Abstract
BackgroundCervical cancer is the third largest cause of cancer mortality in India. The objectives of the study were to compare the pre and the post treatment quality of life in cervical cancer patients and to develop a prediction model to provide an insight into the possibilities in the treatment modules.Methodology/Principal FindingsA total of 198 patients were assessed with two structured questionnaires of Health Related Quality of Life (The European Organisation for Research and Treatment of Cancer, EORTC QLQ C-30 and CX-24). The baseline observations were recorded when the patients first reported (T1) and second evaluation was done at 6 months post treatment (T2). The mean age of detection was 50.9 years with the literacy level being non-educated or less than high school. Majority of them were married/cohabiting 179 (90.4%). On histopathological examination (HPE) squamous cell carcinoma was found to be the most common cell type carcinoma 147 (74.2%) followed by Adenocarcinoma 31 (15.7%). Radical hysterectomy was the most common treatment modality 76 (38.4%), followed by Wertheims Hysterectomy 46 (23.2%) and Radiochemotherapy 59 (29.8%). The mean score of global health of cervical cancer patients post treatment was 77.90, which was significantly higher than the pre - treatment score (54.32). Mean “symptoms score” post treatment was 21.69 with an aggravation of 7.32 compared to pre treatment scores. Patients experienced substantial decrease in sexual activity post treatment.Conclusions/SignificanceThe prediction model(PrediQt-Cx), based on Support Vector Machine(SVM) for predicting post treatment HRQoL in cervical cancer patients was developed and internally cross validated. After external validation PrediQt-Cx can be easily employed to support decision making by clinicians and patients from north India region, through openly made available for access at http://prediqt.org.
Highlights
Cervical cancer is one of the most common cancers worldwide [1]
The mean score of global health of cervical cancer patients post treatment was 77.90, which was significantly higher than pre treatment values 54.32 by about 23.58 points
Post treatment single item scales items- ‘‘dyspnoea’’, ‘‘insomnia’’, ‘‘appetite loss’’ and ‘‘constipation’’ were lower, while the item - financial difficulties was elevated in comparison to pre treatment scores
Summary
The disparity between the mortality rates amongst the high and the low income group countries signifies a health inequity [1]. There exists a higher prevalence in the low socio-economic groups within different countries, which exemplifies uneven availability and accessibility to the health services [2]. Situation The age-adjusted incidence of cervical cancer in India is 25.9%. According to the Population Based Cancer Registries (PBCR), it has the second highest prevalence following breast cancer [4]. The pervasiveness of cervical cancer is much higher in rural and low socioeconomic groups in India [2,5]. Lack of access to screening, affordability, compliance and follow up of treatment are the major causes for this pattern of discordance [6]. Cervical cancer is the third largest cause of cancer mortality in India. The objectives of the study were to compare the pre and the post treatment quality of life in cervical cancer patients and to develop a prediction model to provide an insight into the possibilities in the treatment modules
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