Factors affecting health-related quality of life in cervical cancer survivors: a multicenter cross-sectional study in Korea

Cervical cancer is the fourth most common malignancy among women worldwide. As survival rates continue to improve with advances in early detection and treatment, cervical cancer is increasingly recognized as a chronic condition, making the management of long-term health-related quality of life (HRQoL) increasingly critical. This study aimed to describe the health-related quality of life of Korean cervical cancer survivors using the EuroQol five-dimensional five-level (EQ-5D-5 L) index and identify sociodemographic, clinical, and symptom-related factors that significantly influence their health-related quality of life. A multicenter survey of 230 Korean patients was conducted using convenience sampling between August 2023 and February 2024. Health-related quality of life was assessed using the EQ-5D-5 L, with scores ranging from 0 (equivalent to death) to 1 (full health). Wilcoxon rank-sum and Kruskal-Wallis tests were used to compare health-related quality of life distributions, and multiple linear regression analyses were used to identify the influencing factors. A total of 230 female cervical cancer survivors were enrolled (mean age: 52.6 ± 11.7 years). Most were married (63.9%) and lived with two or more household members (81.7%). The mean EQ-5D-5 L index score was 0.85 ± 0.14. Significant differences in HRQoL were observed across marital status, household size, income level, hypertension, disease status, International Federation of Gynecology and Obstetrics (FIGO) stage, time since last treatment, and dyspnea severity (all p-values < 0.05). Multiple linear regression (R² = 0.689) identified advanced FIGO stage II (β = − 0.17, p < 0.001) and IV (β = − 0.12, p = 0.024), chemotherapy alone within one year (β = − 0.22, p = 0.026), and dyspnea (β = − 0.05, p = 0.037) as independent negative predictors of HRQoL, whereas living with two or more household members was independently associated with better HRQoL (β = 0.10, p = 0.045). Our results demonstrate that cervical cancer is significantly associated with a lower health-related quality of life than in the general population, with advanced cancer stage, chemotherapy, and dyspnea symptoms being the major independent negative predictors. Sociodemographic factors, particularly household composition, also play a significant role in patients’ well-being. These findings highlight the importance of incorporating patient-centered supportive care into cancer management, especially for those with advanced disease or those undergoing chemotherapy, to mitigate the symptom burden and improve the overall quality of life.