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Association of sexual attitudes with sexual dysfunction and sexual distress among Chinese breast cancer survivors: a cross-sectional study

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Abstract

Purpose

Little is known about sexual dysfunction and sexual distress in Chinese female breast cancer survivors (BCSs), and their associations with physical variables, psychological factors, body image, and sexual attitudes.

Methods

A cross-sectional study of 341 BCSs was performed with the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R). Associations between physical variables, psychological factors, body image, sexual attitudes, sexual dysfunction, and sexual distress were evaluated using logistic regression, adjusted for confounding factors.

Results

We found that 75.37% and 18.48% of BCSs reported sexual dysfunction and sexual distress during the past month, respectively. Attitudes toward sexual behavior such as “sexual activity may impede disease recovery,” “sexual activity may cause cancer recurrence or metastasis,” and “sexual activity may weaken treatment effects” were significantly associated with an increased likelihood of reporting sexual dysfunction and sexual distress. Body image disruption such as “felt physically less attractive as a result of your disease or treatment” was significantly associated with the experience of sexual distress.

Conclusion

Sexual dysfunction and sexual distress are common issues in Chinese BCSs. Sexual misconception likely contributes to sexual dysfunction and sexual distress, and body image has a significantly negative association with sexual distress in BCSs. Interventions targeting sexual attitudes and body image might be important to address BCSs’ sexual issues and improve their overall sexual health.

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Acknowledgements

Shanghai Cancer Rehabilitation Club provides invaluable resources for field investigations. We are grateful to all the involved cancer survivors who participated in this study. We also thank all workers and volunteers involved in the acquisition of the data.

Funding

This research was funded by the Special Scientific Research Project of the China Health Education Center (grant number ZJKY-2022-002), the China Postdoctoral Science Foundation (grant number 2021M702936), and the Joint Project of Medical Science and Technology of Henan Province (grant number LHGJ20220428).

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Authors and Affiliations

  1. Big Data Center of Clinical Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China

    Rui Yan

  2. Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China

    Jiwei Wang & **ming Yu

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  1. Rui Yan
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Contributions

Rui Yan conceived the project, designed of the study, collected and analyzed the data, and prepared the manuscript. Rui Yan and Jiwei Wang contributed to data collection and manuscript development. Jiwei Wang and **ming Yu conceived the project and contributed to the manuscript development. All authors have reviewed and approved the final manuscript.

Corresponding author

Correspondence to Rui Yan.

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Ethics approval and consent to participate

This study was approved by the Medical Research Ethics Committee of the School of Public Health, Fudan University (international registry nos. IRB00002408 and FWA00002399). Written informed consent was obtained from all the individual participants included in the study.

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The authors declare no competing interests.

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Table S1: Baseline characteristics between participants included and excluded (DOCX 15 kb)

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Yan, R., Wang, J. & Yu, J. Association of sexual attitudes with sexual dysfunction and sexual distress among Chinese breast cancer survivors: a cross-sectional study. Support Care Cancer 31, 154 (2023). https://doi.org/10.1007/s00520-023-07600-1

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