Sexual health in long-term breast cancer survivors: a comparison with female population controls from the HUNT study

Abstract

Purpose: Sexual health is an important aspect of quality of life. Knowledge concerning sexual health in long-term breast cancer survivors (BCSs) is limited. This study compared sexual health in BCSs 8 years after diagnosis with similarly aged controls and examined the impact of menopausal status at diagnosis and systemic breast cancer treatments on sexual health. Methods: Women aged 20–65 years when diagnosed with stage I–III breast cancer in 2011–2012 were identified by the Cancer Registry of Norway (n = 2803) and invited to participate in a nationwide survey. Controls were women from the Trøndelag Health Study (HUNT4). Sexual functioning and sexual enjoyment were measured by the EORTC QLQ-BR23 subscales scored from 0 to 100, and sexual discomfort by the Sexual Activity Questionnaire scored from 0 to 6. Linear regression analyses with adjustments for sociodemographic and health-related variables were performed to compare groups. Differences of ≥ 10% of range score were considered clinically significant. Results: The study samples consisted of 1241 BCSs and 17,751 controls. Sexual enjoyment was poorer (B − 13.1, 95%CI − 15.0, − 11.2) and discomfort higher (B 0.9, 95%CI 0.8, 1.0) among BCSs compared to controls, and larger differences were evident between premenopausal BCSs and controls (B − 17.3, 95%CI − 19.6, − 14.9 and B 1.2, 95%CI 1.0, 1.3, respectively). BCSs treated with both endocrine- and chemotherapy had lower sexual functioning (B − 11.9, 95%CI − 13.8, − 10.1), poorer sexual enjoyment (B − 18.1, 95%CI − 20.7, − 15.5), and more sexual discomfort (B 1.4, 95% 1.3, 1.6) than controls. Conclusion: Sexual health impairments are more common in BCSs 8 years after diagnosis compared to similar aged population controls. During follow-up, attention to such impairments, especially among women diagnosed at premenopausal age and treated with heavy systemic treatment, is warranted.