title: Patient-rating of distressful symptoms after treatment for early cervical cancer.
abstract: BACKGROUND
  More refined information on sources of symptom-induced distress in a patient population can improve the quality of pretreatment information, make follow-up visits more efficient and guide research priorities in the efforts to modify treatments.
  
  
  METHODS
  In a population-based epidemiological study covering all of Sweden, data were collected 1996-97 by means of an anonymous postal questionnaire. We attempted to enroll all 332 patients with stage IB-IIA cervical cancer registered in 1991-92 at the seven departments of gynecological oncology in Sweden.
  
  
  RESULTS
  A total of 256 cases (77%) completed the questionnaire. After surgery, alone or in combination with intracavitary radiotherapy, several symptoms related to sexual dysfunction are the primary sources of symptom-induced distress (reduced orgasm frequency: much distress 23% (surgery alone) and 23% (intracavitary radiotherapy and surgery), respectively, overall intercourse dysfunction: much distress 17% and 20%, respectively, followed by lymphedema (much distress 14% and 14%, respectively). Dyspareunia (much distress 24%) and defecation urgency (much distress 22%) are two leading causes of distress after surgery and external radiotherapy. After treatment with radiotherapy alone, loose stool and dyspareunia were the two most distressful symptoms (much distress 19% each). When a symptom occurs, fecal leakage and reduced orgasm frequency are the two most distressful ones (measured as much distress, 38% each).
  
  
  CONCLUSIONS
  The observed symptoms are distressful and should, if one focuses on patient satisfaction, be given priority.
authors.affiliation: Department of Oncology, Gynecological Oncology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Bergmark
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Avall-Lundqvist
authors.forename: Paul W
authors.initials: PW
authors.lastname: Dickman
authors.forename: Lars
authors.initials: L
authors.lastname: Henningsohn
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D005242:Fecal Incontinence / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011182:Postoperative Care; D012042:Registries; D012735:Sexual Dysfunction, Physiological / Q000150:complications / Q000453:epidemiology; D013312:Stress, Physiological; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014549:Urinary Incontinence / Q000150:complications / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery