Objective  To systematically retrieve, extract, summarize and analyze the best evidence for sexual health management in patients with cervical cancer, providing evidence-based support for clinical development of sexual health intervention programs for patients with cervical cancer.

Methods  Computerized searches were conducted in UpToDate, guideline and association websites, and relevant databases both domestically and internationally for evidence on sexual health management in cervical cancer patients from November 1, 2013 to October 31, 2023. Two researchers independently screened the included literature, evaluated the quality, extracted the best evidence and graded it to summarize the best evidence of sexual health management for cervical cancer patients.

Results  A total of fourteen articles were included. Thirty-five pieces of evidence were summarized from six aspects: screening and evaluation, health guidance, hormone therapy, non-hormone therapy, reproductive health, training and follow-up.

Conclusion  Clinical medical staff could combine clinical situations and patients' wishes to apply evidence in a personalized and targeted manner to further standardize the sexual health management process of cervical cancer patients and improve their quality of life.

1.Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.

2.魏长慧, 朱继存, 牛媛娜, 等. 2004—2016年中国女性生殖系统恶性肿瘤死亡趋势分析[J].中华疾病控制杂志, 2019, 23(5): 506-511. [Wei CH, Zhu JC, Niu YN, et al. Analysis of the mortality trend of female reproductive system cancer in China from 2004 to 2016[J]. Chinese Journal of Disease Control and Prevention, 2019, 23(5): 506-511.] DOI: 10.16462/j.cnki.zhjbkz.2019.05.003.

3.金鸽, 李魁秀, 郭云峰, 等. 宫颈癌近距离放疗的研究进展[J]. 国际妇产科学杂志, 2022, 49(2): 202-206. [Jin G, Li KX, Guo YF, et al. Research progress in brachytherapy for cervical cancer[J]. Journal of International Obstetrics and Gynecology, 2022, 49(2): 202-206.] DOI: 10.12280/gjfckx.20210574.

4.Cohen PA, Jhingran A, Oaknin A, et al. Cervical cancer[J]. Lancet, 2019, 393(10167): 169-182. DOI: 10.1016/S0140-6736(18)32470-X.

5.邢孔燕, 王茹, 王敏, 等. 我国宫颈癌患者性功能障碍患病率的Meta分析[J]. 中国性科学, 2023, 32(5): 91-96. [Xing KY, Wang R, Wang M, et al. Meta analysis of the prevalence of sexual dysfunction in patients with cervical cancer in China[J]. Chinese Journal of Human Sexuality, 2023, 32(5): 91-96.] DOI: 10.3969/j.issn.1672-1993. 2023.05.024.

6.陈小娟, 叶宇, 黄晓霞, 等. 宫颈癌幸存者性功能障碍风险预测模型的构建及应用研究[J]. 循证护理, 2022, 8(4): 491-494. [Chen XJ, Ye Y, Huang XX, et al. Construction and application of risk prediction model of sexual dysfunction in cervical cancer survivors[J]. Chinese Evidence-based Nursing, 2022, 8(4): 491-494.] DOI: 10.12102/j.issn.2095-8668.2022.04.012.

7.Qian M, Wang L, Xing J, et al. Prevalence of sexual dysfunction in women with cervical cancer: a systematic review and meta-analysis[J]. Psychol Health Med, 2023, 28(2): 494-508. DOI: 10.1080/13548506.2022. 2110270.

8.Edwards WM, Coleman E. Defining sexual health: a descriptive overview[J]. Arch Sex Behav, 2004, 33(3): 189-195. DOI: 10.1023/B:ASEB.0000026619.95734.d5.

9.鲁佳, 李英, 周佳欣, 等. 乳腺癌患者性健康管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(17): 2156-2163. [Lu J, Li Y, Zhou JX, et al. Best evidence summary for sexual health management in breast cancer patients[J]. Chinese Journal of Nursing, 2022, 57(17): 2156-2163.] DOI: 10.3761/j.issn.0254-1769.2022.17.018.

10.朱政, 胡雁, 周英凤, 等. 推动证据向临床转化(三)研究的选题和问题构建[J]. 护士进修杂志, 2020, 35(9): 796-799. [Zhu Z, Hu Y, Zhou YF, et al. Promoting the transformation of evidence to clinical practice: research topic selection and problem construction[J]. Journal of Nurses Training, 2020, 35(9): 796-799.] DOI: 10.16821/j.cnki.hsjx.2020.09.008.

