Life In Cervical Cancer Survivors Research Articles

Impact of Various Treatment Modalities on Long-Term Quality of Life in Cervical Cancer Survivors.

Introduction Given treatment advancements and the long life expectancy of mostly young patients with cervical cancer, their post-treatment quality of life (QoL) is essential to consider. This study aimed to evaluate the long-term QoL in cervical cancer survivors treated with various approaches. Methods We conducted a cross-sectional survey-based study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cervical Cancer Module 24 (EORTC-QLQ-CX24) questionnaires and involved members of the online cervical cancer patient support group (01/2024-02/2024). Eligible participants were ≥18 years old, diagnosed with stage IA2-IIB cervical cancer, and had completed their treatment. Respondents were stratified into four management groups: neoadjuvant chemotherapy + surgery +/- radiation therapy (RT), surgery + RT, RT alone, and surgery alone. Results Overall, 173 patients participated: 20 (11.6%) received neoadjuvant chemotherapy + surgery +/- RT, 50 (28.9%) had surgery + RT, 69 (39.9%) had RT alone, and 34 (19.7%) had surgery alone. Patients after surgery alone had significantly better global QoL (p<0.001). Their physical (p<0.001), role (p=0.037), emotional (p=0.024), and social (p=0.006) functioning were also substantially better. This group also reported the lowest severity of fatigue (p=0.001), nausea and vomiting (p<0.001), and diarrhea (p<0.001). Sexual functioning was better in the surgery-alone group in almost all aspects. There were no major differences in QoL among the groups, receiving RT alone or combined with other treatments. Conclusions Cervical cancer survivors who underwent surgery alone reported the highest QoL and lower symptom intensity compared to those treated with RT or treatment combinations. RT combined with other modalities did not appear to substantially decrease QoL compared to RT alone.

Quality of life in long-term cervical cancer survivors compared with healthy women and women with benign gynecological disorders

ObjectiveThe impact of cervical cancer treatment on the quality of life of long-term survivors compared with the general female population is controversial, and no studies have been conducted comparing patients with benign gynecological diseases. The aim of this study was to compare the quality of life of cervical cancer survivors with that of healthy controls. Study DesignA case-control study was conducted to compare the quality of life of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a healthy woman check-up (n 46) or for a benign gynecological disorder (symptomatic, n 113; asymptomatic, n 26).To measure quality of life, self-administered questionnaires, such as the Functional Assessment Cancer Therapy-cervix and World Health Organization quality of life-brief version, were employed. Baseline scores were collected when patients first reported, and further evaluations were completed at 0–6, 7–12, 13–24, 25–60, and more than 60 months.For the contrastive analysis hypothesis, we employed R statistical software. ResultsExcept for the environment domain at 0–6, 7–12, and 13–24 months (51.52 vs. 60.73, p < 0.0001; 52 vs. 60.73, p < 0.0001; 49.81 vs. 60.73, p < 0.0001, respectively), we found no statistically significant differences in the quality of life between cervical cancer survivors and controls. We did find differences in the physical health domain scores at 0–6 months (60.22 vs. 72.42, p = 0.039) and the social relationships domain scores at 13–24 months (54 vs. 71.42, p = 0.017) between cases and asymptomatic controls. ConclusionExcept for physical well-being, environment and social relationships, which were substantially better for controls, especially in the asymptomatic, long-term cervical cancer survivorśquality of life did not vary from that of controls.

Longitudinal Assessment of the Quality of Life of Cervical Cancer Survivors from a Tertiary Hospital in Seville, Spain: Does Statistical Significance Equate to Clinical Relevance?

Longitudinal Assessment of the Quality of Life of Cervical Cancer Survivors from a Tertiary Hospital in Seville, Spain: Does Statistical Significance Equate to Clinical Relevance?

Development and internal validation of a multivariable prediction model for the quality of life of cervical cancer survivors.

