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Prevalence and predictors of poor sexual well-being over 5 years following treatment for colorectal cancer: results from the ColoREctal Wellbeing (CREW) prospective longitudinal study

Prevalence and predictors of poor sexual well-being over 5 years following treatment for colorectal cancer: results from the ColoREctal Wellbeing (CREW) prospective longitudinal study
Prevalence and predictors of poor sexual well-being over 5 years following treatment for colorectal cancer: results from the ColoREctal Wellbeing (CREW) prospective longitudinal study
Objectives To describe prevalence and predictors of poor sexual well-being for men and women over 5 years following treatment for colorectal cancer.

Design Prospective longitudinal study, from presurgery to 5 years postsurgery, with eight assessment points. Logistic regression models predicted sexual well-being from presurgery to 24 months and 24 months to 60 months; time-adjusted then fully adjusted models were constructed at each stage.

Setting Twenty-nine hospitals in the UK.

Participants Patients with Dukes’ stage A–C, treated with curative intent, aged ≥18 years and able to complete questionnaires were eligible.

Outcome measures The dependent variable was the Quality of Life in Adult Cancer Survivors sexual function score. Independent variables included sociodemographic, clinical and psychosocial characteristics.

Results Seven hundred and ninety participants provided a sexual well-being score for at least one time point. Thirty-seven per cent of men and 14% of women reported poor sexual well-being at 5 years. Baseline predictors for men at 24 months included having a stoma (OR 1.5, 95% CI 1.02 to 2.20) and high levels of depression (OR 2.69/2.01, 95% CI 1.68 to 4.32/1.12 to 3.61); men with high self-efficacy (OR confident 0.33/0.48, 95% CI 0.18 to 0.61/0.24 to 1.00; very confident 0.25/0.42, 95% CI 0.13 to 0.49/0.19 to 0.94) and social support (OR 0.52/0.56, 95% CI 0.33 to 0.81/0.35 to 0.91) were less likely to report poor sexual well-being. Predictors at 60 months included having a stoma (OR 2.30/2.67, 95% CI 1.22 to 4.34/1.11 to 6.40) and high levels of depression (OR 5.61/2.58, 95% CI 2.58 to 12.21/0.81 to 8.25); men with high self-efficacy (very confident 0.14, 95% CI 0.047 to 0.44), full social support (OR 0.26; 95% CI 0.13 to 0.53) and higher quality of life (OR 0.97, 95% CI 0.95 to 0.98) were less likely to report poor sexual well-being. It was not possible to construct models for women due to low numbers reporting poor sexual well-being.

Conclusions Several psychosocial variables were identified as predictors of poor sexual well-being among men. Interventions targeting low self-efficacy may be helpful. More research is needed to understand women’s sexual well-being.
2044-6055
Frankland, Jane
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Wheelwright, Sally
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Permyakova, Natalia V
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Wright, David
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Collaço, Nicole
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Calman, Lynn
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Winter, Jane
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Fenlon, Deborah
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Richardson, Alison
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Smith, Peter W
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Foster, Claire
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Frankland, Jane
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Wheelwright, Sally
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Permyakova, Natalia V
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Wright, David
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Collaço, Nicole
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Calman, Lynn
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Winter, Jane
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Fenlon, Deborah
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Richardson, Alison
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Smith, Peter W
961a01a3-bf4c-43ca-9599-5be4fd5d3940
Foster, Claire
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Frankland, Jane, Wheelwright, Sally, Permyakova, Natalia V, Wright, David, Collaço, Nicole, Calman, Lynn, Winter, Jane, Fenlon, Deborah, Richardson, Alison, Smith, Peter W and Foster, Claire (2020) Prevalence and predictors of poor sexual well-being over 5 years following treatment for colorectal cancer: results from the ColoREctal Wellbeing (CREW) prospective longitudinal study. BMJ Open, 10 (11), [e038953]. (doi:10.1136/bmjopen-2020-038953).

Record type: Article

Abstract

Objectives To describe prevalence and predictors of poor sexual well-being for men and women over 5 years following treatment for colorectal cancer.

Design Prospective longitudinal study, from presurgery to 5 years postsurgery, with eight assessment points. Logistic regression models predicted sexual well-being from presurgery to 24 months and 24 months to 60 months; time-adjusted then fully adjusted models were constructed at each stage.

Setting Twenty-nine hospitals in the UK.

Participants Patients with Dukes’ stage A–C, treated with curative intent, aged ≥18 years and able to complete questionnaires were eligible.

Outcome measures The dependent variable was the Quality of Life in Adult Cancer Survivors sexual function score. Independent variables included sociodemographic, clinical and psychosocial characteristics.

Results Seven hundred and ninety participants provided a sexual well-being score for at least one time point. Thirty-seven per cent of men and 14% of women reported poor sexual well-being at 5 years. Baseline predictors for men at 24 months included having a stoma (OR 1.5, 95% CI 1.02 to 2.20) and high levels of depression (OR 2.69/2.01, 95% CI 1.68 to 4.32/1.12 to 3.61); men with high self-efficacy (OR confident 0.33/0.48, 95% CI 0.18 to 0.61/0.24 to 1.00; very confident 0.25/0.42, 95% CI 0.13 to 0.49/0.19 to 0.94) and social support (OR 0.52/0.56, 95% CI 0.33 to 0.81/0.35 to 0.91) were less likely to report poor sexual well-being. Predictors at 60 months included having a stoma (OR 2.30/2.67, 95% CI 1.22 to 4.34/1.11 to 6.40) and high levels of depression (OR 5.61/2.58, 95% CI 2.58 to 12.21/0.81 to 8.25); men with high self-efficacy (very confident 0.14, 95% CI 0.047 to 0.44), full social support (OR 0.26; 95% CI 0.13 to 0.53) and higher quality of life (OR 0.97, 95% CI 0.95 to 0.98) were less likely to report poor sexual well-being. It was not possible to construct models for women due to low numbers reporting poor sexual well-being.

Conclusions Several psychosocial variables were identified as predictors of poor sexual well-being among men. Interventions targeting low self-efficacy may be helpful. More research is needed to understand women’s sexual well-being.

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Prevalence and predictors of poor sexual wellbeing over 5 years following treatment for colorectal cancer - Accepted Manuscript
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Accepted/In Press date: 9 October 2020
Published date: 12 November 2020

Identifiers

Local EPrints ID: 447264
URI: http://eprints.soton.ac.uk/id/eprint/447264
ISSN: 2044-6055
PURE UUID: 5b84af8e-e0e4-4d7a-8288-d717aabc04de
ORCID for Jane Frankland: ORCID iD orcid.org/0000-0002-3813-8879
ORCID for Sally Wheelwright: ORCID iD orcid.org/0000-0003-0657-2483
ORCID for Nicole Collaço: ORCID iD orcid.org/0000-0003-1398-9105
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Peter W Smith: ORCID iD orcid.org/0000-0003-4423-5410
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378

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Date deposited: 05 Mar 2021 17:35
Last modified: 28 Apr 2022 02:27

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Contributors

Author: Jane Frankland ORCID iD
Author: Natalia V Permyakova
Author: David Wright
Author: Nicole Collaço ORCID iD
Author: Lynn Calman ORCID iD
Author: Jane Winter
Author: Deborah Fenlon
Author: Peter W Smith ORCID iD
Author: Claire Foster ORCID iD

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