Systematic review of studies of body image following ostomy surgery for cancer

Ostomy surgery, often required in the treatment of colorectal, bladder, prostate, and gynecological cancers, has profound effects on body image and psychosocial well-being. A systematic review of ten published studies, comprising 1454 participants, investigated body image across cancer-related ostomy populations. Across studies, the presence of a stoma was consistently associated with poorer body image compared to non-stoma groups. Permanent stomas were linked with the greatest body image disturbance, while reversal of temporary stomas was associated with improvements. Body image was associated with psychosocial outcomes including quality of life, anxiety, depression, self-efficacy, and social support, and many of these psychosocial variables mediated the relationship between stoma status and psychological well-being. However, evidence regarding differences across cancer types was limited, and definitions and measures of body image varied considerably, with some studies relying on instruments not specifically designed for cancer populations. The authors conclude that body image distress is a significant yet under-recognized concern for cancer survivors with ostomies. Greater conceptual clarity, standardized and ostomy-sensitive measurement, and longitudinal research across cancer diagnoses are needed.