Abstract
Objective: With the increasing incidence of endometrial cancer, the high survival rate, and the large number of endometrial cancer survivors, investigations of long-term genitourinary outcomes are important for the management of these outcomes among endometrial cancer survivors. Methods: Cohorts of 2648 endometrial cancer survivors diagnosed in the state of Utah between 1997 and 2012 and 10,503 general population women were identified. All ICD-9 diagnosis codes were collected from the state's two largest healthcare systems and statewide databases. Multivariate Cox regression models were used to estimate hazard ratios at 1–5 years and > 5–10 years after endometrial cancer diagnosis for genitourinary outcomes. Results: Endometrial cancer survivors were at elevated risk for urinary system disorders between 1 and 5 years (HR: 1.64, 95% CI: 1.50–1.78) and > 5–10 years (HR: 1.40, 95% CI: 1.26–1.56) and genital organ disorders between 1 and 5 years (HR: 1.71, 95% CI: 1.58–2.03) and > 5–10 years (HR: 1.33, 95% CI: 1.19–1.49). Significantly elevated risk was observed among endometrial cancer survivors for renal failure, chronic kidney disease, urinary tract infections, and nonmalignant breast conditions, persisting between > 5–10 years. Between 1 and 5 years after cancer diagnosis, those with higher stage, higher grade, older age and treated with radiation or chemotherapy were at higher risk for urinary disorders. Conclusions: Endometrial cancer survivors were at higher risk for many genitourinary outcomes compared to women from the general population. This study presents evidence suggesting the necessity of increased monitoring and counseling for genitourinary disorders for endometrial cancer patients both immediately after treatment cessation and for years afterwards.
| Original language | English |
|---|---|
| Pages (from-to) | 499-506 |
| Number of pages | 8 |
| Journal | Gynecologic Oncology |
| Volume | 148 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2018 |
| Externally published | Yes |
Funding
This work was supported by a grant from the National Cancer Institute ( R21 CA185811 , R03 CA159357 , M. Hashibe, PI), the National Institutes of Health ( K07CA196985 , Y.P. Wu, PI), the Huntsman Cancer Foundation (Y.P. Wu), the Marian Bishop Award from the Department of Family and Preventive Medicine at the University of Utah and the National Center for Research Resources grant, “Sharing Statewide Health Data for Genetic Research” ( R01 RR021746 , G. Mineau, PI) with additional support from the Utah State Department of Health and the University of Utah . We thank the Pedigree and Population Resource of the Huntsman Cancer Institute, University of Utah (funded in part by the Huntsman Cancer Foundation) for its role in the ongoing collection, maintenance and support of the Utah Population Database (UPDB). We thank the University of Utah Center for Clinical and Translational Science (CCTS) (funded by NIH Clinical and Translational Science Awards), the Pedigree and Population Resource, University of Utah Information Technology Services and Biomedical Informatics Core for establishing the Master Subject Index between the Utah Population Database, the University of Utah Health Sciences Center and Intermountain Healthcare. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Keywords
- Cancer survivorship
- Endometrial cancer survivors
- Genitourinary adverse events
- Genitourinary toxicities