Sexual quality of life one year after colorectal cancer surgery: differences by sex and ostomy status

Introduction: Colorectal cancer (CRC) and its treatments can significantly affect sexual quality of life, particularly in areas such as body image, sexual functioning, and sexual satisfaction. Factors such as sex and ostomy status may influence this experience, although their differential impact has not been fully established. The aim of this study was to analyze these differences in individuals with CRC. Methods: A cross-sectional study was conducted with 166 participants with non-metastatic CRC, evaluated one year after surgery. Sociodemographic and clinical variables were collected, including sex and ostomy status (with ostomy vs. without ostomy). Sexual quality of life was assessed using the Quality of Life Questionnaire-Colorectal 38-item (QLQ-CR38) questionnaire. Descriptive analyses and two-way factorial analyses of variance (ANOVA) were performed to examine differences between groups according to sex and ostomy status. Results: Women reported lower sexual functioning (mean = 12.3 vs. 36.2; p < 0.001) and sexual satisfaction (mean = 12.5 vs. 31.2; p = 0.001) than men. Participants without an ostomy reported better body image (mean = 92.8 vs. 72.8; p < 0.001) and greater sexual satisfaction (mean = 25.6 vs. 16.1; p = 0.036) than those with an ostomy. The interaction between sex and ostomy status was significant for sexual satisfaction (p = 0.011): the difference by ostomy status was observed among men but not among women. Men with an ostomy reported more sexual problems than men without an ostomy (p < 0.001). No significant difference was found among women, although this analysis included only 27 respondents. Conclusion: One year after colorectal cancer surgery, sex and ostomy status were associated with different aspects of sexual quality of life. These cross-sectional findings support assessing sexual concerns in both women and men, while the small female subgroup and possible clinical confounding warrant caution when interpreting differences by ostomy status.