(029) The Association Between Cancer Treatment and Sexual Health in Danish Cancer Survivors Treated with Curative Intent

Introduction Cancer treatments, including surgery, chemotherapy, radiation, and endocrine therapy, all have the potential to significantly impair sexual health (SH) either directly or indirectly through symptoms occurring during or following primary treatment. Objective We examined associations between cancer treatment modalities and SH among Danish cancer survivors of breast, prostate, melanoma, colon, rectum, lymphoma, and lung cancer, who received treatment with curative intent. Methods We used data from a nationwide, population-based Danish questionnaire study concerning late-effects among adult cancer survivors 2-12 years following diagnosis. From the questionnaire we obtained information on lifestyle and SH measured with the Quality of Life Sexual Health Questionnaire (QLQ-SH22) developed by the European Organization of Research and Treatment of Cancer (EORTC). Information on received cancer treatment, disease stage, education, income, cohabitation, and comorbidity was obtained from Danish registries. We used multiple logistic regression models adjusted for age, time since diagnosis, sex, education, income, cohabitation, comorbidity, disease stage, body mass index, smoking, and alcohol consumption, to examine the associations between different cancer treatment modalities and SH for each of the included cancer types. Results Among 22,290 cancer survivors, we found that cancer treatments were associated with impaired SH across all cancer types, except for lung cancer. Notably, more intensive treatments were associated with impaired sexual health across most of the measured SH outcomes. This was seen for chemotherapy (vs. no chemotherapy) and endocrine therapy (vs. no endocrine therapy) in survivors of breast cancer, radical prostatectomy alone or combined with endocrine therapy, and/or salvage radiation (vs. active surveillance) in survivors of prostate cancer, and combined surgery, chemotherapy and radiation (vs. surgery only) in survivors of rectum cancer. The highest odds ratios (OR) were found among survivors of prostate cancer generally, e.g. in self-reported effect of treatment on sexual activity, with ORs ranging from 1.41 (95% confidence interval (CI): 1.08-1.83) for survivors who had radiation therapy (vs. active surveillance) to 7.65 (95% CI: 5.04-11.93) for survivors who had combined radical prostatectomy, endocrine therapy and/or salvage radiation therapy (vs. active surveillance). Among female survivors of colorectal cancer with a permanent stoma (vs. no stoma) the ORs of feeling less feminine, were 9.68 (95% CI: 3.19-27.6) and 4.17 (95% CI: 2.18-8.07) for colon and rectum cancer, respectively. Conclusions Except from survivors of lung cancer, we found that treatment modalities were associated with impaired sexual health across all the included cancer types, with the highest odds ratios in survivors who received intensified or combined treatments. Disclosure No