title: Patient preferences for side effects associated with cervical cancer treatment.
abstract: OBJECTIVE
  The aim of this study was to assess patient preferences regarding side effects associated with cervical cancer treatment.
  
  
  METHODS
  The visual analog scale (VAS) and modified standard gamble (SG) were used to elicit preferences of women with no evidence of disease after primary treatment of cervical cancer. Higher scores on VAS and SG indicated more favorable ratings for a given health state. Health states (HS) included vaginal shortening, diarrhea, dietary changes, menopause, moderate nausea/vomiting, rectal bleeding, sexual dysfunction, and urinary self-catheterization. Descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-ranks tests and correlation coefficients were used for statistical analysis.
  
  
  RESULTS
  Seventy-eight patients participated in the study. Median age was 44.1 years (range, 24.9-67.8 years). Median time since treatment completion was 31.2 months (range, 1.0-113.3 months). The HSs rated as most favorable by VAS were also rated as most favorable by SG. Increasing age was associated with higher VAS scores for menopause and vaginal shortening (P = 0.04 and 0.036). African Americans had higher VAS scores for dietary changes (P = 0.05), sexual dysfunction (P = 0.028), and diarrhea (P = 0.05) when compared with Hispanic and non-Hispanic white patients. Women receiving radiation had more favorable VAS scores for menopause compared with women undergoing radical hysterectomy (P = 0.05). Women receiving chemotherapy rated urinary self-catheterization less favorably by VAS score compared with those not receiving chemotherapy (P = 0.045).
  
  
  CONCLUSIONS
  Multiple demographic and clinical factors influence the severity of treatment-related adverse effects perceived by women surviving cervical cancer. A better understanding of factors influencing patient preferences regarding treatment side effects will allow providers to formulate care better tailored to the individual desires of each patient.
authors.affiliation: Departments of *Gynecologic Oncology and Reproductive Medicine and †Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sun
authors.forename: Alaina J
authors.initials: AJ
authors.lastname: Brown
authors.forename: Anuja
authors.initials: A
authors.lastname: Jhingran
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Lois
authors.initials: L
authors.lastname: Ramondetta
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
mesh_terms: D000230:Adenocarcinoma / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003131:Combined Modality Therapy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D009367:Neoplasm Staging; D010147:Pain Measurement; D057240:Patient Preference; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D014839:Vomiting / Q000209:etiology; D055815:Young Adult