Sean Soisson1, Patricia A Ganz2, David Gaffney3, Kerry Rowe4, John Snyder4, Yuan Wan5, Vikrant Deshmukh6, Mike Newman6, Alison Fraser5, Ken Smith5, Kimberly Herget7, Heidi A Hanson8, Yelena P Wu9, Joseph Stanford10, Theresa L Werner11, Veronica Wendy Setiawan12, Mia Hashibe13. 1. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Huntsman Cancer Institute, Salt Lake City, UT, United States. 2. Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States. 3. Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, United States. 4. Intermountain Healthcare, Salt Lake City, UT, United States. 5. Pedigree and Population Resources, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States. 6. University of Utah Health Sciences Center, Salt Lake City, UT, United States. 7. Utah Cancer Registry, Salt Lake City, UT, United States. 8. Pedigree and Population Resources, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, United States. 9. Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, United States. 10. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States. 11. Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Oncology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States. 12. Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, United States. 13. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Huntsman Cancer Institute, Salt Lake City, UT, United States. Electronic address: mia.hashibe@utah.edu.
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 1-5years and >5-10years after endometrial cancer diagnosis for genitourinary outcomes. RESULTS: Endometrial cancer survivors were at elevated risk for urinary system disorders between 1 and 5years (HR: 1.64, 95% CI: 1.50-1.78) and >5-10years (HR: 1.40, 95% CI: 1.26-1.56) and genital organ disorders between 1 and 5years (HR: 1.71, 95% CI: 1.58-2.03) and >5-10years (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 >5-10years. Between 1 and 5years 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.
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 1-5years and >5-10years after endometrial cancer diagnosis for genitourinary outcomes. RESULTS:Endometrial cancer survivors were at elevated risk for urinary system disorders between 1 and 5years (HR: 1.64, 95% CI: 1.50-1.78) and >5-10years (HR: 1.40, 95% CI: 1.26-1.56) and genital organ disorders between 1 and 5years (HR: 1.71, 95% CI: 1.58-2.03) and >5-10years (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 >5-10years. Between 1 and 5years 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 cancerpatients both immediately after treatment cessation and for years afterwards.
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