Abstract
PURPOSE: Cancer treatment often results in sexual dysfunction, and while mindfulness-based interventions (MBIs) could be well-suited to treat these issues, the characteristics and efficacy of MBIs on sexual function in cancer populations have not been fully examined. This systematic review and meta-analysis aimed to describe and evaluate the efficacy of MBIs for alleviating sexual problems in cancer survivors. METHODS: Databases were searched for experimental and quasi-experimental MBI trials using validated sexual function measures and conducted among cancer survivors. Independent reviewers performed study selection, data extraction, and quality assessment (JBI-RCT/NR checklists). Study characteristics and effect sizes were synthesized and described; random effects models were used to calculate within-group mean differences and perform meta-analyses as appropriate. RESULTS: Twelve trials were eligible. Most showed a low/moderate risk of bias (75%, n = 9/12) and were conducted exclusively in women (66%, n = 8/12). All twelve studies reported improvements in at least one domain of sexual function from pre-to-post-MBI, with 75% of trials (n = 9/12) reporting positive effects across all sexual functioning domains. Effect sizes varied across study characteristics. Single-arm trials (50%, n = 6/12) were all conducted on sexual function-specific MBIs and showed the largest effect sizes, whereas RCTs (50%, n = 6/12) were mainly conducted on MBIs without sexual function-specific content and showed less robust effects. Meta-analyses of the Female Sexual Function Index (FSFI) revealed significant and clinically meaningful improvements in women's sexual functioning (FSFI mean difference [95% CI]: total = 4.74 [2.54, 6.93]; desire = 0.68 [0.42, 0.95]; arousal = 0.89 [0.53, 1.25]; lubrication = 0.70 [0.25, 1.16]; orgasm = 0.79 [0.28, 1.31]; satisfaction = 0.70 [0.28, 1.11]; pain = 0.60 [0.29, 0.91]). CONCLUSIONS: MBIs hold promise for improving sexual function after cancer, particularly for women. However, rigorous RCT designs and enhanced diversity within study populations are necessary to address remaining knowledge gaps and substantiate efficacy.