Association between cervical cancer-related anxiety and depression symptoms and health-related quality of life: A Moroccan cross-sectional study

Introduction: Health-related quality of life (HRQoL) of cervical cancer patients treated by Concurrent Chemoradiation (CCRT) in Morocco is influenced by multiple concomitant factors that affect patients' post-treatment physical and psychosocial well-being. Therefore, the assessment of post-treatment health related quality of life may help identify groups of patients and risk factors for future interventions for improving post-treatment quality of life.Method: This study aimed at assessing HRQoL and its association to psychological distress of 103 cervical cancer patients treated with CCRT in Morocco. The assessment was performed using the EORTC-QLQ-C30 and the HADS questionnaires.Results: Cervical cancer patients had diminished HRQoL for functional dimensions ("emotional functioning", "physical functioning" and "role functioning" with averages of 51.78, 54.17, and 58.74, respectively) and high level for symptomatic dimensions with mean scores of 58.90 for "Appetite loss', 38.83 for "financial difficulties", 45.31 for "insomnia", 45.42 for "fatigue", and 46.28 for "pain". The assessment of anxiety and depression symptoms showed that the majority of patients had high level of anxiety (62.1%), and depression (61.2%). Emotional functioning, fatigue and insomnia were the main predictors of anxiety disorders in women with cervical cancer. Lower emotional functioning and greater fatigue and insomnia contributed significantly to higher anxiety level.Conclusions: HRQoL and psychological status of Moroccan cervical cancer patients undergoing CCRT were negatively affected. These findings suggest that future patient care policies should include strategies for improving HRQoL, mainly through psychological support and patient education as well as prevention or reduction treatment complications.