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Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers at diagnosis and one year later: Results from the HORIZONS UK national cohort study

Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers at diagnosis and one year later: Results from the HORIZONS UK national cohort study
Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers at diagnosis and one year later: Results from the HORIZONS UK national cohort study
Objective: Personalised care requires the identification of modifiable risk factors so that interventions can be implemented rapidly following a gynaecological cancer diagnosis. Our objective was to determine what pre-treatment factors are associated with quality of life (QOL) at baseline (pre-treatment) and 12 months.

Methods: 1222 women with a confirmed diagnosis of endometrial, ovarian, cervical or vulvar cancer from 82 UK NHS hospitals agreed to complete questionnaires at baseline, three and 12 months. Questionnaires included measures of QOL, health, lifestyle, support and self-management. The primary outcome measure was QOL as measured by Quality of Life in Adult Cancer Survivors (QLACS). Sites provided clinical data at baseline, six and 12 months. Linear regression models were constructed to examine the association between baseline characteristics and QOL outcomes.

Results: QOL declined between baseline and 3 months, followed by an improvement at 12 months. Baseline (pre-treatment) factors associated with worse QOL at both baseline and 12 months were depression, anxiety, living in a more deprived area and comorbidities which limit daily activities, whereas higher self-efficacy and age of 50+ years were associated with better QOL.

Conclusions: Depression, anxiety and self-efficacy are modifiable risk factors that can impact on QOL. Screening for these, and assessment of whether comorbidities limit daily activities, should be incorporated in a holistic needs assessment and interventions to improve self-efficacy should be made available. Care can then be personalised from the outset to enable all women with a gynaecological cancer the opportunity to have the best QOL.
Cervical cancer, Endometrial cancer, Ovarian cancer, Quality of life, Vulvar cancer
0090-8258
610 - 618
Glasspool, Rosalind
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Wheelwright, Sally
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Bolton, Victoria
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Calman, Lynn
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Cummings, Amanda
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Elledge, Beryl
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Foster, Rebecca
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Frankland, Jane
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Smith, Peter
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Stannard, Sebastian
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Turner, Joshua
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Wright, David
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Foster, Claire
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Glasspool, Rosalind
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Wheelwright, Sally
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Bolton, Victoria
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Calman, Lynn
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Cummings, Amanda
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Elledge, Beryl
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Foster, Rebecca
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Frankland, Jane
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Smith, Peter
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Stannard, Sebastian
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Turner, Joshua
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Wright, David
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Foster, Claire
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Glasspool, Rosalind, Wheelwright, Sally, Bolton, Victoria, Calman, Lynn, Cummings, Amanda, Elledge, Beryl, Foster, Rebecca, Frankland, Jane, Smith, Peter, Stannard, Sebastian, Turner, Joshua, Wright, David and Foster, Claire (2022) Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers at diagnosis and one year later: Results from the HORIZONS UK national cohort study. Gynecologic Oncology, 165 (3), 610 - 618. (doi:10.1016/j.ygyno.2022.03.012).

Record type: Article

Abstract

Objective: Personalised care requires the identification of modifiable risk factors so that interventions can be implemented rapidly following a gynaecological cancer diagnosis. Our objective was to determine what pre-treatment factors are associated with quality of life (QOL) at baseline (pre-treatment) and 12 months.

Methods: 1222 women with a confirmed diagnosis of endometrial, ovarian, cervical or vulvar cancer from 82 UK NHS hospitals agreed to complete questionnaires at baseline, three and 12 months. Questionnaires included measures of QOL, health, lifestyle, support and self-management. The primary outcome measure was QOL as measured by Quality of Life in Adult Cancer Survivors (QLACS). Sites provided clinical data at baseline, six and 12 months. Linear regression models were constructed to examine the association between baseline characteristics and QOL outcomes.

Results: QOL declined between baseline and 3 months, followed by an improvement at 12 months. Baseline (pre-treatment) factors associated with worse QOL at both baseline and 12 months were depression, anxiety, living in a more deprived area and comorbidities which limit daily activities, whereas higher self-efficacy and age of 50+ years were associated with better QOL.

Conclusions: Depression, anxiety and self-efficacy are modifiable risk factors that can impact on QOL. Screening for these, and assessment of whether comorbidities limit daily activities, should be incorporated in a holistic needs assessment and interventions to improve self-efficacy should be made available. Care can then be personalised from the outset to enable all women with a gynaecological cancer the opportunity to have the best QOL.

