关于长期宫颈癌幸存者生活质量可调节因素的研究
A study of modifiable factors associated with health-related quality of life in long-term cervical cancer survivors
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影响因子:3.1
分区:医学2区 / 妇产科学2区
发表日期:2023 Feb
作者:
Alv A Dahl, Anne Gry Bentzen, Sophie D Fosså, Siri Lothe Hess, Cecilie E Kiserud
DOI:
10.1111/aogs.14490
摘要
癌症幸存者的健康相关生活质量（HR-QoL）对缓解症状和提供最佳护理具有重要意义。本横断面研究旨在（a）比较长期宫颈癌幸存者的HR-QoL与参考数据；（b）利用高生活质量作为参考，识别与低一般癌症HR-QoL显著相关的可调节因素。本研究对象为2000年至2007年间治疗的无癌症复发、存活至2013年的宫颈癌患者，寄送问卷，内容包括焦虑、抑郁和HR-QoL量表。仅包括FIGO分期1和2期的患者以确保样本的一致性。问卷采用欧洲肿瘤研究与治疗组织生活质量问卷C-30（EORTC QLQ C-30）。根据一般生活质量项的中位数得分，将高和低生活质量组划分。采用描述性统计分析组间差异，并通过逻辑回归分析识别与低生活质量相关的可调节因素。收到有效问卷472份，患者中位年龄53岁（四分位间距14.9），诊断至调查的中位时间为11年（四分位间距3.9）。其中1期患者占83%，2期占17%。整体平均生活质量得分与参考群体差异不大。在多变量分析中，只有可调节的变量（自评健康状况、可能存在的抑郁、疲劳和疼痛）与低生活质量显著相关。其他变量如焦虑、肥胖、吸烟、睡眠障碍和肠道症状也显示出相关性。临床医生应注意，通过识别和治疗这些可调节因素，长-term宫颈癌幸存者的生活质量有望得到改善。
Abstract
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.