Interventions for Sexual Function and Sexual Health in Women with Cancer: An Umbrella Review of Systematic Reviews...

Numerous systematic reviews and meta-analyses have evaluated interventions for sexual function and sexual health in women with cancer, yet they report inconsistent effect sizes for the same intervention families, and the extent to which they draw on overlapping primary studies has not been quantified. We aimed to synthesize and appraise this review-level evidence under a single framework, evaluating methodological quality (AMSTAR 2), certainty of evidence (GRADE), and between-review overlap (corrected covered area, CCA). Following the PRIOR and PRISMA 2020 guidelines, three databases (1,700 records) plus hand-searching were screened. Eighteen systematic reviews/meta-analyses met eligibility. Each was appraised with AMSTAR 2; certainty was derived for pooling reviews using a GRADE-informed approach; overlap was quantified with CCA and pairwise Jaccard coefficients. Pooled sexual function effects were consistently positive (SMD 0.63-0.98), though partly obscured by scale heterogeneity (raw FSFI mean differences vs. standardized effects) and very high statistical heterogeneity (I² = 79-95%). Methodological quality was low or critically low in 89% (16/18) of reviews. Overall CCA was slight (3.57%) but concentrated within clusters (11.6-37.5%); a single RCT recurred across six reviews, indicating an illusion of independent evidence. Although these interventions show a beneficial direction, certainty is low; effect-magnitude claims should be cautious, and future syntheses should report overlap and apply GRADE.