Pain and quality of life among long-term gynecological cancer survivors: a population-based case-control study.

BACKGROUND: The population of gynecological cancer survivors is growing, yet little is known about the effects of cancer and treatment on pain and quality of life well beyond the completion of therapy. The aims of this study were to investigate quality of life and the prevalence, intensity and presentation of pain in long-term survivors of gynecological cancer compared to a representative group of women from the general population.

METHODS: The study comprised women aged 32-75, residing in a central part of Norway. Cases were gynecological cancer survivors treated at University Hospital, Trondheim, Norway, between 1987 and 1996, and age-matched women selected at random from the general population served as controls. After 1 reminder, the response rate was 55% (176/319) and 41% (521/1,276) for survivors and controls, respectively. A total of 160 gynecological cancer survivors and 493 controls were eligible for final analyses. Pain was measured by the item 'How often do you have pain?' and marks on a body chart indicating pain sites. Ferrans and Powers' Quality of Life Index (QLI) measured quality of life. The level of statistical significance was set at p< or =0.05. A chi2 test for categorical variables, unpaired t-test for continuous variables, and logistic regression were applied.

RESULTS: On average, the long-term gynecological cancer survivors had a complete recurrence-free period of 12 years (range: 7-18). The prevalence of pain was 26%. The results revealed no difference in the prevalence of pain between women who survived gynecological cancer and women without a gynecological cancer history. Women suffering from musculoskeletal disorders or living in households with low income are more likely to suffer pain. The small group of women with a previous history of gynecological cancer and living in a low income household experience more pain, particular if they suffer from edema. Pain shows a clear negative effect on quality of life, especially on the health and functioning domain. There was no difference in the quality of life between cancer survivors and controls.

CONCLUSION: Long-term gynecological cancer survivors do not differ from other women in terms of pain and quality of life. Pain is associated with musculoskeletal disorders and low income.