School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Nursing, Garden City University College, Kumasi, Ghana.
PLoS One. 2022 Jun 3;17(6):e0268831. doi: 10.1371/journal.pone.0268831. eCollection 2022.
Cervical cancer is the second most common female cancer in Ghana. The disease and its treatment significantly affect survivors' health-related quality of life (HRQoL). We determined the overall quality of life (QoL) and identified its predictors among cervical cancer survivors after treatment.
A hospital-based cross-sectional analytical study was conducted on 153 disease-free cervical cancer survivors who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. We used the European Organization for Research and Treatment of Cancer core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) to assess the survivors' overall QoL. QoL domain scores were dichotomised as affected or unaffected by disease and its treatment. Significant differences between the affected and unaffected groups within each QoL domain were determined using the student T-test. We used Kruskal-Wallis and Dunn's tests to examine the difference in QoL domains between treatment types, with significance based on Bonferroni corrections. Multivariable logistic regression was performed to identify predictors of overall QoL. A p-value of less than 0.05 was considered statistically significant.
One hundred and fifty-three (153) women having a mean age of 58.3 (SD 11.4) years were studied. The overall QoL score was 79.6 (SD 16.0), and 74.5% of survivors reported good QoL score within the median follow up time of 41.8 months (interquartile range [IQR], 25.5-71.1 months) after cervical cancer diagnosis. Although the majority (66.0-84.3%) of the QoL functioning scale were unaffected, about a fifth (22.2%) to a third (34.5%) of the subjects had perceptual impairment in cognitive and role functioning. Financial difficulties, peripheral neuropathy and pain were most common symptoms reported as affected. A third of the survivors were worried that sex would be painful, and 36.6% indicated that their sexual activity as affected. The overall QoL scores for survivors who had surgery, chemoradiation and radiation-alone were 86.1 (SD 9.7), 76.9 (SD 17.7), and 80.7 (SD 14.7), respectively (p = 0.025). The predictors of survivor's overall QoL were loss of appetite [Adjusted Odd Ratio (AOR) = 9.34, 95% Confidence Interval (CI) = 2.13-35.8, p = 0.001], pain (AOR = 3.53, 95% CI = 1.25-9.31, p = 0.017) and body image (AOR = 5.89, 95% CI = 1.80-19.27, p = 0.003).
About 75% of the survivors had a good overall quality of life. Primary surgical treatment affords the best prospects for quality of life with the least symptom complaints and financial burden. Loss of appetite, pain or diminution in body image perception predicted the overall quality of life of cervical cancer survivors after treatment.
宫颈癌是加纳第二大常见的女性癌症。该疾病及其治疗方法严重影响了幸存者的健康相关生活质量（HRQoL）。我们确定了治疗后宫颈癌幸存者的总体生活质量（QoL），并确定了其预测因素。
这是一项基于医院的横断面分析研究，共纳入了 153 名无病宫颈癌幸存者，他们于 2004 年 1 月至 2018 年 12 月在加纳库马西的科姆福阿南凯教学医院（KATH）完成了治愈性治疗。我们使用欧洲癌症研究与治疗组织核心 30 项（EORTC QLQ-C30）和宫颈癌模块（EORTC QLQ-CX24）评估幸存者的整体 QoL。QoL 域评分根据疾病及其治疗的影响分为受影响或不受影响。使用学生 t 检验确定每个 QoL 域中受影响和不受影响组之间的显著差异。我们使用 Kruskal-Wallis 和 Dunn 检验来检查不同治疗类型之间 QoL 域的差异，显著性基于 Bonferroni 校正。采用多变量逻辑回归分析确定总体 QoL 的预测因素。p 值小于 0.05 被认为具有统计学意义。
研究了 153 名平均年龄为 58.3（SD 11.4）岁的女性。总体 QoL 评分为 79.6（SD 16.0），在宫颈癌诊断后中位随访时间 41.8 个月（四分位距 [IQR]，25.5-71.1 个月）内，74.5%的幸存者报告了良好的 QoL 评分。尽管大多数（66.0-84.3%）QoL 功能量表不受影响，但约五分之一（22.2%）至三分之一（34.5%）的受试者在认知和角色功能方面存在感知障碍。最常见的报告症状是财务困难、周围神经病变和疼痛。三分之一的幸存者担心性生活会疼痛，36.6%的人表示性生活受到影响。接受手术、放化疗和单纯放疗的幸存者的总体 QoL 评分分别为 86.1（SD 9.7）、76.9（SD 17.7）和 80.7（SD 14.7）（p = 0.025）。幸存者总体 QoL 的预测因素是食欲不振（调整后的优势比 [AOR] = 9.34，95%置信区间 [CI] = 2.13-35.8，p = 0.001）、疼痛（AOR = 3.53，95% CI = 1.25-9.31，p = 0.017）和身体形象（AOR = 5.89，95% CI = 1.80-19.27，p = 0.003）。
约 75%的幸存者生活质量良好。主要手术治疗为生活质量提供了最佳前景，症状投诉和经济负担最小。食欲不振、疼痛或身体形象感知下降预测了宫颈癌幸存者治疗后的总体生活质量。
