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

• Published in: PloS one 2022-06, Vol.17 (6), p.e0268831-e0268831
• Main Authors: Amo-Antwi, Kwabena, Agambire, Ramatu, Konney, Thomas O, Nguah, Samuel B, Dassah, Edward T, Nartey, Yvonne, Appiah-Kubi, Adu, Tawiah, Augustine, Tannor, Elliot K, Peprah, Amponsah, Ansah, Mavis Bobie, Sam, Daniel, Akakpo, Patrick K, Ankobea, Frank, Djokoto, Rex M, Idun, Maame Y K, Opare-Addo, Henry S, Opoku, Baafour K, Odoi, Alexander T, Johnston, Carolyn
• Format: Article
• Language: English
• Subjects: Appetite; Appetite loss; Auroral kilometric radiation; Body image; Cancer; Cancer survivors; Cancer therapies; Care and treatment; Cervical cancer; Cervix; Chemoradiotherapy; Cognitive ability; Confidence intervals; Diabetes; Diagnosis; Disease; Domains; Dosimetry; Health aspects; Hospitals; Hypertension; Image quality; Lymphatic system; Magnetic resonance imaging; Medical imaging; Medicine and Health Sciences; Neuropathy; Oncology; Pain; Patients; Peripheral neuropathy; Quality of life; Radiation; Radiation therapy; Risk factors; Signs and symptoms; Social aspects; Social Sciences; Statistical analysis; Survival; Tertiary; Vagina; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0268831

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 su