A new UBC-led study is shedding light on a long-overlooked consequence of colorectal cancer: the lasting toll it can take on women's sexual health, even years after treatment ends.
Researchers analyzed health data from more than 25,000 women in B.C. diagnosed with colorectal cancer between 1985 and 2017, comparing their experiences to those of cancer-free women. Cancer treatments such as surgery, chemotherapy and radiation were linked to a range of long-term sexual health issues, including a 67 per cent higher risk of dyspareunia-pain during sex-a condition that can cause severe distress and affect quality of life. For women diagnosed before age 40, the risk jumped to 90 per cent.
The study also revealed that survivors were more than three times as likely to experience pelvic inflammatory disease and nearly twice as likely to be diagnosed with endometriosis. Among younger women, the risk of premature ovarian failure-or early menopause-was 75 per cent higher than in their cancer-free counterparts.
The study, published in JNCI: Journal of National Cancer Institute , is one of the first to use population-level data to explore sexual health outcomes for colorectal cancer survivors.
"Sexual health is a fundamental part of quality of life, yet it's an area that needs much more emphasis in colorectal cancer survivorship care. What our study shows is that these issues aren't rare-they're common, significant, and often only diagnosed well after treatment has ended," said Dr. Mary De Vera, senior author and an associate professor in UBC's faculty of pharmaceutical sciences.
Dr. De Vera is herself a colorectal cancer survivor. "As someone who was diagnosed with colorectal cancer, I know how difficult it can be to deal with sexual health issues afterward. In my patient communities, I've seen how often these challenges are experienced-but with very little support. This study was inspired by those experiences and is an opportunity to use research to raise awareness and bring these issues into the open."
Rising rates for a common cancer
Colorectal cancer is one of the most common cancers in Canada, with around 10,500 new cases diagnosed in 2023. While often seen as a disease that affects older men, rates are rising among women and younger people.
Co-author Dr. Lori Brotto, a professor in UBC's faculty of medicine and an expert in women's sexual health, said the findings highlight a critical gap in care.
"Addressing sexual health in cancer care is still not standard of practice, and many healthcare providers attribute this to lack of training in the various ways that cancer can impact a patient's sexual health. These findings highlight the importance of all healthcare providers receiving some training in identifying sexual problems, and in being aware of evidence-based supports for survivors," said Dr. Brotto.
The authors say their findings point to an urgent need for better education, early interventions and more open conversations in cancer care settings. "Identifying and acknowledging these issues is the first step toward more comprehensive, compassionate care for women after cancer," said Dr. De Vera.
