title: Health-related quality of life in cervical cancer survivors: a population-based survey.
abstract: OBJECTIVE
  In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis.
  
  
  METHODS
  All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive after Jan 2006 were identified through the cancer registry. Generic HRQoL (36-Item Short-Form Health Survey, EQ-5D), cervical cancer-specific HRQoL (European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module), and anxiety (6-item State Trait Anxiety Inventory) were assessed and compared with a reference population (n = 349). Data for tumor characteristics at diagnosis and disease progression were available.
  
  
  RESULTS
  A total of 291 women responded (69%), with a mean age of 53 +/- 13 (SD) years (range, 31-88 years). Treatment had consisted of surgery (n = 195) or a combination of therapies (n = 75); one woman had not been treated. Of all women, 85% were clinically disease free, 2% had a recurrence/metastasis, and in 13%, this was unknown. After controlling for background characteristics (age, education, job and marital status, having children, and country of birth), generic HRQoL scale scores were similar to the reference population, except for worse mental health in survivors. The most frequent symptoms were crampy pain in the abdomen or belly (17%), urinary leakage (15%), menopausal symptoms (18%), and problems with sexual activity. Compared with the 6-10-year survivors, more sexual worry and worse body image were reported by the 2-5-year survivors. Compared with surgery only, especially primary radiotherapy was associated with an increased frequency of treatment-related side effects, also after controlling for age and disease stage at diagnosis and follow-up.
  
  
  CONCLUSIONS
  Most cervical cancer survivors were coping well, although their mental health was worse than in the reference population. Even after 2-10 years, radiotherapy was associated with an increased frequency of treatment-related side effects.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. i.korfage@erasmusmc.nl
authors.forename: Ida J
authors.initials: IJ
authors.lastname: Korfage
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
authors.forename: Lonneke
authors.initials: L
authors.lastname: van de Poll-Franse
authors.forename: Roy
authors.initials: R
authors.lastname: Kruitwagen
authors.forename: Marjolein
authors.initials: M
authors.lastname: van Ballegooijen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D017741:Survivors; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000401:mortality / Q000523:psychology / Q000628:therapy