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The Prevalence of Erectile Dysfunction in Post-Treatment Colorectal Cancer Patients and Their Interests in Seeking Treatment: A Cross-Sectional Survey in the West-Midlands


Sue Wilson, PhD, Primary Care Clinical Sciences, University of Birmingham, Birmingham, West Midlands, BB15 2TT, United Kingdon. Tel: 0121 414 7397; Fax: 0121 414 6571; E-mail:


Introduction.  Erectile dysfunction (ED) is a recognized complication of colorectal cancer treatment, particularly if surgery is below the recto-sigmoid junction (RSJ), and is an important quality-of-life issue. Previous studies have generated inconsistent prevalence estimates.

Aim.  We aimed to establish the prevalence of ED in postsurgery colorectal cancer patients and to establish what proportion wished to seek treatment.

Main Outcome Measures.  Questionnaire: sociodemographics, treatment methods, International Index of Erectile Function (IIEF)-5 questionnaire (validated tool to assess erectile function): score of <21 being used to define ED.

Methods.  Cross-sectional survey. Inclusion criteria: adult male colorectal cancer patients diagnosed in 2000–2007, treated with curative intent in one teaching hospital. Statistical analysis: logistic regression analysis to determine predictors of ED.

Results.  The response rate was 46% (229/499). Respondents were aged 28 to 95 years; the majority were white (93.9%), more than half (57.1%) were in a sexual relationship, only a third reported having sex in the past 6 months (33.3%). The vast majority (75.1%; 172/229) of responders had ED as defined by the IIEF-5. ED was significantly associated with increasing age (P < 0.0005), having a malignancy below the RSJ (P = 0.002), having previous radiotherapy (P = 0.007), and having a stoma (P = 0.014). Those with ED were less likely to be in a sexual relationship (P = 0.002) and less likely to have had sex in the last 6 months (P < 0.0005). Only 29% of those with ED were not interested in treatment for their condition.

Conclusions.  These data suggest a prevalence rate of ED of 75% in colorectal cancer survivors; this may be functional or psychological in origin. Quality of life may be improved if follow-up clinics for cancer survivors not only concentrated on the detection of recurrence but also offered assessment of erectile function and referral for patients who desire treatment. Ellis R, Smith A, Wilson S, Warmington S, and Ismail T. The prevalence of erectile dysfunction in post-treatment colorectal cancer patients and their interests in seeking treatment: A cross-sectional survey in the west-midlands. J Sex Med 2010;7:1488–1496.