivity varies with age and partner status.
The aim of this study was to investigate the prevalence of sexual inactivity in long-term CC survivors according to age and partner status, and to examine cancer-related, health, demographic, and psychological factors related to sexual inactivity.
All 974 women treated for CC from 2000 through 2007 in 2 areas of Norway, who were alive and cancer-free by the end of 2013, received a mailed questionnaire. Among them, 523 delivered valid data on current sexual activity (response rate 57%). The prevalence rates of sexual inactivity in relation to age groups and partner status were compared to normative sample (NORMs).
Sexual inactivity during the 4 weeks before the survey was administered.
Median age of the sample at survey was 53 years (range 32-77) and median time since diagnosis was 11 years (range 6-15). Of the survivors aged 35-69 years, 39% (95% CI 35-44%) were sexually inactive at survey compared to 36% (95% CI 32-38%) in the NORMs. Compared with sexually active survivors, inactive ones were significantly older, more frequently had single partner status, and had less frequently been childbearing. Inactive survivors more frequently had low education, did not hold paid work at survey, had poorer self-rated health, and were more often obese. They also had higher prevalence of depression, high neuroticism, and chronic fatigue. On most cancer-related quality of life measures, sexually inactive survivors had significantly lower mean scores than sexually active ones. They significantly more often had been treated with chemotherapy and/or radiation than with conization or major surgery. In multivariable regression analysis, only older age, no prior childbearing, and single partner status remained significantly associated with sexual inactivity.
Sociodemographic variables may be more relevant than clinical and cancer-related variables concerning sexual inactivity in long-term CC survivors.
STRENGTHS & LIMITATIONS: Our study had a considerable sample size and used instruments with established psychometric qualities. The moderate response rates of the study and of the NORMs imply risks for selection biases.
Close to 4 in 10 survivors were sexually inactive which is similar to the rate among NORMs. Demographic factors were most strongly associated with sexual inactivity. Some other significant factors are eventually amenable to treatment and should be checked by the health-care providers. Dahl AA, Bentzen AG, Fosså SD, et al. Sexual Inactivity During the Last 4 Weeks in Long-Term Cervical Cancer Survivors: Prevalence and Associated Factors. J Sex Med 2020;17:1359-1369.
大多数关于宫颈癌（CC）幸存者的研究都描述了与治疗方式相关的性行为不活跃，但很少考虑到这种不活跃会随年龄和伴侣状况而变化。
本研究旨在根据年龄和伴侣状况，调查长期 CC 幸存者中性行为不活跃的流行率，并探讨与性行为不活跃相关的癌症相关、健康、人口统计学和心理因素。
2000 年至 2007 年期间，挪威两个地区接受 CC 治疗的 974 名女性在 2013 年底时均存活且无癌症，她们均收到了邮寄的调查问卷。其中，523 名女性提供了当前性行为活动的有效数据（应答率为 57%）。将性行为不活跃的流行率与年龄组和伴侣状况进行比较，并与正常样本（NORMs）进行比较。
在进行调查前的 4 周内的性行为不活跃情况。
样本的中位年龄为 53 岁（范围 32-77），中位诊断后时间为 11 年（范围 6-15）。在 35-69 岁的幸存者中，39%（95%CI 35-44%）在调查时处于性行为不活跃状态，而 NORMs 中的比例为 36%（95%CI 32-38%）。与性行为活跃的幸存者相比，不活跃的幸存者年龄较大，更多为单身伴侣，较少有生育子女。不活跃的幸存者受教育程度较低，在调查时没有从事有薪工作，自我健康评估较差，并且更常肥胖。她们还患有更高的抑郁、神经质和慢性疲劳。在大多数与癌症相关的生活质量测量中，性行为不活跃的幸存者的平均得分明显低于性行为活跃的幸存者。她们接受化疗和/或放疗的比例明显高于接受锥切术或大手术的比例。在多变量回归分析中，只有年龄较大、无生育子女和单身伴侣状况与性行为不活跃仍有显著相关性。
与临床和癌症相关的变量相比，社会人口统计学变量可能与长期 CC 幸存者的性行为不活跃更为相关。
本研究样本量相当大，并使用了具有既定心理测量质量的工具。研究和 NORMs 的中等应答率意味着存在选择偏差的风险。
近 4 成幸存者处于性行为不活跃状态，与 NORMs 的比例相似。人口统计学因素与性行为不活跃的关系最密切。其他一些重要因素最终可以通过治疗来改善，应引起医疗保健提供者的重视。Dahl AA, Bentzen AG, Fosså SD, et al. 长期宫颈癌幸存者最后 4 周的性行为不活跃：流行率及相关因素。性医学杂志 2020;17:1359-1369.
