| Description |
Endometrial cancer is the second most common cancer among female cancer survivors in the United States. A variety of long-term, adverse health effects have been observed among endometrial cancer survivors but the relationship between endometrial cancer diagnosis and treatment and these outcomes among survivors, years after diagnosis remains poorly understood. Because of the high survival rate and the increasing rate at which new cases are being diagnosed, examining the risk for long-term, adverse health effects among endometrial cancer survivors is essential. Cohorts of 2,648 endometrial cancer survivors diagnosed in Utah between 1997 and 2012 and 10,503 age-matched, cancer-free women from the general population were identified. Electronic medical record data including all International Classification of Diseases , 9th revision (ICD-9) diagnosis codes from Utah's two largest healthcare providers as well as statewide ambulatory surgery and inpatient records were used to capture all available cardiovascular, genitourinary, and gastrointestinal outcomes. Cox regression models were used to estimate risk for outcomes between survivors and individuals in the general population at 1-5 and >5-10 years after diagnosis. Cox regression models were also used to examine potential risk factors for various conditions among endometrial cancer survivors. Endometrial cancer survivors were at elevated risk for cardiovascular, genitourinary, and gastrointestinal disorders overall and for dozens of more specific outcomes within these broader categories compared to the general population. Between 1-5 years after diagnosis, endometrial cancer survivors treated with surgery in conjunction with chemotherapy and/or radiation were at elevated risk for heart, circulatory system, urinary system, genital organ, upper gastrointestinal, lower gastrointestinal, abdominal hernia, and liver disorders compared to those treated with surgery alone. Elevated risk for abdominal hernias and lower gastrointestinal disorders persisted between >5-10 years after diagnosis. These results present sufficient evidence that endometrial cancer survivors experience a greater burden of adverse cardiovascular, genitourinary, and gastrointestinal outcomes many years after diagnosis compared to the general population and that these outcomes may be related to cancer treatment. Many of these conditions contribute to increased morbidity and mortality and adversely affect quality of life. For these reasons, greater attention should be focused both on long-term surveillance and prevention of these conditions among endometrial cancer survivors. |
