Cervical cancer occurs when cervical cells multiply rapidly. This type of cancer occurs in the cervix, the lower part of the uterus, where the uterus connects to the vagina (1). Failure to diagnose or treat this type of cancer can lead to the patient's death. However, there are appropriate strategies, such as the human papillomavirus vaccine, to control this type of cancer (2, 3). According to the World Health Organization reports, cervical cancer was the fourth most common cancer in women in 2018. About 99% of cervical cancers are caused by a virus called human papillomavirus (HPV). Histopathologically, 69% of cervical cancers contain squamous carcinoma cells, and 25% of them contain adenocarcinoma cells (4). Cervical cancer is most commonly diagnosed in women between the ages of 35 and 44, and the average age of diagnosis for this type of cancer in the United States is 50 years old. Early detection of this type of cancer is very easy and very important; Even in the United States, however, more than 20 percent of cases are diagnosed over the age of 65, when the cancer is advanced (5, 6).
Over the past decade, various indicators have been calculated for patients' health output. Indicators such as death rate, survival rate, or pain rate are among these indicators (3). However, one of the most important indicators that deal with all aspects of the patients' health is the Health-related quality of life. Health-related QOL seeks to examine all aspects of health, including physical and mental health. Over the past two decades, mental status and QOL have been the most important issues in clinical research and have been emphasized as one of the effective aspects of patient care. Chronic diseases such as cancer are among the disorders that severely affect people's health and consequently their QOL (7, 8). Diagnosing cancer is a very unpleasant and unbelievable experience for any person. Cancer affects the patient's economic, social, and family life in terms of mental, psychological, and sexual function (9) Cancer severely affects a person's mental health which is not seen in calculating indicators such as survival.
On the other hand, according to the stage of cervical cancer, different treatments can be selected for patients, including various surgical methods, chemoradiation, or a combination of these methods. Each of these methods may have different effects on QOL and the survival of patients (10). Due to the importance of the subject, this study was conducted to investigate the QOL of patients with cervical cancer and determine its relationship with different treatment modalities.

 

The present study is a descriptive cross-sectional study examining the QOL in cervical cancer patients. In this study, 139 patients with cervical cancer attended who were referred to Imam Khomeini hospital, affiliated with the Tehran University of Medical Sciences. The Ethics Committee of Tehran University Medical of Sciences approved the study (IR.TUMS.IKHC.REC.1399.108). After obtaining informed consent from patients, a questionnaire was provided, and information was completed. The questionnaire used in this study was a specific QOL questionnaire for patients with cervical cancer called Cervix 24. This questionnaire consists of 24 questions that have the dimensions of experiencing symptoms (including 11 questions), mental image (including 3 questions), vaginal/sexual dysfunction (including 4 questions), and 6 one-word scales that were measured on the Likert Scale. For all questions except questions related to sexual activity and sexual pleasure, a higher score indicates that there are more problems for that person. The score range after each questionnaire was calculated and adjusted between zero and one hundred (11). For example, the experience of the symptoms of the disease indicates the history of experience of each of the symptoms of the disease and the number of times patients have experienced it. The mental image dimension indicates the type of mental image the patient has of her disease and vaginal disorders and indicates the frequency and types of common vaginal disorders in patients. The sexual status also indicates the amount and quality of sexual intercourse. In order to calculate the total score, the total scores of each dimension were added together and divided into 4 dimensions to obtain a score between zero and 100. The reliability and validity of this questionnaire had previously been assessed by Turkzahrani et al. in Zanjan city. Internal consistency and retest were used to determine the reliability of the QOL questionnaire. Cronbach's alpha coefficient of 0.74 was confirmed. In addition, the result of the retest test was 0.88. In addition to quality-of-life questions, the patient was asked questions about the demographic status, including age, sex, occupation, date of diagnosis and treatment, type of treatment, menopausal status, and the patient's hormone status. In order to analyze the data, descriptive statistics, including mean and standard deviation, and analytical statistics, including regression model were used. Data were analyzed using Stata version 14 software. The significant level was considered less than 0.05.