LUDICAS: sexual dysfunction in patients with lung cancer, a multicenter cross-sectional study

Patients with lung cancer may suffer from sexual dysfunction (SD) related to oncological treatment. This is an under-recognized condition among clinicians. The aim of this study was to describe the prevalence of SD in a multicenter cohort of patients.

This multicenter, cross-sectional, observational study was conducted between July 2023 and February 2024. Sexual function was assessed by patient-reported outcome (PRO) system using sex-specific questionnaire. Descriptive analysis and evaluation of differences between categorical variables were carried out. Associations between clinical characteristics and SD were assessed by logistic regression.

Four hundred and forty-eight patients from 24 hospitals in Spain, Colombia, Argentina, and Portugal were included. Of these, 277 (61.83%) were male and 365 (81.48%) had metastatic disease. Two hundred and eighty-four patients (63.39%) reported the onset of SD following the initiation of oncological treatment. Males and females reported a high frequency of severe impairment of sexual response phases, which was twice as high in females (P= 0.001). Female sex was a factor for severe impairment of desire, arousal, and orgasm [odds ratio (OR) 3.72, 95% confidence interval (CI) 2.48-5.60, P= 0.001] and decreased sexual activity (OR 1.98, 95% CI:1.17-3.19, P = 0.01), in addition to age over 65 years (OR 3.86, 95% CI 1.01-15.25, P= 0.004) and high educational level (OR 0.29, 95% CI 0.09-0.94, P= 0.0040). Patients from Portugal and Latin America were more likely to report dissatisfaction with sexual activity (OR 3.75, 95% CI 1.06-13.22, P= 0.0039). Female sex (OR 3.53, 95% CI 1.88-6.6, P 0.001), smoking history (OR 1.77, 95% CI 1.01-4.01, P= 0.04), and obesity (OR 1.70 95% CI 1.01-3.16, P= 0.05) were associated with global sexual dissatisfaction.

Our patients with lung cancer had a high prevalence of SD after initiation of oncological treatment. There was remarkable sex disparity in the frequency and severity of this disorder as well as an important influence of sociocultural factors in the clinical presentation.