Validation of Clinical Tools for Vaginal and Vulvar Symptom Assessment in Cancer Patients and Survivors

Abstract

IntroductionHealth care professionals can play a pivotal role in promoting vulvovaginal health through assessment and appropriate intervention. AimTo develop and validate brief clinical measurements to facilitate the identification of vulvovaginal symptoms in patients with and survivors of cancer. MethodsOne hundred seventy-five women survivors of cancer attending a Female Sexual Medicine and Women's Health Program from September 26, 2012 through October 31, 2014 completed the Vaginal Assessment Scale (VAS) and the Vulvar Assessment Scale (VuAS)—a modified version of the VAS that targets vulvar symptoms. Pelvic examination results were recorded using a clinical examination checklist. Main Outcome MeasuresInternal consistency of the two scales was assessed using Cronbach α, and the correlation between scales and other outcomes was reported. ResultsThe internal consistency measurements of the VAS and VuAS at the first visit were 0.70 and 0.68, which decreased to 0.53 and 0.66 at the last visit. The VAS composite and VuAS composite scores were moderately correlated with each other (0.42 and 0.45 at first and last visits, respectively). A strong correlation was observed between VAS pain with intercourse and Female Sexual Function Index (FSFI) pain with intercourse (−0.63 and −0.71 at the first and last visits, respectively). Worse pain with examination, worse functioning on the FSFI pain, lubrication, and total scores, and worse vulvar irritation were correlated with more severe symptoms on the VAS and VuAS. ConclusionThe VAS and VuAS are simple tools that can be used by clinicians to assess health concerns in women diagnosed with and treated for cancer. Validation is needed across diverse settings and groups of women.