Heyne Svenja, Esser Peter, Geue Kristina, Friedrich Michael, Mehnert-Theuerkauf Anja
Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
Front Psychol. 2021 Jul 22;12:679870. doi: 10.3389/fpsyg.2021.679870. eCollection 2021.
Multimodal cancer treatments are often associated with sexual problems. Identifying patients with sexual problems could help further elucidate serious issues with their sexuality and thus promote or maintain patients' sexual health. We aimed to assess the occurrence of sexual problems in patients across different tumor locations and to explore associated sociodemographic, medical and psychosocial factors.
We included 3,677 cancer patients (mean age 58 years, age range 18-75 years, 51.4% women) from a large epidemiological multicenter study in Germany on average 13.5 months after cancer diagnosis. The occurrence and frequency of sexual problems were assessed via a binary item on the problem checklist of the Distress Thermometer (DT). Controlled associations of these problems with sociodemographic, medical and psychosocial factors including distress (DT), anxiety (GAD-7), depression (PHQ-9), quality of life (EORTC-QLQ-C30), and social support (SSUK-8) are analyzed using logistic regression analysis.
We found that 31.8% of patients reported sexual problems, with a significant higher proportion in men (40.5%) compared to women (23.7%), OR 2.35, 95% CI [1.80-3.07] and a higher proportion in patients with a partner (35.6%) compared to those without a partner (3.5%), OR 2.83, 95% CI [2.17-3.70]. Tumor location was associated with occurrence of sexual problems: patients with cancer, affecting the male genital organs had the highest chance for sexual problems, OR 2.65, 95% CI [1.18-3.95]. There was no significant difference in the occurrence of sexual problems between age groups OR 0.99, 95% CI [2.13-3.53] and type of therapy (e.g., operation OR 0.91, 95% CI [0.72-1.15]). Sexual problems were further associated with elevated levels of anxiety, OR 1.05, 95% CI [1.02-1.10], less social support, OR 0.93, 95% CI [0.90-0.97] and lower quality of life in terms of impaired functioning (e.g., social function, OR 0.99, 95% CI [0.99-1.00]).
Sexual problems are commonly reported by patients. Male patients and those living with a partner are more likely to report sexual problems. Sexual problems are associated with different aspects of well-being. The findings imply the practical relevance to screen for sexual problems among patients and identified groups that should be particularly monitored.
多模式癌症治疗常常与性问题相关。识别存在性问题的患者有助于进一步阐明其性方面的严重问题，从而促进或维持患者的性健康。我们旨在评估不同肿瘤部位患者中性问题的发生率，并探索相关的社会人口学、医学和心理社会因素。
我们纳入了来自德国一项大型流行病学多中心研究的3677例癌症患者（平均年龄58岁，年龄范围18 - 75岁，51.4%为女性），平均在癌症诊断后13.5个月。通过苦恼温度计（DT）问题清单上的一个二元项目评估性问题的发生情况和频率。使用逻辑回归分析这些问题与社会人口学、医学和心理社会因素（包括苦恼（DT）、焦虑（GAD - 7）、抑郁（PHQ - 9）、生活质量（EORTC - QLQ - C30）和社会支持（SSUK - 8））之间的对照关联。
我们发现31.8%的患者报告存在性问题，男性（40.5%）报告性问题的比例显著高于女性（23.7%），比值比（OR）为2.35，95%置信区间（CI）为[1.80 - 3.07]；有伴侣的患者（35.6%）报告性问题的比例高于无伴侣的患者（3.5%），OR为2.83，95%CI为[2.17 - 3.70]。肿瘤部位与性问题的发生相关：患有影响男性生殖器官癌症的患者出现性问题的几率最高，OR为2.65，95%CI为[1.18 - 3.95]。不同年龄组之间性问题的发生率无显著差异，OR为0.99，95%CI为[2.13 - 3.53]，治疗类型（如手术，OR为0.91，95%CI为[0.72 - 1.15]）之间也无显著差异。性问题还与焦虑水平升高相关，OR为1.05，95%CI为[1.02 - 1.10]，社会支持较少相关，OR为0.93，95%CI为[0.90 - 0.97]，以及在功能受损方面生活质量较低相关（如社会功能，OR为0.99，95%CI为[0.99 - 1.00]）。
患者普遍报告存在性问题。男性患者和有伴侣的患者更有可能报告性问题。性问题与幸福感的不同方面相关。这些发现表明在患者中筛查性问题具有实际意义，并确定了应特别监测的群体。