To elaborate a prediction model for quality of life of cervical cancer survivors. We conducted a prospective cohort study on 229 cervical cancer survivors. The quality of life measures included the Functional Assessment Cancer Therapy-Cervix version 4.0 and the World Health Organization Quality of Life-brief version self-administered questionnaires. We imported the data into the statistical software program R and developed a gamma generalized linear model. Our internally validated predictive model for the Functional Assessment Cancer Therapy-Cervix total score was composed of the following predictors: pain, appetite, vaginal bleeding/discharge/odor, and WHOQOL-BREF social relationships domain. The Harrell's concordance index was 0.75. We developed a solid and internally validated predictive model in cervical cancer survivors based on predictors, such as pain, appetite, vaginal bleeding/odor/discharge, and WHOQOL-BREF social relationships subscale score that contribute significantly to quality of life as targets for potential intervention.

Quality of Life in Cervical Cancer Survivors Treated with Concurrent Chemoradiotherapy.

Background and Objectives: Cervical cancer is the fourth most common cancer in women globally. As survival rates gradually increase, it becomes necessary to assess the quality of life (QoL) after treatment. It is known that different treatment modalities have different effects on QoL. Therefore, we aimed to evaluate the QoL of cervical cancer survivors (CCSs) treated with concurrent chemoradiotherapy (CCRT). Materials and Methods: A cross-sectional monocentric study, conducted in Vilnius university hospital Santaros klinikos between November 2018 and November 2022, included 20 women, who were interviewed once using the European Organization for Research and Treatment of Cancer (EORTC)-designed Quality-of-Life questionnaire cervical cancer module (QLQ-CX24). The sociodemographic and clinical data as well as the results of the questionnaire are presented in mean, standard deviation and percentages. The QoL scores were compared between different age and stage groups using the Mann-Whitney U test. Results: Twenty participants, aged from 27 to 55 years, with a mean age of 44 years (SD = 7.6) participated in the study. All the participants were CCSs with an International Federation of Gynecology and Obstetrics (FIGO) stage from IB to IIIB and all of them were treated with CCRT. The symptom experience was relatively low and revealed a good result (21.8, SD = 10.2). Mean scores on body image, sexual/vaginal functioning, menopausal symptoms and sexual worry scales indicated moderate functioning and a moderate level of some of the cervical cancer specific symptoms after CCRT. Sexual activity and sexual enjoyment of the CCSs were low (11.7 (SD = 16.3), 14.3 (SD = 17.8), respectively). Conclusions: Cervical cancer survivors report a relatively good quality of life regarding symptom experience; however, women following concurrent chemoradiotherapy tend not to be sexually active and rarely feel sexual enjoyment. In addition, this treatment modality negatively affects a woman's body image and self-perception as a woman.

Impact of Cervical Cancer on Quality of Life and Sexuality in Female Survivors.

Cervical cancer is the fourth most frequent cancer in women worldwide, and the 11th most frequent neoplasm in Spain. Despite the optimization of treatments and a 5-year survival rate of 70%, side effects and sequelae are described after treatment. The treatments have physical, psychological and sociocultural consequences that deteriorate the quality of life of patients. One of the sequelae that worries patients is the impairment of sexual function and satisfaction, considered a fundamental dimension of the human being. The aim of this study was to examine quality of life and sexual function and satisfaction among Spanish cervical cancer survivors. A retrospective case-control study was conducted between 2019 and 2022. The sample consisted of 66 patients who completed the Female Sexual Function Index, the Golombok Rust Sexual Satisfaction Inventory and European Organization for Research and Treatment of Cancer quality of life questionnaire. The control group consisted of women without cervical cancer and gynecological pathologies obtained using the so-called online virtual sampling method. The patient group consisted of women with cervical cancer who completed treatment. Cervical cancer survivors reported sexual dysfunction and impaired sexual satisfaction in almost half of the domains. Quality of life was also affected, with pain and fatigue being the most frequent symptoms in these patients. Our results indicate that there is dysfunction, sexual dissatisfaction and a lower level of quality of life in cervical cancer survivors than in healthy women without pathology.

Health-related quality of life among cervical cancer survivors at a tertiary hospital in Ghana.

