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The Rectal Cancer Female Sexuality Score

Development and Validation of a Scoring System for Female Sexual Function After Rectal Cancer Surgery

Thyø, Anne, M.D.1; Emmertsen, Katrine J., M.D., Ph.D.1,2; Laurberg, Søren, M.D., D.M.Sc.1

Diseases of the Colon & Rectum: June 2018 - Volume 61 - Issue 6 - p 656–666
doi: 10.1097/DCR.0000000000001064
Original Contributions: Colorectal Cancer
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BACKGROUND: Sexual dysfunction and impaired quality of life is a potential side effect to rectal cancer treatment.

OBJECTIVE: The objective of this study was to develop and validate a simple scoring system intended to evaluate sexual function in women treated for rectal cancer.

DESIGN: This is a population-based cross-sectional study.

SETTINGS: Female patients diagnosed with rectal cancer between 2001 and 2014 were identified by using the Danish Colorectal Cancer Group’s database. Participants filled in the validated Sexual Function Vaginal Changes questionnaire. Women declared to be sexually active at follow-up were randomly assigned to 2 groups: one for development and one for validation. Logistic regression analyses identified items for the score, and multivariate analysis established a weighted-score value allocated to each item, adding up to the total score. The validity of the score was tested in the validation group.

PATIENTS: Female patients with rectal cancer above the age of 18 who underwent abdominoperineal resection, Hartmann procedure, or total/partial mesorectal excision were selected.

MAIN OUTCOME MEASURES: The primary outcome measured was the quality of life that was negatively affected because of sexual problems.

RESULTS: A total of 466 sexually active women responded. The score includes 7 items with a range of 0 to 29 points. Score ≥9 indicates sexual dysfunction. The score has a sensitivity/specificity of 76%/75% detecting patients bothered by sexual dysfunction with a negative impact on quality of life.

LIMITATIONS: This study was limited by the large amount of nonresponders.

CONCLUSIONS: Living up to our demands for a short and easy-to-use validated tool, we have developed the Rectal Cancer Female Sexuality score. It captures, with high sensitivity, the essential problems of female sexuality seen from the perspective of a surviving rectal cancer patient. See Video Abstract at

1 Colorectal Surgical Unit, Aarhus University Hospital, Denmark

2 Surgical Department, Regional Hospital Randers, Denmark

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Funding/Support: This work was supported by The Danish Cancer Society.

Financial Disclosure: None reported.

Presented at the meeting of the European Society of Coloproctology, Berlin, Germany, September 20 to 22, 2017.

Correspondence: Anne Thyø, M.D., Colorectal Surgical Department, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark. E-mail:

© 2018 The American Society of Colon and Rectal Surgeons