Fallowfield's Sexual Activity Questionnaire in women with without and at risk of cancer

To determine the effect of cancer, cancer risk, menopausal status and psychological factors on sexual activity as measured by Fallowfield's Sexual Activity Questionnaire (FSAQ).

Five groups of women completed the FSAQ: 1451 healthy women who were participating in an ovarian cancer screening trial; 488 healthy women at increased risk of breast cancer who were participating in a chemoprevention trial; 154 healthy women at increased risk of breast cancer who had been offered risk-reducing surgery; 117 women with advanced ovarian cancer; and a healthy non-study sample of 162 women.

There were significant between-group differences regarding age (F=1373.79, P<0.01) and the proportion of women who were sexually active (chi2(4)=212.62, P<0.01) (more younger women reported being sexually active). The most commonly cited reason for sexual inactivity was the absence of a partner. In relation to their sexual activity, women with ovarian cancer reported less pleasure (F=18.27, P<0.01), more discomfort (F=21.33, P<0.01) and less frequency (F=200.01, P<0.01) than the other groups. Premenopausal women reported more pleasure (t=4.41, P<0.01), less discomfort (t=11.79, P<0.01) and greater frequency of sexual activity (t=8.58, P<0.01) than postmenopausal women. Psychological morbidity was associated with decreased pleasure in sexual activity among the women with an elevated risk of cancer - that is, those participating in the chemoprevention trial (t=4.20, P<0.01) and those offered risk-reducing surgery (t=3.32, P<0.01).

The FSAQ is a useful tool for measuring sexual activity in women with cancer and women at a normal or increased risk of developing cancer. Age, cancer, psychological distress and menopausal status affect sexual activity in these groups of women and should be considered in future investigations.