The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions
Objective: To describe disease- and treatment-related survivorship burden amongst survivors of cervical cancer and identify risk factors for hospital admissions after initial treatment. Methods: Retrospective chart review including patients treated for cervical cancer from 2014 to 2020 at a single u...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578924000079 |
| _version_ | 1797301435326529536 |
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| author | Rayne Peerenboom Sarah Ackroyd Nita Lee |
| author_facet | Rayne Peerenboom Sarah Ackroyd Nita Lee |
| author_sort | Rayne Peerenboom |
| collection | DOAJ |
| description | Objective: To describe disease- and treatment-related survivorship burden amongst survivors of cervical cancer and identify risk factors for hospital admissions after initial treatment. Methods: Retrospective chart review including patients treated for cervical cancer from 2014 to 2020 at a single urban academic institution. Clinical, demographic, and hospital admission characteristics were summarized. Associations between patient characteristics and likelihood of admission were examined using univariate and multivariate regression. Results: Of 366 patients undergoing surveillance following completion of primary treatment, 156 (43 %) were hospitalized for cancer or treatment-related sequela in the median follow-up of 3.6 years (IQR 1.4–6.4), with a median of 2 admissions (IQR 1–4.5) per patient and 570 unique admissions. While 65 (35 %) of admitted patients had multiple reasons for admission, the most common reasons for admission were: gastrointestinal complications (43 %), infection (38 %), genitourinary complications (33 %), and pain control (23 %). A substantial proportion of admitted patients underwent interventions including surgical procedures (57 %), transfusion of blood products (40 %), and interventional radiology procedures (28 %) and utilized supportive care services including case management (53 %), physical therapy (40 %), and occupational therapy (36 %). On multivariate analysis, odds of admission were higher among Black patients (aOR 2.4, p <.01), uninsured patients (aOR 2.7, p <.05), those with lower performance status (aOR 1.4, p <.05), and those with recurrence (aOR 5.5, p <.001). Conclusion: Survivors of cervical cancer represent a high-risk population frequently hospitalized after initial treatment. Black patients, uninsured patients, those with recurrence, and those with lower performance status faced higher odds of admission. Comprehensive, team-based care is necessary to address complex survivorship needs. |
| first_indexed | 2024-03-07T23:21:33Z |
| format | Article |
| id | doaj.art-16e8a86938924de1a48a8c4dd78380c0 |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-03-07T23:21:33Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-16e8a86938924de1a48a8c4dd78380c02024-02-21T05:28:50ZengElsevierGynecologic Oncology Reports2352-57892024-02-0151101328The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissionsRayne Peerenboom0Sarah Ackroyd1Nita Lee2University of Chicago, Pritzker School of Medicine, United States; Corresponding author at: 5841 S. Maryland Avenue, MC 6040, Chicago, IL 60637, United States.University of Chicago, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, United StatesUniversity of Chicago, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, United StatesObjective: To describe disease- and treatment-related survivorship burden amongst survivors of cervical cancer and identify risk factors for hospital admissions after initial treatment. Methods: Retrospective chart review including patients treated for cervical cancer from 2014 to 2020 at a single urban academic institution. Clinical, demographic, and hospital admission characteristics were summarized. Associations between patient characteristics and likelihood of admission were examined using univariate and multivariate regression. Results: Of 366 patients undergoing surveillance following completion of primary treatment, 156 (43 %) were hospitalized for cancer or treatment-related sequela in the median follow-up of 3.6 years (IQR 1.4–6.4), with a median of 2 admissions (IQR 1–4.5) per patient and 570 unique admissions. While 65 (35 %) of admitted patients had multiple reasons for admission, the most common reasons for admission were: gastrointestinal complications (43 %), infection (38 %), genitourinary complications (33 %), and pain control (23 %). A substantial proportion of admitted patients underwent interventions including surgical procedures (57 %), transfusion of blood products (40 %), and interventional radiology procedures (28 %) and utilized supportive care services including case management (53 %), physical therapy (40 %), and occupational therapy (36 %). On multivariate analysis, odds of admission were higher among Black patients (aOR 2.4, p <.01), uninsured patients (aOR 2.7, p <.05), those with lower performance status (aOR 1.4, p <.05), and those with recurrence (aOR 5.5, p <.001). Conclusion: Survivors of cervical cancer represent a high-risk population frequently hospitalized after initial treatment. Black patients, uninsured patients, those with recurrence, and those with lower performance status faced higher odds of admission. Comprehensive, team-based care is necessary to address complex survivorship needs.http://www.sciencedirect.com/science/article/pii/S2352578924000079Cervical cancerCancer survivorshipGynecologic neoplasmsHealth disparitiesHealth services research |
| spellingShingle | Rayne Peerenboom Sarah Ackroyd Nita Lee The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions Gynecologic Oncology Reports Cervical cancer Cancer survivorship Gynecologic neoplasms Health disparities Health services research |
| title | The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions |
| title_full | The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions |
| title_fullStr | The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions |
| title_full_unstemmed | The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions |
| title_short | The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions |
| title_sort | burden of cervical cancer survivorship understanding morbidity and survivorship needs through hospital admissions |
| topic | Cervical cancer Cancer survivorship Gynecologic neoplasms Health disparities Health services research |
| url | http://www.sciencedirect.com/science/article/pii/S2352578924000079 |
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