Danbee Kang

Psychometric validation of the Functional Assessment of Cancer Therapy‐Endometrial among endometrial cancer patients

AbstractObjectiveTo evaluate a psychometric validation of the endometrial cancer subscales (EnCS) in the Functional Assessment of Cancer Therapy‐Endometrial (FACT‐EN) among patients with endometrial cancer.MethodsThis cross‐sectional study was conducted at a tertiary university‐based hospital in South Korea between April and October 2022. Participants completed a survey questionnaire that included the FACT‐EN. Exploratory and confirmatory factor analyses (EFA, CFA) and the reliability were measured using the intraclass correlation coefficient (ICC) under a two‐way mixed model. Pearson's correlations were used to evaluate the validity. We also tested known‐group validity.ResultsIn total, 240 patients with endometrial cancer participated in the survey. In EFA, we found EnCS included four domains. In CFA, four‐factor solution model was good: CFI = 0.659; SRMR = 0.066, and RMSEA = 0.073. The mean (SD) of total score of FACT‐EN was 122.84 (23.58). The floor and ceiling effects were 0.4% and 0.4%, respectively. Cronbach's α coefficients for the five scales of the EnCS ranged from 0.78 to 0.91. The ICC of EnCS was 0.76. The convergent and discriminant validity of EnCS was acceptable. In the group analysis, older age and lower ECOG performance scores were associated with higher EnCS scores. The stomach and vaginal domains in EnCS were higher in patients who had completed treatment for more than 1 year compared to those who were still undergoing treatment.ConclusionsFACT‐EN has demonstrated its validity as an assessment tool with significant implications for capturing various symptoms in patients with endometrial cancer.

Increased cardiovascular disease risk among adolescent and young adult survivors of cervical cancer

To investigate the incidence and risk factors of cardiovascular disease (CVD) in adolescent and young adult survivors of cervical cancer. This retrospective cohort study used data from the Korean National Health Insurance Service. Adolescent and young adult (AYA) cervical cancer survivors (n=7,803) were matched with non-cancer controls (n=23,327) using 1:3 propensity score matching, and hazard ratios (HRs) for CVD were determined using Cox regression models. Multivariable Cox regressions were used to assess CVD incidence according to cancer treatment and identify risk factors. A total of 7,803 AYA survivors with cervical cancer were analyzed in this study during a median 8.9 years of follow-up. They developed any CVD with an adjusted HR of 1.47 (95% confidence interval [CI]=1.33-1.62) compared with the non-cancer controls. Those who underwent concurrent chemoradiotherapy had markedly elevated risks of heart failure (subHR=2.66; 95% CI=1.24-5.72), ischemic heart disease (subHR=1.78, 95% CI=1.11-2.86), deep vein thrombosis (subHR=15.32; 95% CI=9.16-25.63), and pulmonary embolism (subHR=14.99; 95% CI=6.31-35.62). Diabetes, hypertension and chemoradiation therapy were identified as potential risk factors that increase the risk of CVD by 1.55-fold, 1.62-fold and 2.64-fold, respectively. These findings indicate a need to pay increased attention to cardiovascular health management in adolescent and young adult cervical cancer survivors, particularly those treated with chemoradiotherapy.