Avaliação da frequência de reposição hormonal em pacientes que tiveram menopausa induzida pelo tratamento de câncer de colo de útero e o impacto em desfechos clínicos e na qualidade de vida dessas pacientes

Abstract

Cervical cancer (CC), a preventable disease, can affect adult women of all ages, with a median age of diagnosis of 47 years in Brazil. More than fifty percent of patients with CC are premenopausal at diagnosis and cancer treatment induces menopause. Objective: The aim of this study was to evaluate hormone replacement therapy (HRT) prescription in patients with induced menopause due to CC treatment and menopausal impact on clinical, social and quality of life outcomes. Methods: Observational, retrospective cohort study, carried out at three Brazilian public health institutions, from February to December 2021. Women aged 18 to 50 years, diagnosed with CC and with menopause onset after treatment were selected and interviewed. Results: One hundred and thirty patients were included, median age 40 years, CC diagnosis between 19-49 years. 44 patients, 33% of the cohort, had been advised about menopause symptoms, 23.1% about HRT, and only 20.8% received HRT. Data analysis, using Fisher's or Pearson's chi square test, has shown that earlier age and higher education were associated with a greater probability of receiving HRT (p=0.021 and 0.001, respectively). Other important data, from a social point of view, is the return to work after treatment, because the vast majority of women with CC diagnosis are part of the economically active population. 52 patients (40%) did not return to their previous work until one year after the end of treatment. Regarding quality of life, patients who received HRT had a better global health score than patients who did not (75.93 vs. 64.89, respectively). Conclusion: A small percentage of CC survivors receive adequate information about menopause and HRT, and a smaller proportion receive HRT, a safe prescription in this clinical context, regarding oncologic outcomes. These data show the need for attention to these young women who have menopause arising from treatment, and reinforce the importance for survivorship guidelines for CC patients.