Sexual dysfunction in women with cancer: a systematic review with meta-analysis of studies using the Female Sexual Function Index.

Abstract

Cancer may impair sexual function in women. We provide an overview of studies that address Female Sexual Dysfunction (FSD) in women with cancer with a meta-analysis of observational studies that used a validated diagnostic tool. Searches included MEDLINE, Scopus, and Google Scholar for studies published from January 2000 to 31 December 2014. Every included study had to involve at least 30 cancer patients, to investigate FSD based on the Female Sexual Function Index (FSFI), and to have been published in peer-review journals. Duplicate independent data extraction and quality assessment were performed. Data were pooled using a random effects model if statistical heterogeneity was present. The main outcomes were FSFI total score and FSD prevalence. FSFI is a 19-item self-report instrument for assessing key dimensions of female sexual function. A value less than 26.55 is consistent with FSD. Thirty-five studies met the inclusion criteria. Among these, 27 reported FSFI scores, and 16 FSD prevalence. Most studies (56%) had low to moderate quality. The mean value of FSFI was lower than 20 at all cancer sites: 16.25 (pooled random effect, 95% CI 14.91-17.58, I 2=14.5%) for colorectal cancer, 18.11 (95% CI 14.45-21.77, I 2=97.8%) for gynecological cancer, and 19.58 (95% CI 17.64-21.53, I 2=90.9%) for breast cancer. FSD prevalence was higher than 60% at all cancer sites, with the highest value for gynecological cancer (78.44%, 95% CI 68.36-88.52%, I 2=94.1%). Women with cancer showed low FSFI scores with a high prevalence of FSD.