丹麦大多数接受辅助内分泌治疗的乳腺癌幸存者存在临床相关的性功能障碍：一项横断面研究。
The majority of Danish breast cancer survivors on adjuvant endocrine therapy have clinically relevant sexual dysfunction: a cross-sectional study.
机构信息
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Sexological Centre, Aalborg University Hospital, Aalborg, Denmark.
出版信息
Acta Oncol. 2021 Jan;60(1):61-68. doi: 10.1080/0284186X.2020.1813326. Epub 2020 Sep 1.
BACKGROUND
Impairments in sexual function are common among breast cancer survivors (BCSs), particularly in BCSs receiving adjuvant endocrine therapy (AET). Whether these impairments cause distress, thus qualifying for a more clinically relevant diagnosis of sexual dysfunction (SD), is inadequately described among BCSs and represents an important research gap. Hence, the primary aim of this study was to estimate the prevalence of clinically relevant SD, in this context: impairments with associated distress, and to identify factors associated with SD among BCSs on AET. Secondly, to explore the extent of distress caused by specific impairments in sexual function.
MATERIALS AND METHODS
In this cross-sectional study of BCSs on adjuvant treatment with endocrine therapy for at least three months, participants completed an online survey comprising standardized measures of sexual and psychosocial function. Female Sexual Function Index (FSFI) and Sexual Complaint Screener - Women (SCS-W) were used to asses clinically relevant SD. Multiple regression analyses were performed to identify factors significantly associated with SD.
RESULTS
In total, 333 BCSs with a mean age of 58.7 years were included in the study, of whom 227 were sexually active. Among sexually active BCSs, 134 (59%) met the criteria for having clinically relevant SD, of whom 78 (58%) perceived cancer treatment as the primary reason for their sexual problems. Factors associated with SD included vaginal dryness (adjusted OR= 2.25, 95% CI: 1.52-3.34, < .01) and psychological well-being (adjusted OR= 1.11, 95% CI: 1.03-1.18, < .01). Age was not related to neither prevalence of SD nor the level of distress caused by any impairment, with exception of low sexual desire. Pain in relation to intercourse was the most distressing impairment.
CONCLUSION
SD was highly prevalent among sexually active BCSs on AET. Sexual health is important to address independent of the woman's age.
背景
性功能障碍在乳腺癌幸存者（BCS）中很常见，尤其是在接受辅助内分泌治疗（AET）的 BCS 中。这些障碍是否会引起痛苦，从而符合更具临床相关性的性功能障碍（SD）诊断，在 BCS 中描述不足，这是一个重要的研究空白。因此，本研究的主要目的是估计在这种情况下具有相关痛苦的临床相关 SD 的患病率：与痛苦相关的障碍，并确定接受 AET 的 BCS 中与 SD 相关的因素。其次，探讨特定性功能障碍引起的痛苦程度。
材料和方法
在这项针对接受内分泌治疗辅助治疗至少三个月的 BCS 的横断面研究中，参与者完成了一项在线调查，其中包括性和社会心理功能的标准化测量。女性性功能指数（FSFI）和性抱怨筛查器-女性（SCS-W）用于评估具有临床相关性的 SD。进行多元回归分析以确定与 SD 显著相关的因素。
结果
共有 333 名年龄平均为 58.7 岁的 BCS 纳入研究，其中 227 名具有性行为。在有性行为的 BCS 中，134 名（59%）符合具有临床相关性的 SD 标准，其中 78 名（58%）认为癌症治疗是其性问题的主要原因。与 SD 相关的因素包括阴道干燥（调整后的 OR=2.25，95%CI：1.52-3.34，<0.01）和心理健康（调整后的 OR=1.11，95%CI：1.03-1.18，<0.01）。年龄与 SD 的患病率或任何障碍引起的痛苦程度均无关，除了性欲低下外。与性行为相关的疼痛是最令人痛苦的障碍。
结论
接受 AET 的有性行为的 BCS 中 SD 的患病率很高。无论女性的年龄如何，性健康都很重要。
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