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Life After Gynecologic Cancer—A Review of Patients Quality of Life, Needs, and Preferences in Regard to Follow-up

Dahl, Lotte MD*; Wittrup, Inge PhD; Væggemose, Ulla PhD; Petersen, Lone Kjeld MD, DMSc*; Blaakaer, Jan MD, DMSc*

International Journal of Gynecological Cancer: February 2013 - Volume 23 - Issue 2 - p 227–234
doi: 10.1097/IGC.0b013e31827f37b0
Reviews

Objective This article reviews the literature on quality of life (QoL) of gynecologic cancer survivors, their needs and preferences regarding follow-up, and possible predictors of long-term QoL.

Methods A systematic literature search was made in the following databases: MEDLINE (PubMed), Bibliotek.dk, CINAHL, Cochrane, EMBASE, PsycINFO, and SveMed+. We searched the period 1995–2012 for English-language literature. The search was made during July 2011 to February 2012. When possible, the search was made using MeSH terms. Additional reports were collected by systematically viewing the reference lists of the retrieved articles.

Results Overall studies indicate that survivors after gynecologic cancer do not have impaired QoL in the long term. In general, the patients are highly satisfied with the follow-up program. The patients’ greatest concern is fear of recurrence. The most frequent reported unmet need is help in dealing and living with the fear of recurrence. It seems that psychosocial status at time of diagnosis is determining for QoL and well-being in the long term. Association has been found between coping style and QoL, risk of depression, and anxiety in the long term after cancer.

Conclusions Even though long-term QoL does not seem to be impaired, the patients are struggling with fear of recurrence, and the way of coping with this fear is a possible predictor for long-term QoL after cancer. However, there is a lack of evidence on QoL, needs, and preferences regarding follow-up of the survivors after gynecologic cancer. The quality of the follow-up regimen is questionable, and it is not evidence based. Thus, it is extremely important to optimize the follow-up program and move focus to life quality. There is a need for an evidence-based strategy regarding follow-up for low-risk gynecologic cancer patients.

*Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark; and †Central Denmark Region, Region House Aarhus, Public Health and Quality Improvement, Denmark.

The authors declare no conflicts of interest.

Address correspondence and reprint requests to Lotte Dahl, MD, Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby, DK 8200 Aarhus N, Denmark. E-mail: lotte.dahl.kristensen@ki.au.dk.

Received September 3, 2012

Accepted November 21, 2012

Copyright © 2013 by IGCS and ESGO