Cancer Res Treat.  2016 Oct;48(4):1321-1329. 10.4143/crt.2015.425.

Comparison of Quality of Life and Sexuality between Cervical Cancer Survivors and Healthy Women

• Lee Y
• Lim MC
• Kim SI
• Joo J
• Lee DO
• Park SY

• KMID: 2356234
• DOI: http://doi.org/10.4143/crt.2015.425

Abstract

PURPOSE
The purpose of this study is to compare quality of life (QoL) and sexual functioning between sexually active cervical cancer survivors and healthy women.
MATERIALS AND METHODS
In this cross-sectional study, propensity-score-matched cervical cancer survivors (n=104) and healthy women (n=104) were compared. All women had engaged in sexual activity within the previous 3 months, and cervical cancer survivors showed no evidence of disease after primary treatment. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), Cervical Cancer Module (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).
RESULTS
Significantly higher scores for lymphedema were observed in the cervical cancer survivors group compared with the healthy women group (mean, 20.2 vs. 12.2; p < 0.05). Sexuality, both in terms of sexual activity, sexual enjoyment, and sexual worry (EORTC QLQ-CX24), and in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain (FSFI) were similar between the groups. When the scale of sexual/vaginal functioning in EORTC QLQ-CX24 was divided into individual questions, cervical cancer survivors reported shorter vaginal length than the control group, but without statistical significance (mean, 80.6 vs. 85.4; p=0.077).
CONCLUSION
Compared with healthy women, sexuality was not impaired in cervical cancer survivors who showed no evidence of disease after primary treatment and engaging in sexual activity. Further prospective cohort studies are warranted to confirm this finding.

Keyword

Uterine cervical neoplasms; Quality of life; Sexuality; Survivors

MeSH Terms

Arousal
Cohort Studies
Cross-Sectional Studies
Female
Humans
Lubrication
Lymphedema
Orgasm
Prospective Studies
Quality of Life*
Sexual Behavior
Sexuality*
Survivors*
Uterine Cervical Neoplasms*

Figure

• 

  Fig. 1. Flow chart of enrollment.

Reference

References

1. Jung KW, Won YJ, Oh CM, Kong HJ, Cho H, Lee DH, et al. Prediction of cancer incidence and mortality in Korea, 2015. Cancer Res Treat. 2015; 47:142–8.

2. Lim MC, Moon EK, Shin A, Jung KW, Won YJ, Seo SS, et al. Incidence of cervical, endometrial, and ovarian cancer in Korea, 1999-2010. J Gynecol Oncol. 2013; 24:298–302.

3. Park SY, Bae DS, Nam JH, Park CT, Cho CH, Lee JM, et al. Quality of life and sexual problems in disease-free survivors of cervical cancer compared with the general population. Cancer. 2007; 110:2716–25.

4. Choi J, Shin DW, Lee S, Jeon MJ, Kim SM, Cho B, et al. Dose-response relationship between cigarette smoking and female sexual dysfunction. Obstet Gynecol Sci. 2015; 58:302–8.

5. Lee Y, Lim MC, Son Y, Joo J, Park K, Kim JS, et al. Development and evaluation of Korean version of Quality of Sexual Function (QSF-K) in healthy Korean women. J Korean Med Sci. 2014; 29:758–63.

6. Lee Y, Lim MC, Joo J, Park K, Lee S, Seo S, et al. Development and validation of the Korean version of the Female Sexual Function Index-6 (FSFI-6K). Yonsei Med J. 2014; 55:1442–6.

7. Kim SI, Lee Y, Lim MC, Joo J, Park K, Lee DO, et al. Quality of life and sexuality comparison between sexually active ovarian cancer survivors and healthy women. J Gynecol Oncol. 2015; 26:148–54.

8. Vistad I, Fossa SD, Dahl AA. A critical review of patient-rated quality of life studies of long-term survivors of cervical cancer. Gynecol Oncol. 2006; 102:563–72.

9. Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, et al. Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res. 2004; 13:863–8.

10. Shin DW, Ahn E, Kim YM, Kang S, Kim BG, Seong SJ, et al. Cross-cultural application of the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire cervical cancer module. Oncology. 2009; 76:190–8.

11. Kim HY, So HS, Park KS, Jeong SJ, Lee JY, Ryu SB. Development of the Korean-version of Female Sexual Function Index (FSFI). Korean J Androl. 2002; 20:50–6.

12. Carter J, Sonoda Y, Baser RE, Raviv L, Chi DS, Barakat RR, et al. A 2-year prospective study assessing the emotional, sexual, and quality of life concerns of women undergoing radical trachelectomy versus radical hysterectomy for treatment of early-stage cervical cancer. Gynecol Oncol. 2010; 119:358–65.

13. Carter J, Sonoda Y, Chi DS, Raviv L, Abu-Rustum NR. Radical trachelectomy for cervical cancer: postoperative physical and emotional adjustment concerns. Gynecol Oncol. 2008; 111:151–7.

14. Frumovitz M, Sun CC, Schover LR, Munsell MF, Jhingran A, Wharton JT, et al. Quality of life and sexual functioning in cervical cancer survivors. J Clin Oncol. 2005; 23:7428–36.

15. Serati M, Salvatore S, Uccella S, Laterza RM, Cromi A, Ghezzi F, et al. Sexual function after radical hysterectomy for early-stage cervical cancer: is there a difference between laparoscopy and laparotomy? J Sex Med. 2009; 6:2516–22.

16. Song T, Choi CH, Lee YY, Kim TJ, Lee JW, Kim BG, et al. Sexual function after surgery for early-stage cervical cancer: is there a difference in it according to the extent of surgical radicality? J Sex Med. 2012; 9:1697–704.

17. Tsai TY, Chen SY, Tsai MH, Su YL, Ho CM, Su HF. Prevalence and associated factors of sexual dysfunction in cervical cancer patients. J Sex Med. 2011; 8:1789–96.

18. Reis N, Beji NK, Coskun A. Quality of life and sexual functioning in gynecological cancer patients: results from quantitative and qualitative data. Eur J Oncol Nurs. 2010; 14:137–46.

19. Nicolosi A, Glasser DB, Kim SC, Marumo K, Laumann EO; GSSAB Investigators' Group. Sexual behaviour and dysfunction and help-seeking patterns in adults aged 40-80 years in the urban population of Asian countries. BJU Int. 2005; 95:609–14.

20. Takahashi M, Inokuchi T, Watanabe C, Saito T, Kai I. The Female Sexual Function Index (FSFI): development of a Japanese version. J Sex Med. 2011; 8:2246–54.

21. Mantegna G, Petrillo M, Fuoco G, Venditti L, Terzano S, Anchora LP, et al. Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis. BMC Cancer. 2013; 13:127.

22. Li X, Song X, Chen Z, Li M, Lu L, Xu Y, et al. Quality of life in rectal cancer patients after radical surgery: a survey of Chinese patients. World J Surg Oncol. 2014; 12:161.

23. Lee SS, Chung HY, Kwon OK, Yu W. Quality of life in cancer survivors 5 years or more after total gastrectomy: a case-control study. Int J Surg. 2014; 12:700–5.

24. Jung J, Forbes GB. Body dissatisfaction and disordered eating among college women in China, South Korea, and the United States: Contrasting predictions from sociocultural and feminist theories. Psychol Women Q. 2007; 31:381–93.

25. Choi OJ, Cho YG, Kang JH, Park HA, Kim KW, Hur YI, et al. Weight control attempts in underweight korean adults: Korea national health and nutrition examination survey, 2007-2010. Korean J Fam Med. 2013; 34:393–402.