Quality of Life and Self-Esteem of Long-Term Survivors of Invasive and Noninvasive Cervical Cancer

Objective: We compared long-term survivors of invasive and noninvasive cervical cancer (1) to determine if there are differences in the quality of life (QOL) and (2) to assess the association between self-esteem and QOL. Methods: A sample of cervical cancer survivors diagnosed with invasive and noninvasive cervical cancer during 1995-1996 was drawn from the metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) cancer registry. There were 145 participating survivors, 42 with invasive and 103 with noninvasive cervical cancer. Data were collected using a structured interview, conducted primarily over the telephone. The outcome measures were the QOL (measured by the Medical Outcomes Study Short Form-36 [ SF-36]) summary scales, the Physical Component Summary (PCS) score and the Mental Component Summary (MCS) score. Differences in MCS and PCS between women with invasive and noninvasive cancer were determined using analysis of covariance (ANCOVA). Multivariate analysis was performed to determine the association between self-esteem and MCS and PCS. Results: There were no differences in either PCS or MCS scores between long-term survivors of invasive and noninvasive cervical cancer. Self-esteem was associated with MCS but not with PCS in women with invasive cancer as well as in women with noninvasive cancer. Conclusions: The distinctive association of self-esteem with MCS but not PCS indicates that interventions for supporting and improving self-esteem may be more effective by promoting psychological well-being rather than physical well-being. Moreover, women with noninvasive cervical cancer, a group often neglected in cervical cancer studies, should also be targeted for these interventions.