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Cumulative prevalence of causes of death, 2005–2011 in Denmark. †Total = 377,410. All decedents were aged 18 years and older. ICD-10 diagnoses were used to define chronic diseases as underlying cause of death. Cancer, diabetes, dementia, ischemic heart disease, cerebrovascular disease, and chronic obstructive pulmonary disease were included in the study. All other causes of death were excluded. ‡Heart failure was defined according to the National Indicator Project – cancer, diabetes, dementia, ischemic heart disease, cerebrovascular disease, and chronic obstructive pulmonary disease, and others were defined according to the Danish Registry of Causes of Death. (PDF 72 kb)

Modification of Charlson comorbidity index by causes of death. *If these diseases were present in patients as the underlying cause of death, as indicated by the shaded boxes, no points were added to the CCI score. For example, a person with myocardial infarction and ulcer disease as comorbidities who died as a result of ischemic heart disease will have a CCI score of myocardial infarction (1) + ulcer disease (1) = total CCI score (2) and points for underlying cause of death, ischemic heart disease (1) = total modified CCI score (1). †These diseases were not present as underlying causes of death. (PDF 63 kb)

Model for aggressiveness of treatment during admission to the ICU. Points assigned for each treatment modality. For example, mechanical ventilation (1), non-mechanical ventilation (0), and dialysis (1) = total score (2). Points grouped as 0–2 points: partial organ support treatment; 3 points: full organ support treatment. (PDF 42 kb)

The majority of women treated for primary breast cancer (BC) will receive adjuvant endocrine treatment (AET). A treatment, which has severalside effects with a varying degree of severity. In some cases, they result in impaired quality of life of the breast cancer survivors (BCS). Foryounger BCS, these side effects are often augmented by the fact, that premenopausal women may turn postmenopausal by the adjuvantchemotherapy.Among the most common side effects are hot flashes, sweating, vaginal dryness and arthralgia. Sexual problems are also common; however,sexual dysfunction (SD), defined as impairments in sexual function causing personal distress, are inadequately described among BCS onAET. Hence, SD may be underreported in both clinical studies and the daily clinic.The primary aim of this study was to estimate the prevalence of clinically relevant SD and to identify possible predictors of SD among BCS onAET.We conducted a cross-sectional survey among BCS who have been treated with AET's for more than 3 months, with no actual signs ofrecurrent disease and no previous cancer diagnosis.The survey consisted of questions regarding demographic factors, present and previous symptoms. The following validated questionnaireswere used: Female Sexual Function Index (FSFI), Sexual Complaint Screener – Women (SCS-W), Beck Depression Inventory (BDI),International Consultation on Incontinence Modular Questionnaire - Female Sexual Matters associated with Lower Urinary Tract Symptoms(ICIQ-FLUTSsex) and subscales of the Cancer Rehabilitation Evaluation System (CARES). Additionally, data concerning tumorcharacteristics and cancer treatment were collected from the medical records.In total, 333 women with a mean age of 58.7 years were included in the study, of which 227 were sexually active. All were heterosexual. In theentire cohort, the most prevalent impairments were low libido (54%), anorgasmia (26%) and lack of arousal (25%). Although dyspareunia wasthe least frequent impairment reported by BCS (21%), it was the most distressing symptom. Urogenital symptoms were common with 47% ofthe women reporting vaginal dryness and 38% reporting pain with sexual intercourse.The sexually active BCS were younger, more often partnered, and more satisfied with their sexual life before the cancer diagnosis than thosewomen being sexually inactive.Among the 227 sexually active women, 134 (59%) qualified for having SD. Of these 134 women, 78 (58%) perceived the cancer treatment asthe primary reason for their sexual problems.In a multivariate analysis, the risk of having SD was significantly associated with experiencing more vaginal dryness and less psychologicalwell-being. Whereas age, relationship satisfaction and duration of AET were not significantly associated with the risk of having SD.In conclusion, SD was highly prevalent among sexually active BCS on AET and was perceived as a long-term side effect of BC treatment bytwo thirds of BCS with SD. Vaginal dryness was the strongest predictor of SD. Of note, age was not related to neither prevalence of SD northe degree of distress caused by the impairments. Hence sexual health is an important topic for BCS and should be addressed by theclinician at follow up visits of BCS independent of their age