Comorbidity in Disease-Free Survivors of Cervical Cancer Compared with the General Female Population

Abstract

Objectives: We aimed to investigate the prevalence of comorbidities in cervical cancer survivors compared with the general population and to identify risk factors and impact on their quality of life (QoL). Methods: 860 female cervical cancer survivors enrolled at six tertiary hospitals and 994 women from the general population were surveyed on current comorbidities and QoL (EORTC QLQ-C30 and QLQ-CX24). Results: Compared with the general female population, the cervical cancer survivors reported higher prevalence of comorbidities (0.93 ± 2.91 vs. 0.37 ± 0.67, p < 0.01), significantly more heart disease (adjusted odds ratio (aOR), 2.64; 95% confidence interval (CI), 1.38–5.07), liver disease (aOR, 3.29; 95% CI, 1.54–7.02), hypertension (aOR, 1.72; 95% CI, 1.30–2.27), gastrointestinal disease (aOR, 1.79; 95% CI, 1.37–2.33) and musculoskeletal disease (aOR, 1.94; 95% CI, 1.45–2.59). Heart and renal disease significantly influenced QoL in many subscales. Patients with diabetes or cerebrovascular disease had an increased likelihood of sexual problems. Conclusions: The cervical cancer survivors had more comorbidities than the general population, and that in turn affected their QoL. Vigilant follow-up of comorbidities should be incorporated into in the care of cancer survivors.

Depression and Suicide Ideas of Cancer Patients and Influencing Factors in South Korea

“…In the present study, the results may have been affected by the fact that more than 50% of participants were aged ≥50 years, and more than 50% had less than a middle-school level of education, so the socioeconomic differences might not be significant. The SEER stage (used to categorize localized primary cancer and metastasized cancer), and the Charlson Comorbidity Index (used to assess the effects of comorbid conditions) revealed no significant differences in depression and suicidal ideation; this differs from the results of previous studies (Recklitis et al, 2010;Shin et al, 2008). The difference might have been related to the fact that we could not stratify the patients by type of cancer because the number of patients with each type of cancer was so small, and previous studies might have focused on specific types of cancer.…”

“…By comprehensively incorporating the significant factors identified in previous studies (Charlson et al, 1987;Miller, 2000;Pirkis, 2000;Akechi et al, 2002;Akechi et al, 2002;Amir., 2002;Bruce et al, 2004;Pirkola, 2004;Bjorkenstam et al, 2005;Misono et al, 2008;Shin et al, 2008;Park et al, 2009;Ahn et al, 2010;Fanger et al, 2010;Recklitis et al, 2010;Shim, 2010;Shin et al, 2010;Mitchell et al, 2011), this study analyzed the influential parameters using depression and suicidal ideation as dependent variables, and sociodemographic characteristics, health-related behavior, clinical conditions, and quality of life as independent variables. Age, education, income (monthly income after cancer diagnosis), and marital status were categorized as sociodemographic characteristics, and smoking and alcohol consumption represented health-related behavior.…”

Prevalence, Awareness, Control, and Treatment of Hypertension and Diabetes in Korean Cancer Survivors: A Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

“…Previous studies found no significant difference in the prevalence of hypertension between cancer survivors and non-cancer survivors (Enright et al, 2010),slightly higher prevalence in cancer survivors according to cancer types (Shin et al, 2008;Weaver et al, 2013), or specific treatment methods (Jain et al, 2007;Valentova et al, 2011). Hypertension was the most frequent comorbid condition treated in cancer survivors (Goytia et al, 2009), and there is a widespread need for the management of chronic diseases and related risk factors to reduce the late adverse effects of chemotherapy and radiation (Daher et al, 2012).…”

“…With the increasing number of cancer survivors, evaluation and management of their chronic comorbid conditions have become important issues (Ogle et al, 2000). Hypertension is the most common comorbidity in cancer survivors, with a prevalence of 20%-65% (Ogle et al, 2000;Park et al, 2006;Shin et al, 2008;Braithwaite et al, 2009). Prevalence of hypertension at the time of cancer diagnosis is similar to that in the general population, however, the much higher rate is observed after treatment such as chemotherapy (Mouhayar et al, 2011).…”

“…Inadequately controlled comorbidities tend to adversely affect health status or disability as well as cancer treatment in cancer survivors, and they have prognostic significance in relation to survival disparity (Muss et al, 1992;Hewitt et al, 2003). Although hypertension and diabetes accounted for a poorer prognosis among cancer survivors in a limited number of studies on certain types of cancers, hypertension was associated with all-cause survival disparity and poor prognosis in stomach, lung, and colon cancer (Park et al, 2006;Shin et al, 2008;Braithwaite et al, 2009), and diabetes was significantly associated with higher mortality and recurrence rates in cancer survivors (Richardson et al, 2005;Griffiths et al, 2012). Therefore, proper management of hypertension and diabetes is important for better survival and quality of life for cancer survivors.…”