title: Higher prevalence of sexual dysfunction in colon and rectal cancer survivors compared with the normative population: a population-based study.
abstract: BACKGROUND
  To compare colorectal cancer survivors with a normative population regarding erectile dysfunction, ejaculation problems, dyspareunia, dry vagina, sexual functioning (SF) and enjoyment (SE). In addition, the sociodemographic, clinical and psychological correlates of (dys)function in survivors are examined.
  
  
  METHODS
  The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-CR38 sexuality subscales were completed by survivors (n=1371; response rate 82%), of which 1359 received surgical treatment and were included in the analysis. The normative population consisted of 400 participants (response rate 78%).
  
  
  RESULTS
  Erectile problems were more often present in rectal cancer (54%) than colon cancer survivors (25%) and the normative population (27%; p<.0001). They also had more ejaculation problems (68%) than colon cancer survivors (47%; p<.001). Dry vagina was common in colon (28%) and rectal cancer survivors (35%), while the normative population scored lower (5%; p=.003). In addition, colon (9%) and rectal cancer survivors (30%) experienced more pain during intercourse than the normative population (0%; p=.001). SE for men was similar across groups, while women with colorectal cancer reported lower scores than the normative population. Higher age, being a woman, not having a partner, a low educational level, rectal cancer, depressive symptoms and fatigue were associated with lower SF. Lower SE was associated with higher age and being a woman, depressive symptoms and cardiovascular disease.
  
  
  CONCLUSIONS
  SF was deteriorated in both sexes after cancer, which affected women's SE negatively. Attention towards sexual (dys)function in colorectal cancer survivors is needed.
authors.affiliation: Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, The Netherlands. b.l.denoudsten@uvt.nl
authors.forename: B L
authors.initials: BL
authors.lastname: Den Oudsten
authors.forename: M J
authors.initials: MJ
authors.lastname: Traa
authors.forename: M S Y
authors.initials: MS
authors.lastname: Thong
authors.forename: H
authors.initials: H
authors.lastname: Martijn
authors.forename: I H J T
authors.initials: IH
authors.lastname: De Hingh
authors.forename: K
authors.initials: K
authors.lastname: Bosscha
authors.forename: L V
authors.initials: LV
authors.lastname: van de Poll-Franse
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012004:Rectal Neoplasms / Q000150:complications; D020018:Sexual Dysfunctions, Psychological / Q000150:complications / Q000453:epidemiology*; D017741:Survivors / Q000706:statistics & numerical data*