Abstract Background Sexual dysfunction is a significant but underrecognized issue among survivors of head and neck cancer, stemming from both physical and psychological consequences of treatment. Despite high prevalence, discussions on sexuality remain infrequent in clinical settings. This systematic review and meta-analysis aimed to determine the pooled prevalence of long-term sexual dysfunction, identify key domains affected, and assess how often sexual health is addressed in survivorship care. Methods A systematic search was conducted across PubMed, Embase, Scopus, Google Scholar, IndMed, and medRxiv (1994–2024), using keywords related to "head and neck cancer" and "sexual dysfunction." Nineteen eligible studies with a combined total of 2739 patients were included. Data were extracted independently by two reviewers and cross-verified by a third. Meta-analysis was performed using a random-effects model. Subgroup analyses assessed specific dysfunction types and timing of evaluations post-treatment. Risk of bias was assessed and studies with ambiguous criteria were excluded. Results The pooled prevalence of negative impacts on sexuality was 51% (95% CI: 38%–64%). Issues with sexual desire were reported in 36% (95% CI: 31%–41%) and intercourse dysfunction in 50% (95% CI: 36%–64%) of patients. Only 24% of patients expressed sexual satisfaction one year after treatment. Alarmingly, 86% of participants reported that sexual health was not discussed during their clinical care. Barriers included stigma, lack of provider training, and role ambiguity. Conclusion Sexual dysfunction remains a prevalent and under addressed concern among head and neck cancer survivors. The findings underscore the urgent need for integrating sexual health assessment and rehabilitation into routine oncologic care. Standardized tools, open communication, and training for healthcare providers are critical to improving survivorship outcomes and enhancing quality of life.
Pavana et al. (Sun,) studied this question.