Self-reported symptoms of faecal incontinence among long-term gynaecological cancer survivors and population-based controls
Received 5 August 2009; received in revised form 7 October 2009; accepted 15 October 2009. published online 19 November 2009.
Abstract
Aim of the study
To make a comprehensive, detailed inventory of gastrointestinal symptoms reported by gynaecological cancer survivors and control women from the general population.
Method
We identified a cohort of 789 eligible women in the Stockholm and Gothenburg areas, treated with pelvic radiotherapy during the period 1991–2003, alone or as combined treatment, for gynaecological cancer. As controls, we randomly recruited 478 women, frequency matched by age and residence from the Swedish Population Registry. We collected data in 2006 by means of a study-specific, validated, postal questionnaire including 351 questions covering symptoms from the pelvic region. We asked about demographics, psychological and quality-of-life issues as well as social functioning.
Results
Participation was 78% for cancer survivors and 72% for controls. Mean follow-up was 7.2years. In this large, population-based study, the greatest age-adjusted absolute risk difference between cancer survivors and control women was observed for the symptom defaecation urgency with faecal leakage and the highest age-adjusted relative risk for emptying of all stools into clothing without forewarning.
Conclusions
Cancer survivors having undergone pelvic radiotherapy alone or as part of combined treatment between the period 1991–2003 for a gynaecological malignancy had a higher occurrence of long-lasting gastrointestinal symptoms as compared to population controls.
aClinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, SE-171 76 Stockholm, Sweden
bClinical Cancer Epidemiology, Sahlgrenska Academy, SE-413 45 Gothenburg, Sweden
cDepartment of Gynaecological Oncology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
dDepartment of Medical Physics, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
eDepartment of Clinical Neuroscience, Section of Psychiatry, St. Göran, SE-112 81 Stockholm, Sweden
fDepartment of Gynaecological Oncology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
Corresponding author: Address: Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska University Hospital, Z5U1, SE-171 76 Stockholm, Sweden. Tel.: +46 8 51772934; fax: +46 8 51779621.
ABSTRACT