Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Australia.
Psychooncology. 2013 Sep;22(9):1963-71. doi: 10.1002/pon.3236. Epub 2012 Dec 12.
Although the survival outcomes among women diagnosed with endometrial cancer are very favorable, little is known about the long-term impact of their cancer experience. This study identifies the extent of positive and negative impacts of cancer and factors associated with this, amongst long-term survivors of endometrial cancer.
Australian women diagnosed with endometrial cancer (N=632) were sent questionnaires at the time of diagnosis and 3-5 years later. Hierarchical multiple regression models were used to examine whether a range of variables at diagnosis/treatment predicted subsequent scores on the Impact of Cancer Scale, which examines positive (e.g. health awareness) and negative (e.g. appearance concerns) impacts amongst cancer survivors.
Overall, women had a higher mean score for the positive than negative impact scales (M=3.5 versus M=2.5, respectively). An intermediate grade of endometrial cancer, a prior diagnosis of cancer and lower levels of education were significant, but weak, predictors of higher scores on the positive impact scale. Higher scores on the negative impact scale were predicted by a higher grade of cancer, poor physical and mental health, a younger age, being single or having lower levels of education.
The study demonstrates that factors that predict positive impact in cancer survivors differ to those that predict negative impact, suggesting that interventions to optimize cancer survivors' quality of life will need to be multi-dimensional, and this supports the need for tailored intervention.
尽管诊断为子宫内膜癌的女性患者的生存结局非常理想,但人们对其癌症经历的长期影响知之甚少。本研究旨在确定长期生存的子宫内膜癌患者的癌症积极和消极影响的程度,以及与这些影响相关的因素。
在诊断时和 3-5 年后,向澳大利亚的 632 名诊断为子宫内膜癌的女性患者发送了问卷。采用分层多重回归模型来检验一系列诊断/治疗时的变量是否可以预测癌症影响量表的后续评分,该量表用于评估癌症幸存者的积极影响(如健康意识)和消极影响(如外貌担忧)。
总体而言,女性在积极影响量表上的平均得分高于消极影响量表(分别为 M=3.5 和 M=2.5)。中等程度的子宫内膜癌、先前的癌症诊断和较低的教育水平是积极影响量表得分较高的显著但较弱的预测因素。癌症严重程度较高、身体和心理健康状况较差、年龄较小、单身或教育水平较低,是消极影响量表得分较高的预测因素。
该研究表明,预测癌症幸存者积极影响的因素与预测消极影响的因素不同,这表明优化癌症幸存者生活质量的干预措施需要具有多维性,这也支持了制定针对性干预措施的必要性。