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

Objectives: 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).

Study Design And Main Outcome Measures: 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.

Results: 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).

Conclusions: 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.