Background This study aimed to examine sexual quality of life (SQoL) and health-related quality of life (HRQoL) among men diagnosed with testicular cancer in Turkey, and to investigate their associations with treatment modality, cancer stage, age, sexual dysfunction, and body image concerns. Methods The study included 242 men receiving treatment or follow-up for testicular cancer at a tertiary care university hospital. Eligible participants were aged between 18 and 50 years (M = 32.1, SD = 8.6) and were cognitively capable of completing self-report questionnaires. Data were collected using a sociodemographic and clinical information form, a sexual problems assessment form, the Sexual Quality of Life Scale–Male (SQOL-M), and the 12-item Short Form Health Survey version 2 (SF-12v2). Descriptive statistics, independent samples t-tests, one-way ANOVA with post-hoc analyses, and Pearson correlation analyses were conducted. Multivariate analysis of variance (MANOVA) and mediation analyses were performed. Results Participants (N = 242) had a mean age of 32.1 ± 8.6 years. Mean SQoL and HRQoL scores were 66.9 ± 14.7 and 69.8 ± 11.9, respectively. Age was negatively correlated with SQoL (r = − 0.18, p = 0.001). Marital status influenced SQoL, with married participants reporting higher scores (71.2 ± 13.8) than single (62.4 ± 14.6) and divorced/widowed individuals (60.7 ± 15.2) (F = 6.01, p = 0.001). Cancer stage was associated with both outcomes, with Stage I patients showing the highest SQoL (71.6 ± 13.4) and HRQoL (74.3 ± 10.6) and Stage III the lowest (SQoL: 58.9 ± 14.2; HRQoL: 63.5 ± 12.8) (F = 11.08, p < 0.001). Treatment modality significantly affected SQoL and HRQoL (F = 14.26, p < 0.001), with surgery-only patients reporting higher scores (SQoL: 73.1 ± 12.9; HRQoL: 75.6 ± 10.3) than other groups. Multiple regression indicated that age (β = − 0.18, p = 0.001), advanced stage (β = − 0.26, p < 0.001), and treatment modality (β = − 0.29, p < 0.001) predicted lower SQoL. Sexual dysfunction (β = − 0.34, p < 0.001) and body image concerns (β = − 0.21, p < 0.001) were the strongest predictors of poorer SQoL and HRQoL. Mediation analysis showed sexual dysfunction partially mediated the effect of treatment modality on SQoL (indirect effect = − 0.21, 95% CI: − 0.33 to − 0.12) and HRQoL (indirect effect = − 0.18, 95% CI: − 0.31 to − 0.10). Conclusion Sexual dysfunction and body image concerns emerged as the strongest determinants of both sexual and health-related quality of life, outweighing the effects of clinical factors such as treatment modality and cancer stage. Notably, sexual dysfunction partially mediated the relationship between treatment modality and quality-of-life outcomes, highlighting its role as a key mechanism linking cancer treatment to patient well-being. These findings underscore the need to move beyond a solely biomedical focus and prioritize routine assessment and targeted management of sexual dysfunction in survivorship care to improve long-term outcomes in men with testicular cancer.

Biopsychosocial Determinants of Sexual and Health-Related Quality of Life Among Men with Testicular Cancer in Turkey

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2026年5月25日

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Zekeriya Temircan

摘要

Background

This study aimed to examine sexual quality of life (SQoL) and health-related quality of life (HRQoL) among men diagnosed with testicular cancer in Turkey, and to investigate their associations with treatment modality, cancer stage, age, sexual dysfunction, and body image concerns.

Methods

The study included 242 men receiving treatment or follow-up for testicular cancer at a tertiary care university hospital. Eligible participants were aged between 18 and 50 years (M = 32.1, SD = 8.6) and were cognitively capable of completing self-report questionnaires. Data were collected using a sociodemographic and clinical information form, a sexual problems assessment form, the Sexual Quality of Life Scale–Male (SQOL-M), and the 12-item Short Form Health Survey version 2 (SF-12v2). Descriptive statistics, independent samples t-tests, one-way ANOVA with post-hoc analyses, and Pearson correlation analyses were conducted. Multivariate analysis of variance (MANOVA) and mediation analyses were performed.

Results

Participants (N = 242) had a mean age of 32.1 ± 8.6 years. Mean SQoL and HRQoL scores were 66.9 ± 14.7 and 69.8 ± 11.9, respectively. Age was negatively correlated with SQoL (r = − 0.18, p = 0.001). Marital status influenced SQoL, with married participants reporting higher scores (71.2 ± 13.8) than single (62.4 ± 14.6) and divorced/widowed individuals (60.7 ± 15.2) (F = 6.01, p = 0.001). Cancer stage was associated with both outcomes, with Stage I patients showing the highest SQoL (71.6 ± 13.4) and HRQoL (74.3 ± 10.6) and Stage III the lowest (SQoL: 58.9 ± 14.2; HRQoL: 63.5 ± 12.8) (F = 11.08, p < 0.001). Treatment modality significantly affected SQoL and HRQoL (F = 14.26, p < 0.001), with surgery-only patients reporting higher scores (SQoL: 73.1 ± 12.9; HRQoL: 75.6 ± 10.3) than other groups. Multiple regression indicated that age (β = − 0.18, p = 0.001), advanced stage (β = − 0.26, p < 0.001), and treatment modality (β = − 0.29, p < 0.001) predicted lower SQoL. Sexual dysfunction (β = − 0.34, p < 0.001) and body image concerns (β = − 0.21, p < 0.001) were the strongest predictors of poorer SQoL and HRQoL. Mediation analysis showed sexual dysfunction partially mediated the effect of treatment modality on SQoL (indirect effect = − 0.21, 95% CI: − 0.33 to − 0.12) and HRQoL (indirect effect = − 0.18, 95% CI: − 0.31 to − 0.10).

Conclusion

Sexual dysfunction and body image concerns emerged as the strongest determinants of both sexual and health-related quality of life, outweighing the effects of clinical factors such as treatment modality and cancer stage. Notably, sexual dysfunction partially mediated the relationship between treatment modality and quality-of-life outcomes, highlighting its role as a key mechanism linking cancer treatment to patient well-being. These findings underscore the need to move beyond a solely biomedical focus and prioritize routine assessment and targeted management of sexual dysfunction in survivorship care to improve long-term outcomes in men with testicular cancer.