Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review
Abstract
1. Introduction
2. Materials and Methods
2.1. Protocol and Registration
2.2. Literature Search Strategy and Study Selection
2.3. Eligibility Criteria and Data Extraction
3. Results
Authors (Year), Country | Aims | Study Design | Participants | Intervention | Duration | Measures |
---|---|---|---|---|---|---|
Reese et al. (2012) [34], USA | To collect preliminary data on the feasibility and efficacy of a telephone-based couples intimacy enhancement (IE) intervention protocol. | Pilot feasibility study | N = 9 couples (CRC patients and partners) Age: M = 61.6 (SD = 14.5) | Intimacy Enhancement Intervention | Four weekly 50 min telephone-based sessions | Utilization of skills Program evaluation ISS FSFI DSCS MSIS DAS-4 |
Outcomes | Program evaluation Considered “quite a bit” easy to participate in, overall helpful, and important for people with CRC for at least 83% of participants; 78% liked the telephone-based format; 72% reported it was “quite a bit” helpful in enhancing intimacy. Preliminary effect sizes CCR Patients: ≥0.80 for sexual distress, female sexual function, and sexual communication; between 0.30 and 0.60 for dyadic adjustment; between 0.20 and 0.30 for intimacy and male sexual function. Spouses: >0.80 for female sexual function; between 0.30 and 0.60 for remaining outcomes. Key Findings IE Intervention may be feasible and effective for CCR survivors and their spouses. | |||||
Reese et al. (2014) [36], USA | To assess the feasibility, acceptability, and preliminary efficacy of a telephone-based couples IE intervention protocol. | Randomized pilot trial | N = 23 couples (CRC patients and partners; IE group n = 10, control group n = 8) Age: M = 52.6 (SD = 10.6) | Intimacy Enhancement Intervention | Four weekly 50 min telephone-based sessions | ISS DSCS MSIS FSFI IIEF Medical impact subscale of SFQ Self-Efficacy |
Outcomes | Feasibility and acceptability Participation: 10 couples completed the full program. Program evaluation and skill utilization: overall favourable program evaluation; skills utilized by most participants during the past 2 weeks. Preliminary efficacy Effect sizes for CRC patients: large for female sexual function; medium to large for the reduction of medical impact on sexual function, self-efficacy, and male sexual function; no effect on sexual distress nor intimacy; negative for sexual communication and two self-efficacy items. Effect sizes for partners: large for sexual communication, male sexual function, and two self-efficacy items; medium to large for sexual distress; medium for medical impact on sexual function, intimacy, and one self-efficacy item. Key findings IE intervention may be feasible for improving CRC patients and partners’ physical and emotional intimacy. | |||||
DuHamel et al. (2016) [38], USA | To evaluate the efficacy of pilot, telephone-based Cancer Survivorship Intervention–Sexual Health (CSI-SH) | Randomized controlled trial | N = 70 female rectal or anal cancer survivors (n = 33 intervention; n = 37 usual care) RC = 69.6% | Cancer Survivorship Intervention–Sexual Health (CSI-SH) | Four individual, 1-h, in-person or telephone sessions. | FSFI IES-R BSI EORTC-QLQ-C30 |
Outcomes | Sexual Functioning and Psychological Distress Follow-up 1: improvement in all scores compared to baseline. Follow-up 2: equivalent results to follow-up 1. Intervention’s effect sizes Follow-up 1: medium range. Follow-up 2: QLQ-C30 emotional functioning and FSFI lubrication presented larger effect sizes at follow-up 2; remaining measures had smaller effect sizes than at follow-up 1. Linear regression Follow-up 1: significant treatment effects for IES total cancer-specific stress and QLQ-C30 emotional functioning, both improved. Follow-up 2: significant treatment effect for QLQ-C30 emotional functioning; higher IES total cancer-specific distress found for married participants. Key findings CSI-SH does not lead to significant improvements in sexual functioning. CSI-SH may lead to improvements in quality-of-life dimensions. CSI-SH is more beneficial for sexually active women and rectal and anal cancer survivors. | |||||
Brotto et al. (2017) [31], Canada | To assess the efficacy of an online adaptation of a face-to-face psychoeducational and mindfulness-based programme for sexual difficulties. | Quantitative: baseline, follow-up 1, and follow-up 2. No control group. Qualitative: Interviews. | Total N = 61 CCR N = 8 women, 15 men (the remaining sample has other types of cancer) | Psychoeducational Intervention for Sexual Health in Cancer Survivors (OPES) | 12 weekly topics, 60 min per topic | DAS BDI Qualitative interviews. |
Outcomes | Program Acceptability Duration: M = 29.9 weeks (SD = 19.4), range 8–111 weeks Informativeness: M = 3.62 (SD = 0.74), i.e., “moderately” and “very much”. Difficulty understanding information: M = 1.58 (SD = 0.79), i.e., “not at all” and “a little”. Sex-related distress Women: more destressed at baseline; significant decrease; further reduction at 6-month follow up. Men: no significant decrease. Sexual Functioning Women: significant improvement in all measured aspects. Men: significant improvement in intercourse satisfaction. Dyadic Adjustment Women: no significant change in consensus, satisfaction, nor cohesion. Men: significant decrease in consensus, no significant change in satisfaction nor cohesion. Mood Women: more depressive symptoms at baseline; significant decrease. Men: no significant decrease in depressive symptoms. Qualitative Interviews Opportunities for self-reflection, newfound sense of intimacy with partners, enjoyment of the online format, enjoyment of homework, and step-by-step instructions. Key findings Feasibility was found for an online mindfulness-based intervention for sexual concerns. Female and male cancer survivors may have different intervention needs. |
3.1. Intimacy Enhancement (IE) Intervention
3.2. Psychoeducational Intervention for Sexual Health in Cancer Survivors (OPES)
3.3. Cancer Survivorship Intervention–Sexual Health (CSI-SH)
3.4. Risk of Bias
4. Discussion
4.1. Study Limitations
4.2. Clinical Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Selection Bias | Study Design | Confounders | Blinding | Data Collection Method | Withdrawals and Dropouts | Global Rating | |
---|---|---|---|---|---|---|---|
Reese et al. (2012) [34] | Weak | Weak | Weak | Weak | Strong | Strong | Weak |
Reese et al. (2014) [36] | Weak | Strong | Strong | Weak | Strong | Weak | Weak |
DuHamel et al. (2016) [38] | Weak | Strong | Strong | Weak | Strong | Weak | Weak |
Brotto et al. (2017) [31] | Weak | Weak | Weak | Weak | Strong | Weak | Weak |
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Rocha, H.B.; Carneiro, B.C.; Vasconcelos, P.A.; Pereira, R.; Quinta-Gomes, A.L.; Nobre, P.J. Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review. Healthcare 2024, 12, 253. https://doi.org/10.3390/healthcare12020253
Rocha HB, Carneiro BC, Vasconcelos PA, Pereira R, Quinta-Gomes AL, Nobre PJ. Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review. Healthcare. 2024; 12(2):253. https://doi.org/10.3390/healthcare12020253
Chicago/Turabian StyleRocha, Hélia B., Bruna C. Carneiro, Priscila A. Vasconcelos, Raquel Pereira, Ana Luísa Quinta-Gomes, and Pedro J. Nobre. 2024. "Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review" Healthcare 12, no. 2: 253. https://doi.org/10.3390/healthcare12020253
APA StyleRocha, H. B., Carneiro, B. C., Vasconcelos, P. A., Pereira, R., Quinta-Gomes, A. L., & Nobre, P. J. (2024). Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review. Healthcare, 12(2), 253. https://doi.org/10.3390/healthcare12020253