Cervical cancer is the second most common female cancer in Ghana. The disease and its treatment significantly affect survivors' health-related quality of life (HRQoL). We determined the overall quality of life (QoL) and identified its predictors among cervical cancer survivors after treatment. A hospital-based cross-sectional analytical study was conducted on 153 disease-free cervical cancer survivors who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. We used the European Organization for Research and Treatment of Cancer core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) to assess the survivors' overall QoL. QoL domain scores were dichotomised as affected or unaffected by disease and its treatment. Significant differences between the affected and unaffected groups within each QoL domain were determined using the student T-test. We used Kruskal-Wallis and Dunn's tests to examine the difference in QoL domains between treatment types, with significance based on Bonferroni corrections. Multivariable logistic regression was performed to identify predictors of overall QoL. A p-value of less than 0.05 was considered statistically significant. One hundred and fifty-three (153) women having a mean age of 58.3 (SD 11.4) years were studied. The overall QoL score was 79.6 (SD 16.0), and 74.5% of survivors reported good QoL score within the median follow up time of 41.8 months (interquartile range [IQR], 25.5-71.1 months) after cervical cancer diagnosis. Although the majority (66.0-84.3%) of the QoL functioning scale were unaffected, about a fifth (22.2%) to a third (34.5%) of the subjects had perceptual impairment in cognitive and role functioning. Financial difficulties, peripheral neuropathy and pain were most common symptoms reported as affected. A third of the survivors were worried that sex would be painful, and 36.6% indicated that their sexual activity as affected. The overall QoL scores for survivors who had surgery, chemoradiation and radiation-alone were 86.1 (SD 9.7), 76.9 (SD 17.7), and 80.7 (SD 14.7), respectively (p = 0.025). The predictors of survivor's overall QoL were loss of appetite [Adjusted Odd Ratio (AOR) = 9.34, 95% Confidence Interval (CI) = 2.13-35.8, p = 0.001], pain (AOR = 3.53, 95% CI = 1.25-9.31, p = 0.017) and body image (AOR = 5.89, 95% CI = 1.80-19.27, p = 0.003). About 75% of the survivors had a good overall quality of life. Primary surgical treatment affords the best prospects for quality of life with the least symptom complaints and financial burden. Loss of appetite, pain or diminution in body image perception predicted the overall quality of life of cervical cancer survivors after treatment.

OC-0588 Impact of persistent symptoms on long-term quality of life of cervical cancer survivors in EMBRACE I

OC-0588 Impact of persistent symptoms on long-term quality of life of cervical cancer survivors in EMBRACE I

Qualidade de vida e fatores associados em mulheres sobreviventes ao câncer do colo do útero

O tratamento para o câncer do colo do útero pode levar à ocorrência de efeitos adversos tardios, como disfunções sexuais, intestinais ou urinárias; menopausa precoce e linfedema em membro inferior, os quais podem ter impacto negativo na qualidade de vida. O objetivo do estudo foi avaliar a qualidade de vida de sobreviventes ao câncer do colo do útero, seus fatores associados e comparar a qualidade de vida com um grupo controle de mulheres sem história de câncer. O grupo câncer foi composto por mulheres com término do tratamento há três meses (n= 37). O grupo controle, de base populacional, foi composto por mulheres sem história de câncer (n= 37). A qualidade de vida foi avaliada pelo WHOQOL-bref e a função sexual pelo Female Sexual Function Índex. Variáveis clínicas, terapêuticas e socioeconômicas foram avaliadas por questionário desenvolvido pelos autores. Em comparação ao controle, o grupo câncer apresentou maior percentual de mulheres que viviam sem companheiro, que consideravam o relacionamento com o companheiro como ruim/regular e que apresentavam disfunções urinárias, intestinais e sexuais. Além disso, o grupo câncer apresentou piores escores nos domínios “Físico” e “Relações Sociais” do WHOQOL-bref (p=0,03 e 0,01, respectivamente). Foram fatores independentemente associados ao domínio “Físico”: linfedema de membros inferiores e retenção urinária; e ao domínio “Relações Sociais”: apoio social de amigos e estenose/encurtamento vaginal. Os resultados sugerem impacto negativo da doença e de seu tratamento sobre a qualidade de vida das sobreviventes. Deve-se investigar a qualidade de vida e os fatores que a influenciam, visando um atendimento mais integral, direcionado às necessidades das pacientes, por meio de equipe multiprofissional.

