A groundbreaking study led by researchers at the University of British Columbia has illuminated a largely overlooked consequence of colorectal cancer in women: the persistent and often debilitating impact on sexual health long after the conclusion of cancer treatment. This research, published in the JNCI: Journal of the National Cancer Institute, leverages an extensive population-based cohort to uncover patterns and risks that have, until now, remained largely hidden from clinical awareness and patient support frameworks.
Colorectal cancer, frequently associated with older males, is on a surprising rise among women and younger populations. This demographic shift has prompted scientists to probe deeper into the unique challenges faced by female survivors. The UBC-led team meticulously analyzed health records of more than 25,000 women in British Columbia diagnosed with colorectal cancer over a span of more than three decades, comparing their health trajectories to those of cancer-free women in the region. The results reveal profound and multifaceted sexual health ramifications attributable to cancer and its treatments.
The study highlights that interventions commonly employed in colorectal cancer care—such as surgical procedures, chemotherapy regimens, and radiation therapy—are correlated with significantly increased risks for a spectrum of sexual health complications. Most notably, the risk of dyspareunia, a condition characterized by painful intercourse, was found to be elevated by 67% in survivors. This statistic intensifies dramatically for women diagnosed before 40 years of age, among whom the risk surges to 90%. Dyspareunia not only causes physical discomfort but also exerts severe psychological distress, undermining intimacy, self-esteem, and overall quality of life.
Beyond pain during sexual activity, this cohort study also disclosed a tripling in the incidence of pelvic inflammatory disease among colorectal cancer survivors. This is an alarming revelation, as pelvic inflammatory disease can lead to chronic pelvic pain, infertility, and increased vulnerability to infections. Simultaneously, survivors were nearly twice as likely to be diagnosed with endometriosis compared to peers without cancer, a finding that suggests cancer or its treatments may alter pelvic tissue or immune responses in ways previously unappreciated by clinicians.
The reproductive health consequences extend further, particularly for younger women. Premature ovarian failure—clinically recognized as early menopause—was 75% more common among women who had faced colorectal cancer. This finding implicates cancer treatments in disrupting endocrine and ovarian functions, precipitating early cessation of menstruation and hormonal changes that can cascade into bone density loss, cardiovascular risks, and cognitive challenges, alongside diminished sexual function.
What sets this study apart is its utilization of population-level data, enabling the detection of trends and associations with a robustness and specificity that smaller clinical series cannot match. The longitudinal design allowed researchers to capture sexual health diagnoses occurring years after active cancer treatment, underscoring the chronic nature of these conditions and the critical window for survivorship care interventions long after the cancer itself is deemed cured.
Dr. Mary de Vera, senior author and assistant professor at UBC’s Faculty of Pharmaceutical Sciences, emphasized that sexual health is a vital component of holistic cancer survivorship—yet one that rarely receives adequate clinical attention. “These sexual health challenges are neither rare nor minor; they are common, significant, and often diagnosed only well after treatment concludes,” she asserted. Dr. de Vera, herself a colorectal cancer survivor, drew inspiration for this research from personal and community experiences highlighting the pervasive lack of support and open dialogue around these debilitating side effects.
Co-author Dr. Lori Brotto, an expert in women’s sexual health and professor in UBC’s Faculty of Medicine, pointed out that the healthcare system’s shortcomings often stem from insufficient training regarding the sexual sequelae of cancer. She noted that many healthcare providers remain unaware of how to recognize or manage sexual dysfunction in cancer survivors, which leads to underdiagnosis and undertreatment. Integrating specialized education and resources for clinicians could bridge this critical care gap.
The implications of these findings call for immediate changes in clinical practice. Oncologists, primary care physicians, gynecologists, and allied health professionals must prioritize conversations about sexual health starting at diagnosis and continuing throughout survivorship. Early screening for dyspareunia, pelvic inflammatory disease, endometriosis, and ovarian function could facilitate timely interventions, whether through medical treatment, physical therapy, psychological support, or counseling.
Moreover, this research underlines the necessity for developing targeted therapies and supportive care protocols specifically designed for female colorectal cancer survivors. Hormonal replacement therapies, pain management modalities, and psychosexual therapies may need to be tailored to the distinct pathophysiological changes these women endure. Importantly, fostering an environment where patients feel safe discussing sexual health could dismantle longstanding taboos and empower survivors to seek help.
From a research standpoint, these insights open new avenues for exploring the biological mechanisms driving sexual health disorders post-colorectal cancer. Immune dysfunction, neural damage, hormonal imbalances, and scar tissue formation within the pelvic region are potential contributors that warrant rigorous biomedical investigation. Such understanding could inform innovations in both preventative strategies and therapeutic interventions.
Public health messaging must also evolve to recognize and communicate the rising prevalence of colorectal cancer among women and younger adults and the nuanced survivorship issues they face. Broader awareness can spur advocacy for funding, support services, and educational programming geared not only towards cancer prevention and early detection, but also toward enhancing life quality after cancer.
In conclusion, this UBC-led research shines an essential light on the post-treatment sexual health burdens endured by women with colorectal cancer. By revealing these prolonged and profound challenges, the study calls for a paradigm shift in survivorship care—one that embraces sexual health as integral to recovery and quality of life. Addressing these concerns is not a peripheral luxury but a clinical imperative demanding the attention and resources of the entire healthcare community.
Subject of Research: People
Article Title: Sexual health outcomes after colorectal cancer diagnosis in females: a population-based cohort study
News Publication Date: 1-Jun-2025
Web References: 10.1093/jnci/djaf120
Image Credits: Justin Ohata/UBC Pharmaceutical Sciences
Keywords: Cancer, Colorectal cancer
