Long-term, adverse genitourinary outcomes among endometrial cancer survivors in a large, population-based cohort study

Abstract

ObjectiveWith the increasing incidence of endometrial cancer, the high survival rate, and the large number of endometrial cancer survivors, investigations of long-term genitourinary outcomes are important for the management of these outcomes among endometrial cancer survivors. MethodsCohorts of 2648 endometrial cancer survivors diagnosed in the state of Utah between 1997 and 2012 and 10,503 general population women were identified. All ICD-9 diagnosis codes were collected from the state's two largest healthcare systems and statewide databases. Multivariate Cox regression models were used to estimate hazard ratios at 1–5years and >5–10years after endometrial cancer diagnosis for genitourinary outcomes. ResultsEndometrial cancer survivors were at elevated risk for urinary system disorders between 1 and 5years (HR: 1.64, 95% CI: 1.50–1.78) and >5–10years (HR: 1.40, 95% CI: 1.26–1.56) and genital organ disorders between 1 and 5years (HR: 1.71, 95% CI: 1.58–2.03) and >5–10years (HR: 1.33, 95% CI: 1.19–1.49). Significantly elevated risk was observed among endometrial cancer survivors for renal failure, chronic kidney disease, urinary tract infections, and nonmalignant breast conditions, persisting between >5–10years. Between 1 and 5years after cancer diagnosis, those with higher stage, higher grade, older age and treated with radiation or chemotherapy were at higher risk for urinary disorders. ConclusionsEndometrial cancer survivors were at higher risk for many genitourinary outcomes compared to women from the general population. This study presents evidence suggesting the necessity of increased monitoring and counseling for genitourinary disorders for endometrial cancer patients both immediately after treatment cessation and for years afterwards.