Table 2. Late symptoms during the past 6 months among gynaecological cancer survivors treated with pelvic radiation therapy with or without surgery and control women.
| Survivors, N=616 (%) | Controls, N=344 (%) | Survivors vs controls Age-adjusted RR (95% CI ) | RT with surgery, N=549 (%) | RT with surgery vs controls Age-adjusted RR (95% CI) | RT without surgery, N=67 (%) | RT without surgery vs controls Age-adjusted RR (95% CI) | |
|---|---|---|---|---|---|---|---|
| Anal-sphincter symptoms | |||||||
| Emptying of all stools into clothing without forewarning at least occasionally | 70/606 (12) | 3/344 (0.9) | 12.7 (4.0–40.3) | 55/546 (10) | 8.8 (2.8–28.3) | 15/60 (25) | 30.3 (9.1–101.1) |
| Leakage of loose stools while awake at least occasionally | 199/608 (33) | 18/344 (5) | 6.0 (3.7–9.6) | 171/545 (31) | 5.5 (3.4–8.8) | 28/63 (44) | 8.5 (5.0–14.5) |
| Leakage of loose stools while asleep at least occasionally | 72/611 (12) | 8/343 (2) | 5.5 (2.6–11.4) | 58/548 (11) | 4.4 (2.1–9.2) | 14/63 (22) | 9.8 (4.3–22.4) |
| Anal leakage of mucus while asleep at least occasionally | 32/607 (5) | 4/344 (1) | 4.9 (1.7–14.1) | 25/545 (5) | 3.3 (1.1–9.4) | 7/62 (11) | 9.7 (2.9–32.3) |
| Leakage of solid stools while awake at least occasionally | 46/607 (8) | 5/344 (1) | 4.4 (1.7–11.0) | 37/544 (7) | 3.4 (1.4–8.7) | 9/63 (14) | 9.3 (3.2–27.0) |
| Faecal leakage without forewarning despite previous defaecation at least occasionally | 188/605 (31) | 23/344 (7) | 4.2 (2.8–6.4) | 168/545 (31) | 3.9 (2.6–6.0) | 20/60 (33) | 4.8 (2.8–8.2) |
| Defaecation urgency with faecal leakage at least occasionally | 298/603 (49) | 42/343 (12) | 4.0 (3.0–5.4) | 262/541 (48) | 3.8 (2.8–5.2) | 36/62 (58) | 4.8 (3.3–6.8) |
| Foul smelling flatulence at least once a week | 116/602 (19) | 22/343 (6) | 3.7 (2.4–5.8) | 102/541 (19) | 3.8 (2.4–5.9) | 14/61 (23) | 3.6 (2.0–6.7) |
| Anal leakage of mucus while awake at least occasionally | 87/603 (14) | 14/343 (4) | 3.5 (2.0–6.1) | 76/542 (14) | 3.2 (1.8–5.6) | 11/61 (18) | 4.1 (1.9–8.6) |
| Self-perception of faecal odour at least occasionally | 108/606 (18) | 18/340 (5) | 3.3 (2.0–5.4) | 95/544 (17) | 3.1 (1.9–5.2) | 13/62 (21) | 4.0 (2.1–7.8) |
| Involuntary flatulence at least once a week | 127/606 (21) | 33/343 (10) | 2.4 (1.7–3.5) | 111/545 (20) | 2.3 (1.5–3.3) | 16/61 (26) | 2.8 (1.7–4.8) |
| Unwanted defaecation while emptying bladder at least occasionally | 238/603 (39) | 57/342 (17) | 2.4 (1.9–3.2) | 213/541 (39) | 2.4 (1.8–3.1) | 25/62 (40) | 2.3 (1.6–3.4) |
| Anal leakage of blood while awake at least occasionally | 42/608 (7) | 12/343 (4) | 2.0 (1.1–3.9) | 37/545 (7) | 2.0 (1.0–3.9) | 5/63 (8) | 2.2 (0.8–6.7) |
