# Health-Related Quality of Life in Menopausal Women with Cancer: Results from the CALCAN Study

## TL;DR

This study finds that menopausal women with cancer, especially those with non-gynecologic cancers, experience worse sexual quality of life, while depression affects all groups.

## Contribution

The study identifies cancer-specific and depression-related impacts on menopause-related quality of life using a large app-based cohort.

## Key findings

- Cancer history is linked to poorer sexual quality of life in menopausal women.
- Depression consistently correlates with worse HRQoL across all groups.
- Non-gynecologic cancer survivors report lower sexual HRQoL than gynecologic cancer survivors.

## Abstract

Menopause can impair quality of life by affecting physical, emotional, and sexual well-being, with potentially greater impact in women with a history of cancer. Using data from a large app-based cohort, we compared menopause-related quality of life in peri- and postmenopausal women with and without cancer, including differences by cancer type. Cancer history was mainly linked to poorer sexual quality of life, while depression was consistently associated with worse outcomes across all groups, supporting more integrated menopause care with greater attention to sexual and mental health.

Background: Menopausal symptoms can negatively affect health-related quality of life (HRQoL), especially in women with a history of cancer. This study compared menopause-specific HRQoL in peri- and postmenopausal women with and without cancer and explored differences by cancer type, menopause treatment use, and depression. Methods: We performed a cross-sectional multicenter study using self-reported data from 6833 women enrolled through the Mi Menopausia mobile app between 2021 and 2024. HRQoL was assessed with the Cervantes SF-16 scale. Results: The final sample consisted of 6833 women: no cancer (n = 6482) and cancer (n = 351), further classified as gynecologic (n = 210) and non-gynecologic (n = 141). Cancer history was associated with worse HRQoL in the Sexuality domain (51.2 ± 23.8 vs. 48.3 ± 24.6; p = 0.013), while global HRQoL did not differ significantly between women with and without cancer (30.6 ± 21.7 vs. 32.3 ± 20.7; p = 0.130). Among cancer women, Sexuality scores were worse in non-gynecologic versus gynecologic cancers (55.7 ± 22.9 vs. 48.2 ± 24.1; p = 0.005). Depression was consistently associated with worse HRQoL in all groups, while menopause treatment use was associated with poorer HRQoL only in women without cancer. Conclusions: Cancer history was mainly associated with poorer sexual menopause-related HRQoL rather than global HRQoL. Depression was a major factor linked to impaired HRQoL, highlighting the need for integrated sexual and mental health assessment in menopausal women, particularly cancer survivors.