Perubahan Keluhan Seksual (Fisik dan Psikologis) pada Perempuan Pascaterapi Kanker Serviks Setelah Intervensi Keperawatan

Introduction: Despite increasing awareness related to sexual health for cervical cancer survivors, health care providers are passive in addressing their sexual issues. The objectives were to develop and investigate the effect of a sexual nursing intervention packet to mitigate sexual dysfunction among cervical cancer survivors.Methods: A sample of 104 survivors were participated consecutively based on required inclusive criteria in this quasi-experimental study. The sexual nursing intervention packet focused on the physical, psychological, and care of relational aspects of sexual health elements. The packet consisted of 6 weekly 2-hour sessions.Results: The participants reported poor sexual satisfaction and sexual function. There were no statistically signi fi cant differences in sexual interest, sexual arousal, orgasm, and vaginal lubrication improvement following the intervention, although all the variables in the intervention group were improved clinically. The sexual nursing intervention packet was effective in increasing sexual satisfaction and decreasing dispareunia among cervical cancer survivors.Conclusion: This study suggests that the quality of life in cervical cancer survivors could be improved with the sexual nursing intervention packet provided as part of supportive group care. This program may be more effective if delivered earlier and for a longer period. Implications for Practice: The sexual nursing intervention packet offers an opportunity to facilitate small-group dynamics that lay the ground for further contacts leading to earlier recognition of sexual problems and active involvement for sexual health improvement for cervical cancer survivors and nurses. It could be utilized for survivor education or support groups to increase sexual satisfaction following cancer treatment.

Quality of Life in Cervical Cancer Survivors and Healthy Women: Thai Urban Population Study

Background:To determine a baseline quality of life (QoL) in cervical cancer survivors compared to that of healthy subjects in the tertiary Thammasat University Hospital, Thailand.Materials and Methods:The investigation was conducted at the outpatient gynecological department of Thammasat University Hospital between January and June 2016. A total of 192 women were entered into the study (97 cervical cancer survivors; 37 after radical hysterectomy (RH), 43 with concurrent chemoradiation (CRT), and 17 featuring both RH and CRT; and 95 control subjects from the same outpatient department with no history of malignancy). Participant QoL was assessed using a Thai version of the EORTC-QLQ-C30 (European Organization for Research Treatment of Cancer Quality-of-Life) and a general survey for the assessment of sociodemographic data was also conducted.Results:There were significant differences in physical, role, emotional and social functions between cervical cancer survivor and control groups. Global health, fatigue, pain, appetite loss, and financial difficulties also demonstrated statistically significant variation. Cervical cancer survivors treated by RH had higher scores for emotional and social function and global health than the control group. Moreover, they had less appetite loss, fatigue and financial difficulties. However, patients treated with CRT experienced more pain than the control group. All cervical cancer survivors had lower physical function scores than the control group.Conclusion:Quality of life in cervical cancer survivors is better than in healthy peers in some domains. Cervical cancer survivors treated with RH may have a better QoL than healthy peers. Early detection for early stage cervical cancer remains most important because treatment in early stages does not cause lowering of the QoL.

Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective.

BackgroundWomen living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa.MethodsWe searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, tertiary prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and tertiary prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories.ResultsA total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary prevention (i.e., screening). The number of publication focusing on primary prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts.ConclusionsCervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.

Lower urinary tract dysfunction and quality of life in cervical cancer survivors after concurrent chemoradiation versus radical hysterectomy

Lower urinary tract dysfunction (LUTD) is a common morbidity. Due to the different pathophysiology of LUT injury, we compared LUTD between patients who received concurrent chemoradiation (CCRT) and radical hysterectomy (RH). Seventy cervical cancer survivors were evaluated with multichannel urodynamic studies. The CCRT group received a total dose of 54 Gy pelvic radiation with 2-3 high-dose-rate brachytherapy, concurrent with platinum-based chemotherapy. The RH group underwent type III RH without pre- or postoperative radiation. Overall, LUTD was insignificantly different between CCRT and RH (60 % and 68.6 %). Voiding dysfunction was significantly higher in RH, particularly high postvoid residual urine and void with abdominal straining. However, storage dysfunction, particularly low bladder compliance and increased bladder sensation, were significantly more prevalent in CCRT; urinary incontinence was not significantly different between groups. LUTD was prevalent in cervical cancer survivors. Different profiles of dysfunction were demonstrated. Voiding dysfunction was higher followng RH, but storage dysfunction was higher following CCRT.

