Article Text
Abstract
Introduction/Background To explore possible associations between modifiable lifestyle factors and health-related quality of life (HRQoL) in endometrial carcinoma survivors.
Methodology This was a cross-sectional population-based study in women having undergone surgery for assumed early-stage endometrial carcinoma. We assessed differences in HRQoL between survivors meeting and not meeting the World Health Organization‘s (WHO) recommendations regarding physical activity, BMI, and smoking. Novel thresholds for clinical importance based on the EORTC QoL working group were used to interpret scores. Effect size (ES) was interpreted as small (d=0.2–0.49), medium (d=0.5–0.8), and large (d>0.8).
Results In total, 1200 women were included. After adjusting for demographics- and disease related factors, meeting physical activity recommendations (46%) and BMI <25kg/m2 (32%) was associated with significantly better global health status (ES=0.18 and ES=-0.11, respectively). On multivariate analysis, women meeting physical activity recommendations had significantly higher scores on physical- (ES=0.31), role- (ES=0.15), and social functioning (ES=0.15), and lower levels of fatigue (ES=-0.16), pain (ES=-0.10), and appetite loss (ES=-0.15) (all p<0.05) compared to non-meeting survivors. Participants with BMI ≥25kg/m2 had lower scores for social functioning (ES=-0.10), and higher levels of pain (ES=0.13) and dyspnea (ES=0.12) (all p<0.05) compared to those with BMI <25kg/m2. Smokers had lower scores for emotional functioning (ES=-0.09) and higher levels of diarrhea (ES=0.10) (all p<0.05) compared to non-smokers. Figure 1 shows proportions of women over thresholds for clinical importance, stratified by if they met WHO recommendations or not. Bars in dark green and light red represent women meeting WHO recommendations.
Conclusion Meeting WHO recommendations for modifiable lifestyle factors is associated with better HRQoL among endometrial carcinoma survivors. Being sufficiently physical active and having a BMI <25kg/m2 are significantly associated with better self-reported global health status. All modifiable factors are associated with better functioning, and reduced symptom burden. This should be communicated to endometrial cancer survivors during treatment and surveillance.
Disclosures None.