11.邢唯杰, 胡雁, 周英凤, 等. 推动证据向临床转化(四)以临床转化为目的的证据资源检索[J]. 护士进修杂志, 2020, 35(10): 879-882. [Xing WJ, Hu Y, Zhou YF, et al. Promoting evidence to clinical transformation: evidence resource retrieval for the purpose of clinical transformation[J]. Journal of Nurses Training, 2020, 35(10): 879-882.] DOI: 10.16821/j.cnki.hsjx.2020.10.004.

12.朱政, 胡雁, 周英凤, 等. 推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J]. 护士进修杂志, 2020, 35(11): 996-1000. [Zhu Z, Hu Y, Zhou YF, et al. Promoting evidence to clinical transformation: evaluation of literature quality in evidence clinical transformation  research[J]. Journal of Nurses Training, 2020, 35(11): 996-1000.] DOI: 10.16821/j.cnki.hsjx.2020.11.009.

13.王春青, 胡雁. JBI证据预分级及证据推荐级别系统（2014版）[J]. 护士进修杂志, 2015, 30(11): 964-967. [Wang CQ, Hu Y. JBI evidence pre-classification and evidence recommendation level system (2014 edition)[J]. Journal of Nurses Training, 2015, 30(11): 964-967.] DOI: 10.16821/j.cnki.hsjx.2015.11.002.

14.Duska LR. Overview of approach to cervical cancer survivors[EB/OL]. (2023-12-13)[2023-12-20]. https://www.uptodate.cn/contents/overview-of-approach-to-cervical-cancer-survivors

15.Bober SL, Krapf J. Overview of sexual dysfunction in female cancer survivors[EB/OL]. (2022-08-15)[2023-12-20]. https://www.uptodate.cn/contents/overview-of-sexual-dysfunction-in-female-cancer-survivors

16.Bachmann G, Pinkerton JV. Genitourinary syndrome of menopause (vulvovaginal atrophy): treatment[EB/OL]. (2023-11-08)[2023-12-20]. https://www.uptodate.cn/contents/genitourinary-syndrome-of-menopause-vulvovaginal-atrophy-treatment

17.Karam A. Cervical cancer in pregnancy[EB/OL]. (2023-07-27)[2023-12-20]. https://www.uptodate.cn/contents/cervical-cancer-in-pregnancy

18.Plante M. Fertility-sparing surgery for cervical cancer[EB/OL]. (2023-08-03)[2023-12-20]. https://www.uptodate.cn/contents/fertility-sparing-surgery-for-cervical-cancer

19.National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cervical cancer (V1.2024)[EB/OL].(2023-09-20)[2023-12-20]. https://nccn.medlive.cn/guide/detail/446

20.Cibula D, Rosaria Raspollini M, Planchamp F, et al. ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer - Update 2023[J]. Radiother Oncol, 2023, 184: 109682. DOI: 10.1016/j.radonc.2023.109682.

21.Lambertini M, Peccatori FA, Demeestere I, et al. Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines[J]. Ann Oncol, 2020, 31(12): 1664-1678. DOI: 10.1016/j.annonc.2020.09.006.

22.中国抗癌协会妇科肿瘤专业委员会. 早期子宫颈癌保留生育功能中国专家共识[J]. 中国实用妇科与产科杂志, 2022, 38(6): 634-641. [Chinese Anti-Cancer Association Gynecologic Oncology Committee. Chinese expert consensus on preserving fertility in early cervical cancer[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2022, 38(6): 634-641.] DOI: 10.19538/j.fk2022060114.

23.Matos SRL, Lucas Rocha Cunha M, Podgaec S, et al. Consensus for vaginal stenosis prevention in patients submitted to pelvic radiotherapy[J]. PLoS One, 2019, 14(8): e221054. DOI: 10.1371/journal.pone.0221054.

24.Liberacka-Dwojak M, Izdebski P. Sexual function and the role of sexual communication in women diagnosed with cervical cancer: a systematic review[J]. Int J Sex Health, 2021, 33(3): 385-395. DOI: 10.1080/19317611.2021. 1919951.

25.Ma'rifah AR, Afiyanti Y, Huda MH, et al. Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials[J]. Support Care Cancer, 2022, 30(10): 8271-8285. DOI: 10.1007/s00520-022-07277-y.

26.Tramacere F, Lancellotta V, Casà C, et al. Assessment of sexual dysfunction in cervical cancer patients after different treatment modality: a systematic review[J]. Medicina (Kaunas), 2022, 58(9): 1223. DOI: 10.3390/medicina58091223.

27.刘明晨, 黄丽华. 妇科癌症幸存者性功能障碍影响因素及干预措施研究进展[J]. 护理与康复, 2019, 18(12): 26-28. [Liu MC, Huang LH. Research progress on influencing factors and intervention measures of sexual dysfunction in gynecological cancer survivors[J]. Nursing and Rehabilitation Journal, 2019, 18(12): 26-28.] DOI: 10.3969/j.issn.1671-9875.2019.12.007.

