Table 2.

Key risk factors of SQoL

Risk factor	Association with SQoL	Studies*	Cancer type
1.1 Age and menopausal status	Older age (< 55): SD, low sexual desire and shyness to discuss sexual concerns	10, 17, 24, 25, 37, 42, 45	CC, EC, GC, VC
	Young age: worst SQoL outcomes and higher rehabilitation needs	4, 5, 7, 11, 31, 37	CC, EC, VC, GC, OC
	Menopause: long-term factor in QoL and SR. Premenopausal women at diagnosis reported feeling the loss of feminity	11, 32, 39	CC, EC, OC
1.2 Relationship status	Single status: IBI, SD and higher rehabilitation needs	3, 5, 6, 17, 25, 28, 32, 46	CC, EC, GC, VC
1.3 Treatment modality	Pelvic radiotherapy (RT): severe SD and VD, substantial late toxicity, psychosexual and psychosocial distress and impaired QoL. Risk factor in menopause, lymphedema and rehabilitation needs	2, 5, 19, 23, 29, 30, 33, 40, 42, 44, 45, 46	CC, EC, VC, VAC (1), GC
	Chemotherapy (CT): altered SR and IBI	11, 46	GC
	RT + CT: (above) + FIC, changes in hormones, marital cohesion and social role functions	1, 39, 43	CC, EC
	Radical hysterectomy (RH) removal of the reproductive organs affects SR. SD, VD, numbness (labia), lymphedema, depression, anxiety and emotional distress	11, 27, 38, 39, 40, 45	CC, EC, OC
	Radical vaginal trachelectomy, radical vulvar excisions or ovaries removal: pain, bleeding, SD, feelings of isolation, IBI, FIC, lymphedema, and menopause	6, 3, 34, 11, 40, 45	CC, VC, EC, OC
	Pelvic surgeries or GC treatment (unspecified) SD and VD, lower sexual and relationship satisfaction, pain and bleeding, menopause, changed sexual self-concept, FIC, lower QoL	3, 7, 10, 11, 21, 24, 36	CC, EC, GC, OC

SD—sexual dysfunction, VD—vaginal dysfunction, SR—sexual response, IBI—impaired body image, CC—cervical cancer, EC—endometrial cancer, GC—gynaecological cancer, OC—ovarian cancer, VC—vulvar cancer, VAC—vaginal cancer FIC—feminine identity crisis/grief of womanhood *Study numbers refer to the first column of Table 1 (Appendix A)