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Quality of life and disparities among long-term cervical cancer survivors
Howard P Greenwald1, Ruth McCorkle, Kathy Baumgartner
1Sol Price School of Public Policy, University of Southern California, 650 Childs Way, Los Angeles, CA, 90089-0626, USA, greenwa@usc.edu.
Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
Cervical cancer does not generally reduce QOL among long-term survivors. Economic disadvantage and residential location affect QOL through mechanisms yet to be determined.
Implications For Cancer Survivors:
Women diagnosed with cervical cancer have good prospects for high quality of life; socioeconomic status strongly affects quality of life over the long term.
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