“Prevalence of sexual dysfunction and narrative synthesis of associated factors in patients with different type of cancer: a systematic review and meta-analysis”

Sexual dysfunction (SD) is a prevalent but underrecognized consequence of cancer and its treatment, affecting patients’ quality of life, psychological well-being, and intimate relationships. Despite its clinical importance, the literature on SD remains fragmented, with previous reviews focusing primarily on specific cancer types. This systematic review and meta-analysis aimed to estimate the overall prevalence of SD across various cancer types and to identify demographic, clinical, psychosocial, and treatment-related factors associated with its occurrence. A systematic search was conducted in both English and Persian databases, including PubMed, Scopus, Web of Science, Embase, CINAHL, Google Scholar, and regional platforms (SID, Magiran, IranMedex) for observational studies reporting on prevalence of SD and its determinants in cancer patients. The inclusion criteria were developed based on the SPIDER framework, targeting quantitative studies that focused on the prevalence and risk factors associated with SD. Eligible studies were screened independently by two reviewers and assessed using the Observational Studies Quality Evaluation (OSQE) tool. A random-effects meta-analysis was used to calculate pooled prevalence estimates 39 included studies. Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity using Comprehensive Meta-Analysis version 4 software. Additionally, a narrative synthesis of associated factors was performed based on 37 included studies. A total of 39 studies involving 17,970 participants were included. The overall pooled prevalence of SD was 54.0% (95% CI: 50.4%–58.8%), with significant heterogeneity (I2 = 95%). Subgroup analysis revealed the highest prevalence among patients with gynecological (93.7%), breast (59.2%), and colorectal (57.4%) cancers. Meta-regression identified publication year, cancer type, and geographical region as significant moderators. However, a large portion of heterogeneity remained unexplained due to insufficient reporting of key socio-demographic and clinical variables. Narrative synthesis identified age, treatment modality, menopausal status, body image, psychological distress, and social factors as major determinants of SD. These findings underscore the urgent need for standardized assessment tools, individualized care strategies, and theory-informed interventions that integrate sexual health into routine oncology care. Future research should focus on longitudinal designs and individual-level data to better understand the complex interplay of factors contributing to SD in cancer patients.