| Involuntary loud flatulence at least occasionally | 359/607 (59) | 150/344 (44) | 1.4 (1.2–1.6) | 314/546 (58) | 1.3 (1.1–1.5) | 45/61 (74) | 1.7 (1.4–2.1) |
| Bowel symptoms | |||||||
| Defaecation urgency at least once a week | 175/602 (29) | 19/341 (6) | 5.7 (3.5–9.1) | 157/542 (29) | 5.7 (3.5–9.1) | 18/60 (30) | 6.0 (3.3–10.8) |
| Protracted abdominal pain lasting >1 year, yes | 69/593 (12) | 15/339 (4) | 3.2 (1.9–5.6) | 59/532 (11) | 3.1 (1.7–5.5) | 10/61 (16) | 3.8 (1.8–7.9) |
| Loose stools at least once a week | 234/602 (39) | 48/344 (14) | 3.0 (2.2–3.9) | 205/540 (38) | 2.9 (2.1–3.9) | 29/62 (47) | 3.5 (2.4–5.1) |
| Abdominal pain and vomiting at least occasionally | 60/605 (10) | 13/344 (4) | 2.6 (1.4–4.7) | 49/545 (9) | 2.2 (1.2–4.1) | 11/60 (18) | 4.8 (2.2–10.1) |
| Mucus in stools at least occasionally | 156/607 (26) | 45/343 (13) | 2.1 (1.5–3.0) | 143/545 (26) | 2.2 (1.6–3.0) | 13/62 (21) | 1.6 (0.9–2.8) |
| Abdominal bloating at least once a week | 147/605 (24) | 60/342 (18) | 1.8 (1.4–2.3) | 129/544 (24) | 1.8 (1.3–2.3) | 18/61 (30) | 1.8 (1.1–2.7) |
| Rectal bleeding at least occasionally | 103/604 (17) | 42/341(12) | 1.6 (1.1–2.2) | 92/545 (17) | 1.6 (1.2–2.4) | 11/59 (19) | 1.5 (0.8–2.8) |
| Abdominal pain and stools at least occasionally | 198/602 (33) | 79/343 (23) | 1.6 (1.3–2.0) | 171/541 (32) | 1.5 (1.2–1.9) | 27/61 (44) | 2.0 (1.4–2.8) |
| Abdominal pain at least occasionally | 307/604 (51) | 137/340 (40) | 1.4 (1.2–1.6) | 272/544 (50) | 1.4 (1.2–1.6) | 35/60 (58) | 1.5 (1.2–1.9) |
| Abdominal pain and bloating at least occasionally | 228/603 (38) | 106/340 (31) | 1.4 (1.2–1.7) | 199/542 (37) | 1.4 (1.2–1.7) | 29/61 (48) | 1.6 (1.2–2.1) |
| Urinary tract symptoms | |||||||
| Difficulty feeling the need to empty bladder at least occasionally | 56/604 (9) | 11/343 (3) | 2.8 (1.5–5.4) | 46/544 (8) | 2.5 (1.3–5.0) | 10/60 (17) | 5.1 (2.3–11.3) |
| Difficulty emptying bladder at least occasionally | 49/602 (8) | 11/343 (3) | 2.7 (1.4–5.2) | 43/542 (8) | 2.7 (1.4–5.5) | 6/60 (10) | 3.2 (1.3–8.4) |
| Difficulty feeling full bladder at least occasionally | 90/602 (15) | 18/342 (5) | 2.7 (1.6–4.5) | 76/543 (14) | 2.4 (1.4–4.1) | 14/59 (24) | 4.5 (2.4–8.4) |
| Haematuria at least occasionally | 20/606 (3) | 5/344 (1) | 2.5 (0.9–6.9) | 16/546 (3) | 2.4 (0.8–6.8) | 4/60 (7) | 5.0 (1.4–17.8) |
| Straining to initiate emptying of bladder at least occasionally | 77/605 (13) | 21/343 (6) | 2.2 (1.4–3.7) | 68/545 (12) | 2.4 (1.5–3.9) | 9/60 (15) | 2.5 (1.2–5.3) |
| Painful emptying of bladder at least occasionally | 60/605 (10) | 20/341 (6) | 2.0 (1.2–3.3) | 52/545 (10) | 1.9 (1.1–3.3) | 8/60 (13) | 2.3 (1.1–5.0) |
