Article Text
Abstract
Objectives To describe prevalence and predictors of poor sexual well-being for men and women over 5 years following treatment for colorectal cancer.
Design Prospective longitudinal study, from presurgery to 5 years postsurgery, with eight assessment points. Logistic regression models predicted sexual well-being from presurgery to 24 months and 24 months to 60 months; time-adjusted then fully adjusted models were constructed at each stage.
Setting Twenty-nine hospitals in the UK.
Participants Patients with Dukes’ stage A–C, treated with curative intent, aged ≥18 years and able to complete questionnaires were eligible.
Outcome measures The dependent variable was the Quality of Life in Adult Cancer Survivors sexual function score. Independent variables included sociodemographic, clinical and psychosocial characteristics.
Results Seven hundred and ninety participants provided a sexual well-being score for at least one time point. Thirty-seven per cent of men and 14% of women reported poor sexual well-being at 5 years. Baseline predictors for men at 24 months included having a stoma (OR 1.5, 95% CI 1.02 to 2.20) and high levels of depression (OR 2.69/2.01, 95% CI 1.68 to 4.32/1.12 to 3.61); men with high self-efficacy (OR confident 0.33/0.48, 95% CI 0.18 to 0.61/0.24 to 1.00; very confident 0.25/0.42, 95% CI 0.13 to 0.49/0.19 to 0.94) and social support (OR 0.52/0.56, 95% CI 0.33 to 0.81/0.35 to 0.91) were less likely to report poor sexual well-being. Predictors at 60 months included having a stoma (OR 2.30/2.67, 95% CI 1.22 to 4.34/1.11 to 6.40) and high levels of depression (OR 5.61/2.58, 95% CI 2.58 to 12.21/0.81 to 8.25); men with high self-efficacy (very confident 0.14, 95% CI 0.047 to 0.44), full social support (OR 0.26; 95% CI 0.13 to 0.53) and higher quality of life (OR 0.97, 95% CI 0.95 to 0.98) were less likely to report poor sexual well-being. It was not possible to construct models for women due to low numbers reporting poor sexual well-being.
Conclusions Several psychosocial variables were identified as predictors of poor sexual well-being among men. Interventions targeting low self-efficacy may be helpful. More research is needed to understand women’s sexual well-being.
- gastrointestinal tumours
- quality in health care
- health services administration & management
- oncology
- adult oncology
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Footnotes
Contributors CF is the overall project lead and grant holder with responsibility for the design and execution of the protocol. CF, AR, PWS, DF, JW, PWS and LC contributed to the design of the CREW study. LC and DF managed data collection. JW provided clinical expertise. JF, SW and NVP designed the data analysis plan. SW and NVP undertook data analysis. JF, NC, DW and SW drafted the paper. All authors read, commented on and approved the final manuscript.
Funding The ColoREctal Well-being study (CREW) was funded by Macmillan Cancer Support grant number 3546834.
Competing interests Deborah Fenlon has received an honorarium from Roche.
Patient consent for publication Not required.
Ethics approval The study was granted ethical approval by the UK National Health Service National Research Ethics Service (REC reference number: 10/H0605/31).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. Access to deidentified data can be requested at http://www.horizons-hub.org.uk/access_data.html
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