Lifestyle modification in cervical cancer survivors: an ongoing need.
OBJECTIVE
With the introduction of multimodality therapy for cervical cancer, many women will be long-term survivors in need of comprehensive surveillance care. Our goals were to evaluate patterns of obesity and smoking in a cohort of cervical cancer survivors and to assess the potential influence of these comorbidities on subsequent follow-up.


METHODS
We reviewed the records of patients treated for invasive cervical cancer at our institution from 2000 to 2003 who had no evidence of disease for 3 or more years. Demographic and clinical data were collected, including smoking history and anthropometric measurements. Body mass index (BMI) was categorized according to World Health Organization criteria. Logistic regression and Wilcoxon rank sum analyses were performed.


RESULTS
Two hundred ninety-eight women had complete follow-up data at 3 years. The median age at diagnosis was 43.5 years (range, 17.6-87.1 years). At diagnosis, 31.9% had a normal BMI, 28.2% were overweight, and 34.6% were obese compared with 31.7%, 21.1%, and 30.2% at 3 years, respectively. Of the 51 women whose BMI categorization changed, 33 (64.7%) had weight gain, and 18 (35.3%) had weight loss. By paired analyses, increase in BMI was significant over the 3-year interval (P < 0.001). Seventy patients actively smoked at diagnosis. Compared with nonsmokers, current smokers had a greater odds of referral to the pain service (odds ratio [OR], 6.56; confidence interval [CI], 6.26-16.43; P < 0.001), physical therapy (OR, 4.74; CI, 1.29-17.36; P = 0.02), and gastroenterology (OR, 2.25; CI, 1.14-4.24; P = 0.02).


CONCLUSIONS
Obesity and smoking are significant comorbidities that may complicate care in cervical cancer survivors. Interventions aimed at modifying these risk factors should be routinely undertaken in this population.
*Division of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ; and †Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Matthew P
MP
Schlumbrecht
Charlotte C
CC
Sun
Marilyn S
MS
Huang
Fran
F
Zandstra
Diane C
DC
Bodurka
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D012907:Smoking / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000523:psychology*; D055815:Young Adult