| Urinary incontinence without urinary urgency at least occasionally | 88/603 (15) | 24/342 (7) | 1.8 (1.2–2.9) | 81/543 (15) | 1.9 (1.2–3.0) | 7/60 (12) | 1.6 (0.7–3.6) |
| Night-time emptying of bladder at least twice per night or more, yes | 222/607 (37) | 58/341 (17) | 1.8 (1.4–2.4) | 199/548 (36) | 1.8 (1.4–2.4) | 23/59 (39) | 2.2 (1.5–3.2) |
| Need of antibiotics because of urinary tract infection twice or more, yes | 93/605 (15) | 31/344 (9) | 1.6 (1.1–2.3) | 86/545 (16) | 1.7 (1.1–2.5) | 7/60 (12) | 1.3 (0.6–2.9) |
| Urinary incontinence because of urinary urgency at least occasionally | 209/607 (34) | 66/342 (19) | 1.6 (1.2–2.0) | 186/545 (34) | 1.5 (1.2–2.0) | 23/62 (37) | 1.8 (1.2–2.7) |
| Slow emptying of bladder at least occasionally | 122/605 (20) | 47/344 (14) | 1.6 (1.2–2.2) | 106/546 (19) | 1.5 (1.1–2.2) | 16/59 (27) | 2.0 (1.2–3.3) |
| Self-perception of urine odour at least occasionally | 149/605 (25) | 62/341(18) | 1.4 (1.1–1.9) | 126/544 (23) | 1.3 (1.0–1.8) | 23/61 (38) | 2.1 (1.4–3.0) |
| Urinary urgency at least occasionally | 346/605 (57) | 139/343 (41) | 1.3 (1.1–1.5) | 308/544 (57) | 1.3 (1.1–1.5) | 38/61 (62) | 1.5 (1.2–1.8) |
| Feeling of incomplete bladder emptying at least occasionally | 232/604 (38) | 101/343 (29) | 1.3 (1.1–1.6) | 203/544 (37) | 1.3 (1.0–1.6) | 29/60 (48) | 1.6 (1.2–2.2) |
| Symptoms related to sexuality | |||||||
| Protracted genital pain lasting for >1 year, yes | 28/593 (5) | 4/339 (1) | 5.0 (1.7–14.5) | 21/532 (4) | 4.3 (1.4–13.0) | 7/61 (11) | 9.6 (2.9–31.8) |
| Genital bleeding during or after intercourse at least once, yes | 54/585 (9) | 13/329 (4) | 3.7 (2.1–6.7) | 45/523 (9) | 3.6 (2.0–6.7) | 9/62 (15) | 3.9 (1.8–8.4) |
| Deep dyspareunia when having intercourse, at least a little | 101/583 (17) | 23/330 (7) | 3.7 (2.4–5.7) | 90/521 (17) | 3.7 (2.4–5.8) | 11/62 (18) | 3.0 (1.6–5.7) |
| Vaginal lubrication when sexually aroused, no | 39/577 (7) | 7/333 (2) | 2.9 (1.3–6.4) | 37/517 (7) | 2.9 (1.3–6.5) | 2/60 (3) | 1.6 (0.3–7.5) |
| Decreased ability for intercourse leading to lower intercourse frequency, at least a little | 176/575 (31) | 37/327 (11) | 2.9 (2.1–4.1) | 160/515 (31) | 2.9 (2.0–4.0) | 11/60 (18) | 2.5 (1.5–4.1) |
| Vaginal elasticity, no | 172/502 (34) | 41/302 (14) | 1.8 (1.3–2.4) | 148/451 (33) | 1.6 (1.2–2.2) | 24/51 (47) | 2.5 (1.7–3.7) |
| Genital swelling when sexually aroused, no | 82/571 (14) | 35/327 (11) | 1.5 (1.0–2.2) | 72/512 (14) | 1.5 (1.0–2.2) | 10/59 (17) | 1.6 (0.9–3.1) |
| Superficial dyspareunia when having intercourse, at least a little | 140/584 (24) | 67/330 (20) | 1.5 (1.2–2.0) | 125/523 (24) | 1.5 (1.1–2.0) | 15/61 (25) | 1.4 (0.8–2.2) |
