title: Comorbid chronic diseases and their associations with quality of life among gynecological cancer survivors.
abstract: BACKGROUND
  Many gynecological cancer survivors (GCS) have comorbid chronic diseases (CCD). This study was to estimate the impacts of CCD on quality of life (QOL) in GCS.
  
  
  METHODS
  We collected cross-sectional self-reported survey data from 598 GCS between April and July 2013, in Shanghai, China. All the subjects were asked to complete a questionnaire containing the European Organization for Research and Treatment quality of life version 3 questionnaire (EORTC QLQ-C30) and questions on socio-demographic characteristics and CCD. In order to mitigate the bias caused by confounding factors, multiple linear models were employed to calculate adjusted means of QOL scores.
  
  
  RESULTS
  Approximately three-quarters of subjects reported at least one CCD. The highest overall prevalence of all CCD was found in endometrial cancer survivors. Subjects with CCD generally reported lower scores for most EORTC QLQ-C30 scales when compared to subjects without CCD, indicating poorer QOL, particularly for cardiovascular diseases, respiratory diseases, digestive diseases, and musculoskeletal disease.
  
  
  CONCLUSIONS
  The CCD are common health problems among GCS. CCD have significantly negative influence on QOL, and GCS with CCD generally reported lower QOL scores. These findings suggested comprehensive cares for GCS.
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Wang
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Jonathan and Karin Fielding School of Public Health, University of California, 650 Charles Young Drive South, Los Angeles, CA, 90095, USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
authors.forename: Xiao-Huan
authors.initials: XH
authors.lastname: Cong
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
authors.forename: Xue-Fen
authors.initials: XF
authors.lastname: Chen
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Tang
authors.affiliation: College of Clinical Medicine, Anhui Medical University, Hefei, Anhui Province, China.
authors.forename: Dong-Hui
authors.initials: DH
authors.lastname: Yu
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
authors.forename: Tian-Rui
authors.initials: TR
authors.lastname: Zhang
authors.affiliation: Shanghai Health Education Association, 122 Shan-Xi-Nan Road, 200040, Shanghai, China.
authors.forename: Zheng-Nian
authors.initials: ZN
authors.lastname: Luo
authors.affiliation: Shanghai Cancer Rehabilitation Club, 2795 Yang-Gao-Zhong Road, Shanghai, 200135, China.
authors.forename: Zheng-Ping
authors.initials: ZP
authors.lastname: Yuan
authors.affiliation: School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China. jmy@fudan.edu.cn.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D057566:Self Report; D017741:Survivors