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2022-RA-1614-ESGO Impact of various cervical cancer treatments on sexual functioning and quality of life of women: a systematic review and meta-analysis
  1. Nicoleta Monica Jiboc1,
  2. Andrei Pasca2,3,
  3. Diana Taut1,
  4. Eduard-Alexandru Bonci2,
  5. Patriciu Andrei Achimas-Cadariu2,3 and
  6. Adriana Smaranda Baban1
  1. 1Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
  2. 2Surgical Oncology and Gynecologic Oncology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca, Romania
  3. 3Surgical Oncology, ‘Prof. Dr. Ion Chiricuta’ Institute of Oncology, Cluj-Napoca, Romania


Introduction/Background Despite the comprehensive implementation of screening strategies and vaccination programs against HPV, Cervical Cancer (CC) remains a significant health problem. Various treatments ranging from fertility sparring to combinatory regimes for both early and advanced disease produce significant distress regarding sexuality, body image and sexual functioning of these patients while potentially influencing their decision. More advanced stages impose more radical and aggressive treatments, while early stages raise controversy surrounding their treatment extent and possibilities of fertility preservation. This review and meta-analysis aimed to evaluate the impact of CC treatments on sexual functioning and quality of life in women.

Methodology A predefined search formula was used to scout the most popular English databases from inception to the 25th of May and rendered 22031 studies. After exclusion of duplicates and irrelevant studies using PICO formulated inclusion criteria. These full-text articles evaluated the sexual functioning and quality of life of patients undergoing CC treatments and were finally included.

Results High heterogeneity regarding assessment scales were observed between studies. Female Sexual Function Index (FSFI), Short Form Survey (SF-36), Hospital Anxiety and Depression Scale (HADS) and EORTC QLQ-C30 and -CX24 were among the most popular questionnaires. The scales, as mentioned earlier, identified sexuality, body image, sexual worry, pain, arousal, day-to-day limitations and emotional problems as the most common issues among specific CC treatments. Combinable data allowed for a meta-analysis to compare the EORTC QLQ-C30 scoring in patients undergoing surgery alone vs chemoradiation regimens. A mean difference (MD) of 2.55 (CI:-1.27;6.38) was found between the two groups with no statistical significance (p=0.07) at a z=1.31.

Conclusion All treatments produce general and sexual distress in CC patients. Multiple scales identified several problems for specific treatments, while more complex analyses showed no difference between surgery alone and chemoradiation therapies.

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