Sexual health outcomes after colorectal cancer diagnosis in females: a population-based cohort study

Abstract

Background Colorectal cancer (CRC) affects a growing number of females. Our objective was to evaluate the impact of CRC on sexual health outcomes among females, while controlling for age. Methods We conducted a cohort study using administrative health data from the province of British Columbia (BC) including linked health visits and cancer registry from 1985–2017. The cohort included females with CRC (n = 25,402; mean age (SD): 69.0 (13.1)) and matched controls without cancer (n = 254,020; 69.0 (13.1)) in a 1:10 ratio by age, further stratified by age groups (≤39 years and ≥40 years). Multivariable Cox regression models assessed the associations between CRC and five sexual health outcomes (dyspareunia, pelvic inflammatory disease, endometriosis, abnormal bleeding, and premature ovarian failure), adjusting for covariates. Sensitivity analyses focused on females with CRC to explore associations between sociodemographic and cancer-related factors and sexual health outcomes. Tests were 2-sided (statistical significance p-value < 0.05). Results Females with CRC had higher risks of dyspareunia (HR 1.67; 95% CI 1.62–1.73), pelvic inflammatory disease (HR 3.42; 95% CI: 3.07–3.81), and endometriosis (HR 1.95; 95% CI: 1.69 –2.25) compared to controls. In the ≥40-year group, these associations persisted, while in the ≤39-year group, endometriosis was not associated with CRC, but premature ovarian failure was (HR 1.75; 95% CI: 1.40–2.19). In sensitivity analyses, we also observed associations with cancer treatments (surgery, chemotherapy, radiation) and sexual health outcomes. Conclusions This population-based study identified associations between CRC and adverse sexual health outcomes among female patients, highlighting the need for targeted interventions and support.