| Sensitivity to touch inside vagina, no | 221/540 (41) | 65/310 (21) | 1.3 (1.0–1.6) | 192/485 (40) | 1.2 (1.0–1.5) | 29/55 (53) | 1.7 (1.3–2.2) |
| Sensitivity to touch of labia and clitoris, no | 186/558 (33) | 61/320 (19) | 1.2 (0.9–1.5) | 163/501 (33) | 1.1 (0.9–1.4) | 23/57 (40) | 1.5 (1.1–2.1) |
| Pelvic bone symptoms | |||||||
| Pubic pain when walking indoors at least occasionally | 46/603 (8) | 6/343 (2) | 4.9 (2.1–11.6) | 35/542 (6) | 4.1 (1.7–10.2) | 11/61 (18) | 10.3 (4.0–26.7) |
| Pubic pain when walking outdoors 500 m at least occasionally | 42/596 (7) | 7/343 (2) | 3.7 (1.7–8.4) | 34/536 (6) | 3.3 (1.4–7.7) | 8/60 (13) | 6.6 (2.5–17.5) |
| Pubic pain, yes | 67/603 (11) | 12/339 (4) | 3.4 (1.9–6.4) | 53/544 (10) | 3.0 (1.6–5.7) | 14/59 (24) | 7.0 (3.5–14.2) |
| Hip pain, yes | 212/599 (35) | 113/343 (33) | 1.0 (0.8–1.2) | 182/538 (34) | 0.9 (0.8–1.2) | 30/61 (49) | 1.5 (1.1–2.0) |
| Hip pain when walking outdoors 500 m at least occasionally | 193/598 (32) | 102/340 (30) | 1.0 (0.8–1.3) | 165/536 (31) | 1.0 (0.8–1.2) | 28/62 (45) | 1.5 (1.1–2.0) |
| Sacral pain, yes | 232/600 (39) | 179/344 (52) | 0.8 (0.7–0.9) | 196/539 (36) | 0.7 (0.6–0.8) | 36/61 (59) | 1.1 (0.9–1.4) |
| Lower abdomen and leg symptoms | |||||||
| Erysipelas on abdomen or legs, yes | 17/597 (3) | 3/336 (1) | 3.6 (1.0–12.8) | 14/537 (3) | 4.0 (1.1–14.5) | 3/60 (5) | 5.2 (1.1–25.1) |
| Lower abdominal heaviness at least occasionally | 119/600 (20) | 38/344 (11) | 2.1 (1.5–3.0) | 101/540 (19) | 2.1 (1.4–3.0) | 18/60 (30) | 2.7 (1.7–4.5) |
| Pain in lower abdomen in connection with oedema at least occasionally | 92/607 (15) | 33/343 (10) | 1.9 (1.3–2.8) | 75/546 (14) | 1.7 (1.1–2.6) | 17/61 (28) | 3.0 (1.8–5.0) |
| Leg pain in connection with oedema at least occasionally | 164/606 (27) | 54/342 (16) | 1.7 (1.3–2.3) | 145/545 (27) | 1.7 (1.2 (2.2) | 19/61 (31) | 2.0 (1.3–3.2) |
| Swollen lower abdomen at least occasionally | 121/599 (20) | 51/342 (15) | 1.7 (1.3–2.4) | 106/538 (20) | 1.8 (1.3–2.5) | 15/61 (25) | 1.7 (1.0–2.8) |
| Protracted leg pain lasting >1 year, yes | 134/593 (23) | 48/339 (14) | 1.5 (1.1–2.1) | 115/532 (22) | 1.4 (1.0–2.0) | 19/61 (31) | 2.2 (1.4–3.4) |
| Swollen legs at least occasionally | 218/606 (36) | 94/344 (27) | 1.4 (1.1–1.7) | 197/546 (36) | 1.4 (1.1–1.9) | 21/60 (35) | 1.4 (0.9–2.0) |
| Heavy legs at least occasionally | 210/606 (35) | 97/344 (28) | 1.1 (1.1–1.6) | 186/546 (34) | 1.3 (1.0–1.6) | 24/60 (40) | 1.4 (1.0–2.1) |
Abbreviations: CI=confidence interval; RR=relative risk; RT=radiation therapy.
Bold entries indicate statistic significance. The symptoms are sorted into anatomical region of supposed origin and in size order for RR, the number in the denominator may vary because of missing information.