Female sexual problems after treatment for colorectal cancer – a population-based study

Aim: 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. Method: 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)]. Conclusion: 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.