Sexual health problems in French cancer survivors 2 years after diagnosis-the national VICAN survey

Abstract

Purpose: The purpose of this study is to assess French cancer survivors' sexual health 2 years after diagnosis.

Methods: Using the French National Health Insurance System database, the representative national VICAN survey was created comprising 4349 adults (12 cancer sites), still alive 2 years after diagnosis and aged 18-52 ("younger") or 53-82 ("older"). Sexual health was evaluated using six items from the Relationship and Sexuality Scale, and an overall indicator was created.

Results: Among the study's 1955 sexually active participants, 18.6 % (versus 13.1 %), 39.8 % (versus 39.9 %) and 29.4 % (versus 29.8 %) of men (versus women) were affected, respectively, by "strong", "moderate" and "weak" sexual health deterioration, while 12.2 % (versus 17.1 %) were spared sexual problems (P = 0.001). Strong deterioration more often concerned older men with prostate (27.7 %) and lung (26.1 %) cancers, younger men with upper aero-digestive tract cancers (25.2 %) and women (younger/older) with cervical cancer (24.2 %). Substantial (strong/moderate) sexual health deterioration was observed for all cancer sites, rates ranging from 68.3 % (prostate) to 37.2 % (melanoma). In all four gender/age subgroups, increasing age predicted poorer sexual health, although statistical significance was not reached in older women. Apart from genital cancer, perceived consequences, such as general sequelae and fatigue, were the primary factors associated with severe sexual problems.

Conclusions: Two years after diagnosis, the majority of sexually active French cancer survivors reported impaired sexual health. Younger and older men and women with cancer in non-reproductive sites also reported problems.

Implications for cancer survivors: Interventions aimed at improving sexual health irrespective of age and cancer site should be developed.

Keywords: French cancer survivors; Sexual health problems; Sexually active; VICAN.