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Assessment of sexual difficulties associated with multi-modal treatment for cervical or endometrial cancer: A systematic review of measurement instruments

White, I. D., Sangha, A., Lucas, G. ORCID: 0000-0001-5941-5233 & Wiseman, T. (2016). Assessment of sexual difficulties associated with multi-modal treatment for cervical or endometrial cancer: A systematic review of measurement instruments. Gynecologic Oncology, 143(3), pp. 664-673. doi: 10.1016/j.ygyno.2016.08.332


Background: Practitioners and researchers require an outcome measure that accurately identifies the range of common treatment-induced changes in sexual function and well-being experienced by women after cervical or endometrial cancer. This systematic review critically appraised the measurement properties and clinical utility of instruments validated for the measurement of female sexual dysfunction (FSD) in this clinical population.

Methods: A bibliographic database search for questionnaire development or validation papers was completed and methodological quality and measurement properties of selected studies rated using the Consensus-based Standards for the selection of health Measurement Instrument (COSMIN) checklist.

Results: 738 articles were screened, 13 articles retrieved for full text assessment and 7 studies excluded, resulting in evaluation of 6 papers; 2 QoL and 4 female sexual morbidity measures.
Five of the six instruments omitted one or more dimension of female sexual function and only one instrument explicitly measured distress associated with sexual changes as per DSM V (APA 2013) diagnostic criteria.
None of the papers reported measurement error, responsiveness data was available for only two instruments, three papers failed to report on criterion validity, and test-retest reliability reporting was inconsistent. Heterosexual penile-vaginal intercourse remains the dominant sexual activity focus for sexual morbidity PROMS terminology and instruments lack explicit reference to solo or non-coital sexual expression or validation in a non-heterosexual sample. Four out of six instruments included mediating treatment or illness items such as vaginal changes, menopause or altered body image.

Conclusions: Findings suggest that the Female Sexual Function Index (FSFI) remains the most robust sexual morbidity outcome measure, for research or clinical use, in sexually active women treated for cervical or endometrial cancer.

Publication Type: Article
Additional Information: © 2016 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Publisher Keywords: Female sexual morbidity, Cervical cancer, Endometrial cancer, Patient reported outcome measures, Clinical assessment, Measurement properties
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RG Gynecology and obstetrics
Departments: School of Health & Psychological Sciences > Nursing
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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