To assess the impact of a screening tool, the Brief Sexual Symptom Checklist for Women, on referral rates to physiotherapists, sexual counselors, and psychologists for sexual issues among patients attending the practices of two gynecological oncologists.
A prospective observational cohort study. A retrospective cohort of consecutive patients matched for age, diagnosis, and stage was used as a control group.
Seventy-eight women were recruited to the intervention group. Diagnoses were endometrial carcinoma (38%), ovarian carcinoma (33%), and cervical carcinoma (24%). Sixty percent had completed adjuvant treatment, and 89% were married or in a de facto relationship. More than half of participants reported at least one sexual difficulty and were not satisfied with their sexual function. The most commonly reported sexual issue was decreased sexual desire. Twelve of 77 (15%) women screened in the intervention group were referred to a sexual counselor and/or a physiotherapist for a sexual issue. Twelve percent of women in the intervention group were referred to a sexual counselor, compared with 5% in the control group (p = 0.072). There was no difference in the proportion of women referred to a pelvic floor physiotherapist between the two groups (8% of women in the intervention group vs. 8% in the control group; p = 1.000).
In the current study, the Brief Sexual Symptom Checklist for Women identified sexual health concerns in over half of gynecological cancer survivors and resulted in a non-significant trend to more referrals for sexual counseling.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2012) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386
Lindau ST, Abramsohn EM, Matthews AC (2015) A manifesto on the preservation of sexual function in women and girls with cancer. Am J Obstet Gynecol 213(2):166–174
World Health Organization (2002) Defining sexual health: report of a technical consultation on sexual health, 28–31 January 2002, Geneva. https://www.who.int/reproductivehealth/publications/sexual_health/defining_sh/en. Accessed 1 Nov 2018
Abbott-Anderson K, Kwekkeboom KL (2012) A systematic review of sexual concerns reported by gynecological cancer survivors. Gynecol Oncol 124(3):477–489
Dizon DS, Suzin D, McIlvenna S (2014) Sexual health as a survivorship issue for female cancer survivors. Oncologist 19(2):202–210
Falk SJ, Dizon DS (2013) Sexual dysfunction in women with cancer. Fertil Steril 100(4):916–921
Krychman M, Millheiser LS (2013) Sexual health issues in women with cancer. J Sex Med 10(Suppl 1):5–15
Carr SV (2015) Psychosexual health in gynecological cancer. Int J Gynaecol Obstet 131(Suppl 2):S159–S163
Joly F, McAlpine J, Nout R, Åvall-Lundqvist E, Shash E, Friedlander M, Gynaecologic Cancer InterGroup (GCIG) (2014) Quality of life and patient-reported outcomes in endometrial cancer clinical trials: a call for action! Int J Gynecol Cancer 24(9):1693–1699
Huffman LB, Hartenbach EM, Carter J, Rash JK, Kushner DM (2015) Maintaining sexual health throughout gynecologic cancer survivorship: a comprehensive review and clinical guide. Gynecol Oncol S0090-8258(15):30182–30187
Zeng YC, Li Q, Li X, Loke AY (2012) Chinese women’s sexuality concerns after gynecologic cancer. Cancer Nurs 35(4):257–264
Grimm D, Hasenburg A, Eulenburg C, Steinsiek L, Mayer S, Eltrop S, Prieske K, Trillsch F, Mahner S, Woelber L (2015) Sexual activity and function in patients with gynecological malignancies after completed treatment. Int J Gynecol Cancer 25(6):1134–1141
Myers Virtue S, Manne SL, Ozga M, Kissane DW, Rubin S, Heckman C, Rosenblum N, Graff JJ (2014) Cancer-related concerns among women with a new diagnosis of gynecological cancer: an exploration of age group differences. Int J Gynecol Cancer 24(1):165–171
Janda M, Obermair A, Cella D, Crandon AJ, Trimmel M (2004) Vulvar cancer patients’ quality of life: a qualitative assessment. Int J Gynecol Cancer 14(5):875–881
Mirabeau-Beale KL, Kornblith AB, Penson RT, Lee H, Goodman A, Campos SM, Duska L, Pereira L, Bryan J, Matulonis UA (2009) Comparison of the quality of life of early and advanced stage ovarian cancer survivors. Gynecol Oncol 114(2):353–359
de Groot JM, Mah K, Fyles A, Winton S, Greenwood S, DePetrillo D, Devins GM (2007) Do single and partnered women with gynecologic cancer differ in types and intensities of illness- and treatment-related psychosocial concerns? A pilot study. J Psychosom Res 63(3):241–245
Shankar A, Prasad N, Roy S, Chakraborty A, Sharma Biswas A, Patil J, Kishort Rath G (2017) Sexual dysfunction in females after cancer treatment: an unresolved issue. Asian Pac J Cancer Prev 18(5):1177–1182
Mercadante S, Vitrano V, Catania V (2010) Sexual issues in early and late stage cancer: a review. Support Care Cancer 18(6):659–665