Cervical Cancer Survivors: Meaning in Life

This study endeavors to understand the meaning in life of cervical cancer survivors in India using narrative analysis. Cervical Cancer survivor participants were interviewed to obtain a holistic view of their experiences in their own words, which was followed by administration of Thematic Apperception Test. Interview data was analyzed using Narrative Analysis. The narratives indicated that the participants viewed life being predestined and guided by fate. In some cases the realization of immortality resulted in peace and satisfaction. This renewed meaning was strongly mediated by faith in God and increased religiosity which facilitated hope and resilience. Strong support systems further enhanced meaning in their lives. However, underlying factors like fatigue, fear of recurrence of the disease and perceived burden continue to be distressing factors. On the other hand, some participants who experienced a preoccupation with somatic complaints and ambivalent feelings toward God experienced a sense of meaninglessness, lack of purpose and diminished hope. The most frequently used defense mechanisms were sublimation, reaction formation, undoing, displacement and projection.

The correlates of unemployment and its association with quality of life in cervical cancer survivors

ObjectiveLittle is known regarding cervical cancer survivors' employment status, which represents social integration of cancer survivors as a pivotal domain of long-term quality of life. The goal of this study was to assess the correlates of unemployment and evaluate the impact on the comprehensive quality of life in cervical cancer survivors.MethodsWe enrolled 858 cervical cancer survivors from the gynecologic oncology departments of multi-centers in Korea. Factors associated with unemployment were identified using multivariate logistic regression analyses. We assessed different health-related quality of life domains with multivariate-adjusted least-square means between cervical cancer survivors who currently work and do not.ResultsAfter diagnosis and treatment, the percentage of unemployed survivors increased from 50.6% to 72.8%. Lower income (adjusted odds ratio [aOR], 1.97; 95% confidence interval [CI], 1.38 to 2.81), medical aid (aOR, 1.58; 95% CI, 1.05 to 2.38), two or more comorbidities (aOR, 1.80; 95% CI, 1.12 to 2.90), current alcohol drinkers (aOR, 2.33; 95% CI, 1.54 to 3.52), and employed at the time of diagnosis (aOR, 10.72; 95% CI, 7.10 to 16.16) were significantly associated with unemployment. Non-working groups showed significant differences with respect to physical functioning, role functioning, depression, and existential well-being.ConclusionThe proportion of unemployed cervical cancer survivors seems to increase, with low-income status and the presence of medical aid negatively being associated with employment, in addition to other comorbidities and previous working status. Effort should be made to secure the financial status of cervical cancer survivors.

Quality of life of cervical cancer survivors and its association with clinical and pathological factors

Abstract Background and aim : Material and methods: Findings : Mean age of participants was 57.85 with standard deviation 11.02. Mean age of participants’ at the time of diagnosis was 54.83 with standard deviation of 11.33. Quality of life scores for these patients was 46.98 with standard deviation of 7.60 , which is considered a moderate level of quality of life. Scores of physical functioning ,emotional ,and social functioning sub scales were 25±9.61 -53.8±14.53 and 61.34±18.33 respectively.Therer was a significant association between quality of life scores and socioeconomic status .A significant association was also found between quality of life scores and duration of time from diagnosis and treatment completion. Conclusion: Findings of this study showed that quality of life of cervical cancer survivals was affected by cancer. Improving physical function and recovery form symptoms may improve quality of life of these patients. Key words : Quality of life. Cervical cancer. Cancer survivors A descriptive correlational design was used. 65 cervical cancer survivors who had completed their treatment during the time period from 2001 to 2008 participated in the study. Data were collected by two questionnaires:” European Organization for Research and Treatment of Cancer Quality of Life Questionnaire –Cervix 24 “ and “ European Organization for Research and Treatment of Cancer Quality of Life Questionnaire- Core30-Version 3”. Medical records were reviewed for pathologic and clinical features of these patients. Validity of these questionnaires was assured by content validity. Questionnaires were completed by phone interview with the patients. Reliability of these questionnaires was obtained by computing internal consistency (Cronbach alpha) and test re test. Data were analyzed by SPSS 17. Cervical cancer is one of the most common cancers of women in developing countries. Disease and its treatments affect different aspects of patients’ life. The aim of the present study was to assess the quality of life among long term cervical cancer survivors and its association with clinical and pathological features in patients attended to cancer centers in Shahid Beheshti university of medical sciences,Tehran,Iran.

