title: Cervical cancer survivorship in a population based sample.
abstract: OBJECTIVE
  Though cervical cancer is preventable, this cancer nonetheless poses serious mortality and morbidity threats to American women and women globally. The purpose of this study is to utilize a multidimensional framework to assess Health-related Quality of Life (HRQOL) and its salient predictors among a population based sample of cervical cancer survivors.
  
  
  METHODS
  A cross-sectional design was used with a population-based sample ascertained from the California Cancer Surveillance Program. Descriptive, bivariate and multivariate regression analyses were conducted.
  
  
  RESULTS
  Participants were 560 cervical cancer survivors: English-speaking Latina- (n=88), Spanish-speaking Latina- (n=199) and European- (n=273) Americans. The greatest concerns were documented for family/social and emotional well-being, and body image and sexual health. In general, Latina-Americans reported poorer overall HRQOL, functional, emotional, and social/family wellbeing compared to European-Americans. Differences in HRQOL persisted by ethnic/language group after controlling for covariates. Radiation, comorbidity, role limitations, perceived health status, psychological wellbeing, body image, sexual impact, doctor-patient relationship, and social support were significant predictors of overall HRQOL. The regression model explained 58% of the variance in predicting HRQOL.
  
  
  CONCLUSIONS
  These cervical cancer survivors reported poor to moderate HRQOL with persistent psychosocial challenges. Our findings indicate that lower SES, monolingual Latinas are at greatest risk for poor HRQOL outcomes. Clinicians should pay attention to their patients' socio-ecological context as a risk factor for poorer outcomes; and provide early referrals to resources that are low cost and culturally and linguistically appropriate.
authors.affiliation: Center of Community Alliance for Research and Education, Division of Population Sciences, City of Hope National Medical Center, 1500 E. Duarte Rd, Duarte, CA 91010, USA. kashing@coh.org
authors.forename: Kimlin T
authors.initials: KT
authors.lastname: Ashing-Giwa
authors.forename: Judith S
authors.initials: JS
authors.lastname: Tejero
authors.forename: Jinsook
authors.initials: J
authors.lastname: Kim
authors.forename: Geraldine V
authors.initials: GV
authors.lastname: Padilla
authors.forename: Marjorie
authors.initials: M
authors.lastname: Kagawa-Singer
authors.forename: M Belinda
authors.initials: MB
authors.lastname: Tucker
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Lim
mesh_terms: D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012944:Social Support; D012959:Socioeconomic Factors; D017741:Survivors; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000523:psychology*; D044465:White People