Advanced gynaecological cancer : Quality of life one year after diagnosis

Objective: Gynecological cancer treatment impacts women’s physical and psychological health. Our objective was to examine quality of life (QoL) in women with advanced gynecological cancer at diagnosis and one year later, and to identify sociodemographic and clinical characteristics associated with QoL. Methods: Women with endometrial, ovarian or cervical cancer treated in Uppsala, Sweden 2012-2019 were included. FIGO stage ≥II was considered advanced gynecological cancer, whereas women in FIGO stage I were used as a control group. QoL was assessed with SF-36. We obtained information on sociodemographic and clinical characteristics from medical records and health questionnaires. Differences in QoL domains were tested with t-tests, a mixed model ANOVA and multiple linear regression analyses. Results: The study population (n=372) included 150 (40.3%) women with advanced gynecological cancer. At diagnosis, women with advanced cancer reported lower physical (71.6 vs 81.8 (mean) p<0.05) and role functioning/physical scores (62.6 vs 77.2 (mean) p<0.05) than women in FIGO stage I. One year later, women with advanced cancer reported higher scores in the mental health domain (78.3 vs 73.2 (mean) p<0.05) than women in FIGO stage I. Women with a history of psychiatric illness, higher BMI and comorbidity reported poorer physical and mental QoL at follow-up, while advanced stage, level of education and smoking were not associated with QoL. Conclusion: Women with advanced gynecological cancer have equally good QoL one year after diagnosis as women with limited disease. Women with previous psychiatric illness, high BMI, and comorbidities are at risk of impaired physical and mental health