Longitudinal Assessment of the Quality of Life of Cervical Cancer Survivors from a Tertiary Hospital in Seville, Spain: Does Statistical Significance Equate to Clinical Relevance?

We aimed to perform a longitudinal assessment of the quality of life of cervical cancer survivors comparing statistical significance with minimal clinically important difference.

We conducted a prospective cohort study on the quality of life of 106 cervical cancer survivors between August 1, 2016 and January 31, 2019. The self-reported measures included the FACT-Cx v.4.0 and the WHOQOL-BREF questionnaires.

We found no statistically significant changes in the quality of life (p > 0.05), except for a significant worsening in the group that underwent primary surgery and adjuvant radiation therapy and chemotherapy (p = 0.041). However, we observed minimal clinically important differences for all questionnaires regarding the total score (7.81 vs. 23.83 vs. 11.5 vs. 15.5 vs. 26.87 SDs), “physical” (7.28 vs. 4.75 vs. 5.13 vs. 3.79 vs. 4.95 SDs), “functional” (7.87 vs. 4.84 vs. 3.21 vs. 6.93 vs. 12.02 SDs), “emotional” (4.12 vs. 2.34 vs. 1 vs. 1 vs. 3.54 SDs; except for the comparison between the questionnaires at 12–24 months and 24–60 months after the end of the therapy), and “additional concerns” (8.59 vs. 11.13 vs. 8.19 vs. 6.93 vs. 5.66 SDs; except for the comparison between the questionnaires at 0–6 months and 12–24 months after the end of the therapy) domains of the FACT-Cx. The quality of life of long-term cervical cancer survivors was moderate-optimal regarding WHOQOL-BREF questionnaire scores (minimum “psychological health^a”: 48 ± 14.04; maximum “environment^d” 67.46 ± 20.40).

The quality of life of long-term cervical cancer survivors was moderate-optimal. No significant changes in the quality of life were found. However, considering minimal clinically important differences, there was an improvement of the quality of life throughout the follow-up.