title: The prevalence of erectile dysfunction in post-treatment colorectal cancer patients and their interests in seeking treatment: a cross-sectional survey in the west-midlands.
abstract: BACKGROUND
  Erectile dysfunction (ED) is a recognized complication of colorectal cancer treatment, particularly if surgery is below the recto-sigmoid junction (RSJ), and is an important quality-of-life issue. Previous studies have generated inconsistent prevalence estimates.
  
  
  OBJECTIVE
  We aimed to establish the prevalence of ED in postsurgery colorectal cancer patients and to establish what proportion wished to seek treatment.
  
  
  METHODS
  Questionnaire: sociodemographics, treatment methods, International Index of Erectile Function (IIEF)-5 questionnaire (validated tool to assess erectile function): score of <21 being used to define ED.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  adult male colorectal cancer patients diagnosed in 2000-2007, treated with curative intent in one teaching hospital.
  
  
  METHODS
  logistic regression analysis to determine predictors of ED.
  
  
  RESULTS
  The response rate was 46% (229/499). Respondents were aged 28 to 95 years; the majority were white (93.9%), more than half (57.1%) were in a sexual relationship, only a third reported having sex in the past 6 months (33.3%). The vast majority (75.1%; 172/229) of responders had ED as defined by the IIEF-5. ED was significantly associated with increasing age (P < 0.0005), having a malignancy below the RSJ (P = 0.002), having previous radiotherapy (P = 0.007), and having a stoma (P = 0.014). Those with ED were less likely to be in a sexual relationship (P = 0.002) and less likely to have had sex in the last 6 months (P < 0.0005). Only 29% of those with ED were not interested in treatment for their condition.
  
  
  CONCLUSIONS
  These data suggest a prevalence rate of ED of 75% in colorectal cancer survivors; this may be functional or psychological in origin. Quality of life may be improved if follow-up clinics for cancer survivors not only concentrated on the detection of recurrence but also offered assessment of erectile function and referral for patients who desire treatment.
authors.affiliation: School of Medicine, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Ellis
authors.forename: Anthony
authors.initials: A
authors.lastname: Smith
authors.forename: Sue
authors.initials: S
authors.lastname: Wilson
authors.forename: Sally
authors.initials: S
authors.lastname: Warmington
authors.forename: Tariq
authors.initials: T
authors.lastname: Ismail
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery*; D003125:Colostomy / Q000523:psychology / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004739:England; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires