National Advisory Unit for Late Effects After Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.
Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway.
Acta Obstet Gynecol Scand. 2023 Feb;102(2):218-225. doi: 10.1111/aogs.14490. Epub 2023 Jan 23.
Health-related quality of life (HR-QoL) in cancer survivors is relevant for symptom relief and optimal care. The aim of this cross-sectional study of long-term cervical cancer survivors was two-fold: (a) To compare HR-QoL in long-term cervical cancer survivors with reference data; and (b) to identify modifiable factors significantly associated with low levels of generic cancer HR-QoL in long-term cervical cancer survivors using high HR-QoL as reference.
Women treated for cervical cancer from 2000 through 2007 who were cancer-free and alive in 2013 received a mailed questionnaire including scales for anxiety, depression, and HR-QoL. To obtain a homogeneous sample only women with FIGO stages 1 and 2 were included. The questionnaire included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.C-30 (EORTC QLQ C-30) for generic HR-QoL. Groups with high and low HR-QoL were defined by the median score on the general HR-QoL item. Between-group differences were examined with descriptive statistics. Logistic regression analyses examined independent variables associated with low generic HR-QoL.
Complete C-30 scores were delivered by 472 long-term cervical cancer survivors. Median age at survey was 53 (interquartile range 14.9) years, and median time since diagnosis was 11 (interquartile range 3.9) years. The proportion of survivors with stage 1 disease was 83% and stage 2 was 17%. Mean generic HR-QoL scores showed minor differences between long-term cervical cancer survivors and reference data. In the multivariable analysis, only modifiable variables remained significantly associated with low generic HR-QoL namely self-rated health, probable depression, fatigue, and pain. In bivariate analyses other modifiable variables also showed significant associations with low generic HR-QoL like probable anxiety disorder, obesity, smoking, sleep disturbances, and bowel symptoms.
Clinicians should be aware that generic HR-QoL in long-term cervical cancer survivors eventually may be improved by identification and treatment of modifiable factors through the whole follow-up period.
癌症幸存者的健康相关生活质量（HR-QoL）与症状缓解和最佳护理相关。本项针对长期宫颈癌幸存者的横断面研究有两个目的：（a）将长期宫颈癌幸存者的 HR-QoL 与参考数据进行比较；（b）通过以高 HR-QoL 为参考，确定与长期宫颈癌幸存者低水平通用癌症 HR-QoL 显著相关的可改变因素。
2000 年至 2007 年接受宫颈癌治疗且在 2013 年无癌症且存活的女性收到了一份邮寄问卷，其中包括焦虑、抑郁和 HR-QoL 量表。为了获得同质样本，仅纳入 FIGO 分期 1 和 2 的女性。问卷包括欧洲癌症研究与治疗组织（EORTC）生活质量问卷-C30（EORTC QLQ C-30）的通用 HR-QoL。通过一般 HR-QoL 项目的中位数将高和低 HR-QoL 组进行定义。使用描述性统计检验组间差异。逻辑回归分析检验与低通用 HR-QoL 相关的独立变量。
472 名长期宫颈癌幸存者完成了完整的 C-30 评分。调查时的中位年龄为 53 岁（四分位距 14.9），诊断后中位时间为 11 年（四分位距 3.9）。患有 1 期疾病的幸存者比例为 83%，2 期为 17%。通用 HR-QoL 评分显示长期宫颈癌幸存者与参考数据之间存在微小差异。在多变量分析中，仅可改变的变量与低通用 HR-QoL 显著相关，即自我报告的健康状况、可能的抑郁、疲劳和疼痛。在双变量分析中，其他可改变的变量，如可能的焦虑障碍、肥胖、吸烟、睡眠障碍和肠道症状，也与低通用 HR-QoL 显著相关。
临床医生应该意识到，通过整个随访期间识别和治疗可改变的因素，长期宫颈癌幸存者的通用 HR-QoL 最终可能会得到改善。
