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The Impact of an Ostomy on Body Image and Sexual Function of Patients With Colorectal Cancer: A Systematic Review and
Claudia Redeker1, Elizabeth Grunfeld1, Anne Miles1
1Birkbeck, University of London, London, UK.
Background:
Body image disturbance and sexual dysfunction are two of the most common issues reported by patients with colorectal cancer (CRC). The objective of our systematic review and meta-analysis was to examine the effects of an ostomy on body image (BI) and sexual dysfunction (SX) in patients with CRC.
Methods:
In this systematic review and meta-analysis, we searched seven databases (MEDLINE, PsychINFO, EMBASE, The Cochrane Library, PubMed, CINAHL, WEB of SCIENCE) covering articles published in English between January 1st, 2000 and July 20, 2024. Statistical analysis was carried out using the Comprehensive Meta-Analysis (CMA) version 4 software.
Results:
Of 6321 identified articles, 92 met the inclusion criteria, totalling 27,039 patients. Patients with an ostomy reported significantly more body image concerns (g = -0.467 (95% CI -0.546 to -0.388), p < 0.001; prediction interval (PI): -1.046 to 0.112) and sexual dysfunction (g = -0.331 (95% CI -0.406 to -0.256), p < 0.001; PI: -0.894 to 0.232). Meta-regression showed that for BI, publication date and the choice of questionnaire explained 30% of the variance in effect size (R2analog = 0.30, df = 3, p < 0.05). For SX, gender and publication date explained 31% of the variance in effect size (R2analog = 0.3, df = 2, p < 0.001).
Conclusion:
The findings revealed that patients with an ostomy, compared to those without, experience significantly higher levels of BI concerns and SX, with moderate-to-large effect sizes observed. However, there was significant heterogeneity, indicated by the broad prediction interval across studies. Results from the meta-regression suggested that the measurement tools, gender and publication date contributed to the observed variability. Future research should explore additional factors that influence outcomes in body image and sexual health for individuals with lived experience of CRC.
Prospero Registration:
No CRD42020167716.
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