Cervical cancer survivorship in a population based sample.
ABSTRACT Though cervical cancer is preventable, this cancer nonetheless poses serious mortality and morbidity threats to American women and women globally. The purpose of this study is to utilize a multidimensional framework to assess Health-related Quality of Life (HRQOL) and its salient predictors among a population based sample of cervical cancer survivors.
A cross-sectional design was used with a population-based sample ascertained from the California Cancer Surveillance Program. Descriptive, bivariate and multivariate regression analyses were conducted.
Participants were 560 cervical cancer survivors: English-speaking Latina- (n=88), Spanish-speaking Latina- (n=199) and European- (n=273) Americans. The greatest concerns were documented for family/social and emotional well-being, and body image and sexual health. In general, Latina-Americans reported poorer overall HRQOL, functional, emotional, and social/family wellbeing compared to European-Americans. Differences in HRQOL persisted by ethnic/language group after controlling for covariates. Radiation, comorbidity, role limitations, perceived health status, psychological wellbeing, body image, sexual impact, doctor-patient relationship, and social support were significant predictors of overall HRQOL. The regression model explained 58% of the variance in predicting HRQOL.
These cervical cancer survivors reported poor to moderate HRQOL with persistent psychosocial challenges. Our findings indicate that lower SES, monolingual Latinas are at greatest risk for poor HRQOL outcomes. Clinicians should pay attention to their patients' socio-ecological context as a risk factor for poorer outcomes; and provide early referrals to resources that are low cost and culturally and linguistically appropriate.
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ABSTRACT: Little population-based research has been done on social, economic, and environmental factors affecting quality of life (QOL) among long-term cancer survivors. This research assesses the impact of disease and nondisease factors on QOL among long-term survivors of cervical cancer. In a collaborative, observational study, data were obtained from cancer registries, interviews, and self-administered questionnaires. Comparisons of QOL were made between women with cervical cancer histories and women from the general population. A total of 715 women 4-28 years postdiagnosis were identified from cancer registries in Connecticut (N = 208), Detroit Metropolitan Area (N = 211), New Mexico (N = 197), and Hawaii (N = 99). QOL was measured according to four SF-36 dimensions-physical functioning, social functioning, bodily pain, and general health status. Means on SF-36 measures among women with cervical cancer histories were close to or higher than women in the general population. In a multiple regression analysis, economic disadvantage negatively predicted physical functioning (B = -13.4, SE = 2.1), social functioning (B = -13.2, SE = 2.4), bodily pain (B = -12.6, SE = 2.5), and general health (B = -12.8, SE = 2.1). Residence in New Mexico negatively predicted several QOL dimensions. No impact of race was detected when income was controlled. Disease stage did not predict QOL. Cervical cancer does not generally reduce QOL among long-term survivors. Economic disadvantage and residential location affect QOL through mechanisms yet to be determined. Women diagnosed with cervical cancer have good prospects for high quality of life; socioeconomic status strongly affects quality of life over the long term.Journal of Cancer Survivorship 04/2014; · 3.57 Impact Factor
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ABSTRACT: The goal of this study was to quantify the burden of cervical cancer in Texas and provide information about the health care needs of survivors. Data from multiple sources including the Texas Cancer Registry, Behavioral Risk Factor Surveillance System, and Texas Medicare claims were used in this effort. In 2009, there were over 100,000 cervical cancer survivors in Texas. Our descriptive analysis revealed that these women consumed less fruit and vegetables, were more often smokers, and had worse physical and mental health than women without a history of cancer. Survivors aged 65 and older cost Medicare over $15 million in inpatient, outpatient, and hospice care in 2009 alone, or $9,827 per cervical cancer survivor - nearly a third more than the average Medicare enrollee in Texas that year. Providers and public health practitioners can play an integral role in reducing the human and economic burden of cervical cancer in Texas through smoking cession and healthy lifestyle counseling for survivors, recommending the HPV vaccine to males and females aged 9-26, and continuing to offer cervical cancer screening for women up to age 65.Texas public health journal. 01/2013; 65(2):51-55.
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ABSTRACT: Purpose Social suffering, language difficulties, and cultural factors may all make the cancer experience more difficult for immigrants. This study aimed to document unmet needs, and variables associated with these, in a population-based sample of first-generation immigrants and Anglo-Australians who had survived cancer. Methods Participants were recruited via Australian cancer registries. Eligible cancer survivors had a new diagnosis 1–6 years earlier and were aged between 18 and 80 years at diagnosis. Eligible immigrant participants and parents were born in a country where Arabic, Chinese (Mandarin, Cantonese, and other dialects), or Greek is spoken, and they spoke one of these languages. A random sample of English-speaking Anglo-Australian-born controls was recruited. Results Five hundred ninety-six patients (277 immigrants) were recruited to the study (response rate, 26 %). Compared to Anglo-Australians, the adjusted odds ratio of Chinese immigrants for at least one unmet information/support need was 5.1 (95 % CI 3.1, 8.3) and for any unmet physical need was 3.1 (95 % CI 1.9, 5.1). For Greek, these were 2.0 (95 % CI 1.1, 4.0) and 2.7 (95 % CI 1.4, 5.2). Arabic patients had elevated, but not statistically significant, odds ratios compared to Anglo-Australians. Written information and having a specialist, support services, and other health professionals who spoke their language were in the top ten unmet needs amongst immigrants. Conclusion Immigrant cancer survivors, several years after initial diagnosis, are more likely to have an unmet need for information or for help with a physical problem than Anglo-Australians. They strongly desire information and support in their own language.Supportive Care Cancer 04/2013; 21(9). · 2.50 Impact Factor