Aerts L, Enzlin P, Vergote I, Verhaeghe J, Poppe W, Amant F (2012) Sexual, psychological, and relational functioning in women after surgical treatment for vulvar malignancy: a literature review. J Sex Med 9(2):361–371
Jeppesen MM, Mogensen O, Dehn P, Jensen PT (2015) Needs and priorities of women with endometrial and cervical cancer. J Psychosom Obstet Gynaecol 36(3):122–132
Trivers KF, Patterson JR, Roland KB, Rodriguez JL (2013) Issues of ovarian cancer survivors in the USA: a literature review. Support Care Cancer 21(10):2889–2898
Carter J, Sonoda Y, Baser RE, Raviv L, Chi DS, Barakat RR, Iasonos A, Brown CL, Abu-Rustum NR (2010) A 2-year prospective study assessing the emotional, sexual, and quality of life concerns of women undergoing radical trachelectomy versus radical hysterectomy for treatment of early-stage cervical cancer. Gynecol Oncol 119(2):358–365
Hazewinkel MH, Laan ET, Sprangers MA, Fons G, Burger MP, Roovers JP (2012) Long-term sexual function in survivors of vulvar cancer: a cross-sectional study. Gynecol Oncol 126(1):87–92
Forner DM, Dakhil R, Lampe B (2015) Quality of life and sexual function after surgery in early stage vulvar cancer. Eur J Surg Oncol 41(1):40–45
Hayslett RL, Nykamp D (2015) Sexual dysfunction in women. US Pharmacist 40(9):4649
Carter J, Auchincloss S, Sonoda Y, Krychman M (2003) Cervical cancer: issues of sexuality and fertility. Oncology (Williston Park) 17(9):1229–1234 discussion 1234-6, 1239, 1242
Barbera L, Zwaal C, Elterman D, McPherson K, Wolfman W, Katz A, Matthew A, the Interventions to Address Sexual Problems in People with Cancer Guideline Development Group (2017) Interventions to address sexual problems in people with cancer. Curr Oncol 24(3):192–200
Sears CS, Robinson JW, Walker LM (2017) A comprehensive review of sexual health concerns after cancer treatment and the biopsychosocial treatment options available to female patients. Eur J Cancer Care e12738
Schapira L, Dizon DS (2015) Sex after cancer: the unaddressed issue. Medscape https://www.medscape.com/viewarticle/849944. Accessed 30 Nov 2018
Nishimoto P, Starr U (2015) Supporting the couple with female dyspareunia. Clin J Oncol Nurs 19(4):390–392
Ofman U (2004) “...And how are things sexually?” helping patients adjust to sexual changes before, during, and after cancer treatment. Support Cancer Ther 1(4):243–247
Barlow EL, Hacker NF, Hussain R, Parmenter G (2014) Sexuality and body image following treatment for early-stage vulvar cancer: a qualitative study. J Adv Nurs 70(8):1856–1866
Hatzichristou D, Rosen RC, Derogatis LR, Low WY, Meuleman EJ, Sadovsky R, Symonds T (2010) Recommendations for the clinical evaluation of men and women with sexual dysfunction. J Sex Med 7(1 Pt 2):337–348
Stabile C, Goldfarb S, Baser RE, Goldfrank DJ, Abu-Rustum NR, Barakat RR, Dickler MN, Carter J (2017) Sexual health needs and educational intervention preferences for women with cancer. Breast Cancer Res Treat 165(1):77–84
Whicker M, Black J, Altwerger G, Menderes G, Feinberg J, Ratner E (2017) Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer. Am J Obstet Gynecol 217(4):395–403
Marino JL, Saunders CM, Emery LI, Green H, Doherty DA, Hickey M (2016) How does adjuvant chemotherapy affect menopausal symptoms, sexual function, and quality of life after breast cancer? Menopause. 23(9):1000–1008
Farthmann J, Hanjalic-Beck A, Veit J, Rautenberg B, Stickeler E, Erbes T, Foldi M, Hasenburg A (2016) The impact of chemotherapy for breast cancer on sexual function and health-related quality of life. Support Care Cancer 24(6):2603–2609
Eaton L, Kueck A, Maksut J, Gordon L, Metersky K, Miga A, Brewer M, Siembida E, Bradley A (2017) Sexual health, mental health, and beliefs about cancer treatments among women attending a gynecologic oncology clinic. Sex Med 5(3):e175–e183
The authors would like to acknowledge the help of Stephanie Jeffares, Research Officer, St John of God Subiaco Hospital, and our sincere thanks to all the patients who participated in the study.
Ethical approval for the study was granted by the St John of God Healthcare Human Research Ethics Committee (Reference 942) and informed consent was obtained from all participants.
Conflict of interest
The authors declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendix. Brief Sexual Symptom Checklist for Women (BSSC-W)
Appendix. Brief Sexual Symptom Checklist for Women (BSSC-W)
About this article
Cite this article
Roberts, K., Chong, T., Hollands, E. et al. Screening for sexual health concerns in survivors of gynecological cancer. Support Care Cancer 28, 599–605 (2020). https://doi.org/10.1007/s00520-019-04872-4
- Gynecological cancer
- Sexual function
- Brief Sexual Symptom Checklist
- Supportive care
- Screening for sexual issues