28.Cianci S, Tarascio M, Arcieri M, et al. Post treatment sexual function and quality of life of patients affected by cervical cancer: a systematic review[J]. Medicina (Kaunas), 2023, 59(4): 704. DOI: 10.3390/medicina59040704.

29.Kuijer RG, Ybema JF, Buunk BP, et al. Active engagement, protective buffering, and overprotection: three ways of giving support by intimate partners of patients with cancer[J]. Journal of Social and Clinical Psychology, 2000, 19(2): 256-275. DOI: 10.1521/jscp.2000.19.2.256.

30.匡丹, 苏珍珍, 顾丹凤, 等. 患者及照顾者对“互联网+护理服务”体验质性研究的Meta分析[J]. 护理实践与研究, 2023, 20(23): 3551-3558. [Kuang D, Su ZZ, Gu DF, et al. Meta analysis of qualitative research on patients' and caregivers' experience of "Internet + Nursing Service"[J]. Nursing Practice and Research, 2023, 20(23): 3551-3558.] DOI: 10.3969/j.issn.1672-9676. 2023.23.013.

31.吴志勇, 李燕云, 徐丛剑. 子宫颈癌患者治疗后的性生活管理[J]. 中国实用妇科与产科杂志, 2024, 40(1): 38-41. [Wu ZY, Li YY, Xu CJ. Management of sexual life of patients with cervical cancer after treatment[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2024, 40(1): 38-41.] DOI: 10.19538/j.fk2024010111.

32.高福锋, 张师前. 子宫颈癌的预防与规范化诊疗 [J]. 中国临床医生杂志, 2023, 51(3): 258-263. [Gao FF, Zhang SQ. Prevention and standardized diagnosis and treatment of cervical cancer[J]. Chinese Journal for Clinicians, 2023, 51(3): 258-263.] DOI: 10.3969/j.issn.2095-8552.2023.03.002.

33.Akbaba S, Oelmann-Avendano JT, Krug D, et al. The impact of vaginal dilator use on vaginal stenosis and sexual quality of life in women treated with adjuvant radiotherapy for endometrial cancer[J]. Strahlenther Onkol, 2019, 195(10): 902-912. DOI: 10.1007/s00066-019-01466-1.

34.Haddad NC, Soares Brollo LC, Pinho Oliveira MA, et al. Diagnostic methods for vaginal stenosis and compliance to vaginal dilator use: a systematic review[J]. J Sex Med, 2021,18(3): 493-514. DOI: 10.1016/j.jsxm.2020.12.013.

35.Law E, Kelvin JF, Thom B, et al. Prospective study of vaginal dilator use adherence and efficacy following radiotherapy[J]. Radiother Oncol, 2015, 116(1): 149-155. DOI: 10.1016/j.radonc.2015.06.018.

36.徐迎婷, 王国蓉, 刘瑶, 等. 妇科肿瘤病人放疗后阴道扩张器使用依从性的系统评价[J]. 全科护理, 2022, 20(17): 2409-2415. [Xu YT, Wang GR, Liu Y, et al. A systematic review of the compliance of vaginal dilator use in gynecological tumor patients after radiotherapy[J]. Chinese General Practice Nursing, 2022, 20(17): 2409-2415.] DOI: 10.12104/j.issn.1674-4748.2022.17.029.

37.单潇, 王岚, 谷璇, 等. 宫颈癌病人治疗后性功能障碍预防及管理的最佳证据总结[J]. 全科护理, 2024, 22(6): 1027-1031. [Shan X, Wang L, Gu X, et al. The best evidence summary of prevention and management of sexual dysfunction in patients with cervical cancer after treatment[J]. Chinese General Practice Nursing, 2024, 22(6): 1027-1031.] DOI: 10.12104/j.issn.1674- 4748.2024.06.008.

38.Kuznicki ML, Chambers LM, Morton M, et al. Fertility-sparing surgery for early-stage cervical cancer: a systematic review of the literature[J]. J Minim Invasive Gynecol, 2021, 28(3): 513-526. DOI: 10.1016/j.jmig.2020. 10.013.

39.Pandraklakis A, Thomakos N, Prodromidou A, et al. The conundrum of prematurity and pregnancy outcomes after fertility sparing treatment modalities for early stage cervical cancer: a systematic review of the literature[J]. Folia Med (Plovdiv), 2020, 62(3): 453-461. DOI: 10.3897/folmed.62.e48736.