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Breast cancer survivorship and sexual dysfunction: a population-based cohort study

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Background

Breast cancer is the most common non-skin cancer in women and an increasing number of people are living as breast cancer survivors. While the prognosis of breast cancer continues to improve, the rates of sexual dysfunction and the risk related to cancer treatments have not been well characterized in a population-based study.

Methods

We identified a cohort of 19,709 breast cancer survivors diagnosed between 1997 and 2017 from the Utah Cancer Registry, and 93,389 cancer-free women who were matched by age and birth state from the Utah Population Database. Sexual dysfunction diagnoses were identified through ICD-9 and ICD-10 codes from electronic medical records and statewide healthcare facilities data. Cox proportional hazard models were used to estimate hazard ratios for risk of sexual dysfunction.

Results

Breast cancer survivors were at higher risk of sexual dysfunction diagnosis (9.1% versus 6.9%, HR 1.60, 95% CI 1.51–1.70) compared to the general population. This risk increased 2.05-fold within 1 to 5 years after cancer diagnosis (95% CI 1.89–2.22) and 3.05-fold in individuals diagnosed with cancer at < 50 years of age (95% CI 2.65–3.51). Cancer treatments including endocrine therapy, chemotherapy and radiation therapy were associated with an increased risk of sexual dysfunction among breast cancer survivors.

Conclusions

Risk of sexual dysfunction in breast cancer survivors is higher than in the general population, but may be underdiagnosed in the clinical setting. Health care professionals should be encouraged to address the topic of sexual health early on in the treatment of breast cancer, and routinely screen patients for symptoms of sexual dysfunction.

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Data availability

The data that support the findings of this study are available upon request with appropriate approval from the Resource for Genetic and Epidemiologic Research (RGE) and IRB approval. The data are not publicly available due to privacy or ethical restrictions.

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Funding

This work was supported by grants from the NIH (R21 CA185811, R03 CA159357, M.Hashibe, PI), the Huntsman Cancer Institute, and the Cancer Control and Population Sciences Program (HCI Cancer Center Support Grant P30CA042014). This research was supported by the Utah Cancer Registry, which is funded by the National Cancer Institute's SEER Program, Contract No. HHSN261201800016I, the US Center for Disease Control and Prevention's National Program of Cancer Registries, Cooperative Agreement No. NU58DP007131, with additional support from the University of Utah and Huntsman Cancer Foundation. Research was supported by the NCRR grant, “Sharing Statewide Health Data for Genetic Research” (R01 RR021746, G. Mineau, PI) with additional support from the Utah Department of Health and Human Services and the University of Utah. Partial support for all datasets within the Utah Population Database is provided by the University of Utah, Huntsman Cancer Institute and the Huntsman Cancer Institute Cancer Center Support grant, P30 CA2014 from the National Cancer Institute, and Intermountain Healthcare. We thank the Utah Clinical and Translational Science Institute (CTSI) (funded by NIH Clinical and Translational Science Awards), the Pedigree and Population Resource, University of Utah Information Technology Services and Biomedical Informatics Core for establishing the Master Subject Index between the Utah Population Database and the University of Utah Health Sciences Center. The computational resources used were partially funded by the NIH Shared Instrumentation Grant 1S10OD021644-01A1.

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Author notes

  1. Chun-Pin Chang and Tiffany F. Ho have contributed equally to this work.

Authors and Affiliations

  1. Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    Chun-Pin Chang, Tiffany F. Ho & Mia Hashibe

  2. Huntsman Cancer Institute, Salt Lake City, UT, USA

    Chun-Pin Chang & Mia Hashibe

  3. Intermountain Healthcare, Salt Lake City, UT, USA

    John Snyder & Mark Dodson

  4. Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Mark Dodson

  5. University of Utah Health Sciences Center, Salt Lake City, UT, USA

    Vikrant Deshmukh & Michael Newman

  6. Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA

    Ankita Date

  7. Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI, USA

    N. Lynn Henry

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  1. Chun-Pin Chang
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Contributions

Conceptualization: CC, TH. Formal Analysis: CC. Funding Acquisition: MH. Investigation: CC, TH, MH. Methodology: CC, TH, MH. Writing (original draft): CC, TH, MH. Writing (review and editing): CC, TH, JS, MD, VD, MN, AD, NLH, MH.

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Correspondence to Mia Hashibe.

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Chang, CP., Ho, T.F., Snyder, J. et al. Breast cancer survivorship and sexual dysfunction: a population-based cohort study. Breast Cancer Res Treat 200, 103–113 (2023). https://doi.org/10.1007/s10549-023-06953-9

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