Quality of life in cervical cancer survivors: Patient and provider perspectives on common complications of cervical cancer and treatment

ObjectiveThis study's objective was to quantify the impact (utility) of common complications of early cervical cancer treatment on quality of life (QOL). Utilities assigned by survivors were compared to those assigned by providers. Methods30 survivors of early cervical cancer identified from our Tumor Registry and 10 gynecologic oncology providers were interviewed. Participants evaluated complications (health states) using the standard gamble (SG) and visual analogue scale (VAS). Each participant was randomly assigned to rate 5 of 13 health states. Mixed-effects linear models were used to generate confidence intervals for utility means, and evaluate the effect of group (survivors versus providers). Higher utilities indicate the health state is closer to perfect health. ResultsSurvivors and providers mean ages were similar (44 and 40). Mean time from diagnosis was 6.7years. 28 of 30 survivors had no evidence of disease. 56% of survivors had complications. Using SG, providers consistently assigned utilities 7% higher than survivors (p=0.035) for all health states except “ileostomy”, which survivors rated higher than providers. Survivors assigned the lowest utility to small bowel obstruction (SBO) (fixable without an ostomy) and ureteral obstruction (UO). Survivors rated SBO 16% and UO 21% lower than providers. Personal history of complications or higher stage did not have a consistent effect on QOL adjustments. DiscussionProviders assign higher utilities than survivors to health states. Providers and survivors diverge on which complications impact QOL the most. Data on patient preferences should be considered when weighing treatment options with similar survival but different associated complications.

A longitudinal evaluation of sexual functioning and quality of life in cervical cancer survivors

Objective: Sexual functioning is a critical issue for women undergoing treatment for cervical cancer. This study sought to longitudinally: (1) assess sexual functioning and quality of life (QOL) in patients with newly diagnosed cervical cancer; and (2) objectively measure changes in vaginal length.

Quality of Life in Cervical Cancer Survivors: A Review of the Literature and Directions for Future Research

To describe the most current trends in quality-of-life (QOL) research in cervical cancer survivors and to discuss directions for future research. A literature search was conducted among five electronic databases using the terms cervical or cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles were published either in English or Chinese from January 2005 to June 2009. Thirty-one articles were identified. The major QOL issues among cervical cancer survivors were categorized at the individual and systemic levels. The most current trends include research into the positive and negative aspects of cancer survivorship; studies that examine unhealthy lifestyle behaviors, which contribute to poor QOL; studies concerned with the impact of cervical cancer survivorship on male partners and family caregivers; and three primary types of instruments used for assessment. Future research directions should include (a) exploring and optimizing the positive outcomes of cervical cancer survivorship, (b) using interventions to reduce risky lifestyles or unhealthy behaviors, (c) conducting exploratory studies to determine the impact of cervical cancer survivorship on families, (d) conducting longitudinal studies to document the ongoing changes in QOL among cervical cancer survivors, and (e) developing new instruments to assess the systemic level of QOL. Expanding the understanding of QOL and related factors in cervical cancer survivors would enable nurses to assess and develop interventions to improve QOL and overall survival outcomes for this population.

Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors

BackgroundWomen with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors.MethodsA literature search of five electronic databases was conducted using the terms cervical/cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles published in either English or Chinese from January 2000 to June 2009 were searched. Only those adopting an established quality of life instrument for use in cervical cancer survivors were included.ResultsA total of 11 validated multidimensional quality of life instruments were identified from 41 articles. These instruments could be classified into four categories: generic, cancer-specific, cancer site-specific and cancer survivor-specific instruments. With internal consistency varying from 0.68-0.99, the test-retest reliability ranged from 0.60-0.95 based on the test of the Pearson coefficient. One or more types of validity supported the construct validity. Although all these instruments met the minimum requirements of reliability and validity, the original versions of these instruments were mainly in English.ConclusionSelection of an instrument should consider the purpose of investigation, take its psychometric properties into account, and consider the instrument's origin and comprehensiveness. As quality of life can be affected by culture, studies assessing the quality of life of cervical cancer survivors in China or other non-English speaking countries should choose or develop instruments relevant to their own cultural context. There is a need to develop a comprehensive quality of life instrument for Chinese cervical cancer survivors across the whole survivorship, including immediately after diagnosis and for short- (less than 5 years) and long-term (more than 5 years) survivorship.