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Abstract：
OBJECTIVE: There has been limited focus on female sexuality after treatment for colorectal cancer. The aim of this study was to investigate long-term female sexual dysfunction in disease-free colorectal cancer survivors in the Danish population.
METHODS: All female Danish patients treated for colorectal cancer between 2001 and 2014 were included if they reported to have been sexually active at the time of diagnosis. They were requested to answer the validated Sexual Vaginal Changes Questionnaire.
RESULTS: A total of 2402 patients were included for analysis (43%). Overall, rectal cancer patients reported more sexual inactivity and problems compared to colon cancer patients, but there were no differences in any sexual function domains when excluding irradiated patients and patients with a permanent stoma. A permanent stoma was associated with sexual inactivity [OR 2.56 (95% CI 1.42-4.70)] and overall sexual dysfunction [OR 2.95 (95% CI 1.05-6.38)] in colon cancer patients, as well as inactivity [OR 1.43 (95% CI 1.01-2.04)] and overall dysfunction [OR 2.0 (95% CI 1.18-3.41)] in rectal cancer patients. Furthermore, a permanent stoma was associated with dyspareunia [OR 2.17 (95% CI 1.39-3.38)] and reduced vaginal dimension [OR 3.16 (95% CI 1.99-5.01)]. In rectal cancer patients, radiotherapy exposure increased the odds for overall sexual dysfunction [OR 1.80 (95% CI 1.02-3.16)] and was associated with dyspareunia [OR 1.72 (95% CI 0.95-3.12)].
CONCLUSIONS: Sexual problems after treatment of colorectal cancer are common. Major risk factors are a permanent stoma and radiotherapy. Relevant patients should be offered professional counselling and treatment.
METHODS: All female Danish patients treated for colorectal cancer between 2001 and 2014 were included if they reported to have been sexually active at the time of diagnosis. They were requested to answer the validated Sexual Vaginal Changes Questionnaire.
RESULTS: A total of 2402 patients were included for analysis (43%). Overall, rectal cancer patients reported more sexual inactivity and problems compared to colon cancer patients, but there were no differences in any sexual function domains when excluding irradiated patients and patients with a permanent stoma. A permanent stoma was associated with sexual inactivity [OR 2.56 (95% CI 1.42-4.70)] and overall sexual dysfunction [OR 2.95 (95% CI 1.05-6.38)] in colon cancer patients, as well as inactivity [OR 1.43 (95% CI 1.01-2.04)] and overall dysfunction [OR 2.0 (95% CI 1.18-3.41)] in rectal cancer patients. Furthermore, a permanent stoma was associated with dyspareunia [OR 2.17 (95% CI 1.39-3.38)] and reduced vaginal dimension [OR 3.16 (95% CI 1.99-5.01)]. In rectal cancer patients, radiotherapy exposure increased the odds for overall sexual dysfunction [OR 1.80 (95% CI 1.02-3.16)] and was associated with dyspareunia [OR 1.72 (95% CI 0.95-3.12)].
CONCLUSIONS: Sexual problems after treatment of colorectal cancer are common. Major risk factors are a permanent stoma and radiotherapy. Relevant patients should be offered professional counselling and treatment.
摘要：
目的：对女性结直肠癌治疗后的性行为关注有限。这项研究的目的是调查丹麦人群中无疾病结直肠癌幸存者的长期女性性功能障碍。
方法：包括在2001年至2014年期间接受结直肠癌治疗的所有丹麦女性患者，如果他们在诊断时报告有性活跃的话。他们被要求回答经过验证的性阴道变化问卷。
结果：共纳入2402例患者进行分析（43%）。总的来说,与结肠癌患者相比，直肠癌患者报告了更多的性不活动和问题，但当排除受照射患者和永久性造口患者时，任何性功能领域均无差异。结肠癌患者永久性造口与性不活动[OR2.56(95%CI1.42-4.70)]和总体性功能障碍[OR2.95(95%CI1.05-6.38)]相关，以及直肠癌患者的不活动[OR1.43(95%CI1.01-2.04)]和总体功能障碍[OR2.0(95%CI1.18-3.41)]。此外，永久性造口与性交困难[OR2.17(95%CI1.39-3.38)]和阴道尺寸减小[OR3.16(95%CI1.99-5.01)]相关.在直肠癌患者中，放疗暴露增加了总体性功能障碍的几率[OR1.80(95%CI1.02-3.16)],并与性交困难相关[OR1.72(95%CI0.95-3.12)].
结论：结直肠癌治疗后的性问题很常见。主要危险因素是永久性造口和放疗。应向相关患者提供专业的咨询和治疗。
方法：包括在2001年至2014年期间接受结直肠癌治疗的所有丹麦女性患者，如果他们在诊断时报告有性活跃的话。他们被要求回答经过验证的性阴道变化问卷。
结果：共纳入2402例患者进行分析（43%）。总的来说,与结肠癌患者相比，直肠癌患者报告了更多的性不活动和问题，但当排除受照射患者和永久性造口患者时，任何性功能领域均无差异。结肠癌患者永久性造口与性不活动[OR2.56(95%CI1.42-4.70)]和总体性功能障碍[OR2.95(95%CI1.05-6.38)]相关，以及直肠癌患者的不活动[OR1.43(95%CI1.01-2.04)]和总体功能障碍[OR2.0(95%CI1.18-3.41)]。此外，永久性造口与性交困难[OR2.17(95%CI1.39-3.38)]和阴道尺寸减小[OR3.16(95%CI1.99-5.01)]相关.在直肠癌患者中，放疗暴露增加了总体性功能障碍的几率[OR1.80(95%CI1.02-3.16)],并与性交困难相关[OR1.72(95%CI0.95-3.12)].
结论：结直肠癌治疗后的性问题很常见。主要危险因素是永久性造口和放疗。应向相关患者提供专业的咨询和治疗。
