A study presented at ESMO Gynae 2026 underscores the prevalence of sexual health concerns among women with gynaecologic cancers receiving psycho-oncology care.
“[These concerns] are clinically significant … yet remain under-identified when relying on single structured screeners,” noted the investigators from Washington University School of Medicine, St Louis, Missouri, US.
“[There is] limited integration of psychosocial predictors with patient-reported explanations for sexual inactivity in gynaecologic oncology populations,” they added.
The investigators conducted a retrospective cross-sectional analysis of 132 women (mean age 55.1 years) with gynaecologic cancers evaluated in a psycho-oncology clinic. [ESMO Gynae 2026, abstract 200P]
The most common cancer type was ovarian cancer (n=51), followed by endometrial (n=33), cervical (n=25), and uterine cancer (n=13). There were low incidences of vaginal and vulvar cancers (n=3 and 2, respectively). Five women had multiple gynaecologic cancers.
Approximately three-quarters (74.2 percent) of the participants had surgery, 59.8 percent had chemotherapy, 22.7 percent had radiation, and 12.1 percent had hormone therapy. As per the National Comprehensive Cancer Network (NCCN) screening tool, 95.5 percent had anxiety/worry, and 77.3 percent had sadness/depression.
To characterize sexual activity and sexual health concerns, the investigators used self-reported responses to three validated screeners: NCCN Distress Problem List – Sexual Health Item, Functional Assessment of Cancer Therapy–General (FACT-G) – Satisfaction Item, and Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function Short Form (SF).
The prevalence of sexual health concerns varied by screening measure: 20 percent in the NCCN, 80 percent in the FACT-G, and 22 percent in the PROMIS Sexual Function SF.
When stratifying by NCCN sexual health concern, a majority of the women with sexual health concerns are those with ovarian, cervical, and uterine cancers (n=8, 6, and 4, respectively).
What were the concerns?
Thematic analysis of open-text responses from patients reporting sexual inactivity (n=30) identified multilevel reasons for sexual inactivity, including treatment-related factors, physical symptoms, and psychological factors.
According to the investigators, chemotherapy, surgery, and radiation were the most frequently cited barriers to sexual activity.
Other reasons pinpointed were body image and psychology, as well as relational and partner factors. “Changes in appearance and self-perception linked to cancer treatment contributed to avoidance [of sexual activity]. Partner absence, relationship strain, and communication barriers were also prominent,” they said.
Moreover, pain, dryness, bleeding, and changes in sexual response were cited as concerns. “Fear of pain or injury during sexual activity led to prolonged activity,” they added.
The investigators noted that the multilevel qualitative barriers spanned physical, psychological, relational, and fear-based domains and were not captured by single-item screens alone.
Close the knowledge gap
The screener discordance underscores the need for multi-domain validated assessment in routine workflows, they said. “The patient-reported barriers reflect intersecting physical, emotional, and relational drivers supporting a biopsychosocial framework for gynaecologic oncology.”
“[Hence,] systematic multi-domain sexual health screening alongside provider training and referral pathways is needed to close the identification gap in gynaecologic cancer care [and address sexual health concerns],” the investigators concluded.