To examine sexual health, including sexual satisfaction, and perceived changes in relationships and sexual relationships of human papillomavirus oropharyngeal cancer (HPV-OPC) survivors ≥12 months following (chemo)radiotherapy (CRT).
We undertook a cross-sectional study of HPV-OPC survivors who had completed treatment ≥12 months prior. Eligible patients completed the EORTC QLQ-SHQ22, a customised relationship questionnaire, the EORTC QLQ-C30, MDASI-HN and PROMIS Anxiety and Depression scales.
We enrolled 136 survivors (median age 61 [range 42-87], male 84%, currently partnered 72%). The median time from CRT completion was 2.8y (range 1.0-5.5y). Most patients (71/131; 60%) reported an active sex life as important, however, only 20% (26/133) reported significant recent sexual activity (“quite a bit”/”very much”). The mean sexual satisfaction score was 47/100 (IQR 27-67; SD 28). On univariable analysis, greater sexual satisfaction was positively associated with greater importance of sexual activity, stronger libido, greater relationship security and more erection confidence (males). Lower sexual satisfaction was significantly associated with female gender (p=0.04), more medical comorbidities (p=0.008) and more time since treatment completion (p=0.006). Only few patients reported a change in their marital status (10/136, 7%). The majority (62/109, 57%) of patients partnered at diagnosis reported no change in their pre-cancer relationship. Of those reporting a change, it was more frequently perceived as positive (29/109; 27%) than negative (16/109; 15%). Regarding their sexual relationship, 54/107 (50%) reported no change, 40/107 (37%) reported a negative change and 8/107 (7%) reported a positive change.
Although an active sex life is important to many HPV-OPC survivors, fewer reported significant recent sexual activity. Sexual satisfaction scores were moderate in this cohort. While subject to recall bias, most patients reported either no change or a positive change in their interpersonal relationship. Prospective studies evaluating sexual health outcomes and addressing informational needs in HPV-OPC survivors are needed.
Copyright © 2020. Published by Elsevier Inc.