Perceived threat and PTSD symptoms in women undergoing surgery for gynecologic cancer or benign conditions

Abstract

Objective: We sought to examine levels of perceived threat and traumatic stress symptoms both before and in the short- and long-term period after surgery and associated care in women diagnosed with gynecologic cancer or benign conditions.

Methods: Women with advanced-stage cancer (n=22), early-stage cancer (n=31), benign gynecologic disease (n=33), and no disease (n=25; post-annual pelvic examination) completed questionnaires (Perceived Threat, Impact of Event Scale (IES), and Post-Traumatic Stress Disorder (PTSD Checklist (PCL)) on three occasions: 1 week before surgery (Time 1), 7 weeks after surgery or comparable time (Time 2), and 16 months after surgery (Time 3).

Results: Perceived threat did not differ across disease groups at Time 1, but there were differences at both later times (F(2, 93.1)=11.83; p<0.001; group × time interaction); women with advanced cancer reported the highest levels. IES scores were consistently higher for the disease groups compared with the no-disease group (F(3,104.2)=11.19; p<0.001), but were not significantly different from one another. IES scores declined over time, most markedly for the three disease groups (group × time interaction (F(6,163.8)=2.60; p=0.02). Survival analysis indicated significant differences across the groups in risk of estimated PTSD [Wilcoxon χ(2) (3, N=96)=7.83, p=0.050] with 34% of advanced cancer, 16% of early cancer, and 15% of benign disease groups reaching estimated PTSD criteria.

Conclusions: Women with gynecologic cancer, regardless of stage, and women with benign conditions experience heightened traumatic stress at the time of diagnosis, and some continue to be distressed many months afterwards. Broad-based screening and intervention for traumatic stress symptoms may be warranted.