Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Leah M. Ferrucci

Abstract

Background: Endometrial cancer is the most common cancer of the female reproductive organs and one of few cancers in the United States with rising incidence and mortality rates. Few studies have examined factors that influence health-related quality of life (HRQOL) of endometrial cancer survivors after active treatment and existing studies have been limited in sample size. In this study, we examined sociodemographic and clinical factors associated with HRQOL and symptom burden in a national sample of endometrial cancer survivors.

Methods: We evaluated 331 endometrial cancer survivors from the longitudinal American Cancer Society’s Study of Cancer Survivors-I who completed self-administered questionnaires at 1-year post-diagnosis on socioeconomic, demographic, and clinical characteristics. The 36-Item Short Form Health Survey (SF-36) and Modified Rotterdam Symptom Checklist (RSCL-M) were completed at 1- and 2-years post-diagnosis. We assessed characteristics associated with HRQOL (via SF-36 scores) using multivariate linear regression with backwards stepwise selection.

Results: The majority of the 331 endometrial cancer survivors were non-Hispanic white (85.2%) and diagnosed with a localized disease (73.11%). The mean SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) scores 1-year post-diagnosis were 50.07 (SD ± 10.65) and 46.95 (SD ± 10.41), respectively. Older age, having health insurance, being a person of color, and lower symptom burden (i.e., lower RSCL-M score) were associated with higher SF-36 MCS scores 1-year post-diagnosis (p<0.05). Employment, higher income, fewer co-morbid conditions, and lower symptom burden were associated with a higher SF-36 PCS score 1-year post-diagnosis (p<0.05). The mean RSCL-M score was 42.18 (SD ± 9.79) and 30 percent of women reported at least 12 symptoms at 1-year post-diagnosis. There was no change in HRQOL over time among the 277 women with longitudinal data.

Conclusions and Implications: We identified a range of characteristics associated with mental and physical components of HRQOL. Symptoms were common in this population. Our results may help clinicians identify patients with lower HRQOL who could benefit from targeted psychosocial support and better integrated treatment plans to manage symptoms.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2023

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