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Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers - Accepted Manuscript
Restricted to Repository staff only until 14 March 2023.
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Modifiable pre-treatment factors are associated with quality of life in women with gynaecological cancers at diagnosis and one year later: Results from the HORIZONS UK national cohort study - Accepted Manuscript
Restricted to Repository staff only until 14 March 2023.
Request a copy
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Accepted/In Press date: 14 March 2022
e-pub ahead of print date: 26 March 2022
Additional Information: Funding Information: We thank all HORIZONS study participants and recruiting NHS trusts and boards; Faye Doyle, Amber Cole, Flavia Bellotto-Trigo, Helen Clegg, Hugh Hiscock, Laura Ingram, Ellysia Mason, Christine May, Joanna Oakley, Rebecca Petch, Bjoern Schukowsky, Nicola Scott, Nicole Tipler, Amber Wilson (study support); Nicole Collaço, Amy Din, Chloe Grimmett, Joanne Haviland, Mubarak Patel, Natalia Permyakova, Samantha Sodergren, Sophia Taylor (researchers). Members of the Tumour Specific Expert Panel for the Gynaecological cancers cohort: Simon Crawford, Beryl Elledge, Alison Farmer, Emma Hudson, Raluca Nagy, Anne Lanceley, Eila Watson. Members of the Programme Management Group: Carl May, Alison Richardson, Anne Rogers and Peter Smith. Members of the Study Advisory Board: Jo Armes, Dany Bell, Andy Davies, Anna Gavin, Rosie Loftus, Iain McNeish, Andy Ness, Alison Richardson, Lesley Smith, Peter Smith, Richard Stephens, Galina Velikova, David Weller and Jessica Corner. Members of the User Reference Group: Elspeth Banks, Beryl Elledge, Angela McCullagh, Tricia Moate, Raluca Nagy, Sue Natt, Jackie Rafferty, Janette Rawlinson, Susan Restorick-Banks, Stephen Scowcroft, Irene Soulsby, Richard Stephens, Lesley Turner. The Macmillan HORIZONS Programme is funded by Macmillan Cancer Support (ref: 3546834). Funding Information: We thank all HORIZONS study participants and recruiting NHS trusts and boards; Faye Doyle, Amber Cole, Flavia Bellotto-Trigo, Helen Clegg, Hugh Hiscock, Laura Ingram, Ellysia Mason, Christine May, Joanna Oakley, Rebecca Petch, Bjoern Schukowsky, Nicola Scott, Nicole Tipler, Amber Wilson (study support); Nicole Colla?o, Amy Din, Chloe Grimmett, Joanne Haviland, Mubarak Patel, Natalia Permyakova, Samantha Sodergren, Sophia Taylor (researchers). Members of the Tumour Specific Expert Panel for the Gynaecological cancers cohort: Simon Crawford, Beryl Elledge, Alison Farmer, Emma Hudson, Raluca Nagy, Anne Lanceley, Eila Watson. Members of the Programme Management Group: Carl May, Alison Richardson, Anne Rogers and Peter Smith. Members of the Study Advisory Board: Jo Armes, Dany Bell, Andy Davies, Anna Gavin, Rosie Loftus, Iain McNeish, Andy Ness, Alison Richardson, Lesley Smith, Peter Smith, Richard Stephens, Galina Velikova, David Weller and Jessica Corner. Members of the User Reference Group: Elspeth Banks, Beryl Elledge, Angela McCullagh, Tricia Moate, Raluca Nagy, Sue Natt, Jackie Rafferty, Janette Rawlinson, Susan Restorick-Banks, Stephen Scowcroft, Irene Soulsby, Richard Stephens, Lesley Turner. The Macmillan HORIZONS Programme is funded by Macmillan Cancer Support (ref: 3546834). Publisher Copyright: © 2022 Copyright: Copyright 2022 Elsevier B.V., All rights reserved.
Keywords: Cervical cancer, Endometrial cancer, Ovarian cancer, Quality of life, Vulvar cancer

Identifiers

Local EPrints ID: 457096
URI: http://eprints.soton.ac.uk/id/eprint/457096
ISSN: 0090-8258
PURE UUID: 79619b01-e771-47d2-b939-56bb574fb3a0
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017
ORCID for Amanda Cummings: ORCID iD orcid.org/0000-0002-5743-2774
ORCID for Rebecca Foster: ORCID iD orcid.org/0000-0002-9320-4269
ORCID for Jane Frankland: ORCID iD orcid.org/0000-0002-3813-8879
ORCID for Joshua Turner: ORCID iD orcid.org/0000-0002-7918-2294
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378

Catalogue record

Date deposited: 24 May 2022 16:32
Last modified: 16 Sep 2022 01:47

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Contributors

Author: Rosalind Glasspool
Author: Sally Wheelwright
Author: Victoria Bolton
Author: Lynn Calman ORCID iD
Author: Amanda Cummings ORCID iD
Author: Beryl Elledge
Author: Rebecca Foster ORCID iD
Author: Jane Frankland ORCID iD
Author: Peter Smith
Author: Sebastian Stannard
Author: Joshua Turner ORCID iD
Author: David Wright
Author: Claire Foster ORCID iD

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