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. 2025 Feb 25;13(3):70.
doi: 10.3390/diseases13030070.

Quality of Life and Stress-Related Psychological Distress Among Patients with Cervical Cancer: A Cross-Sectional Analysis

Razvan Betea  1 , Mirabela Dima  2 , Veronica Daniela Chiriac  3
Affiliations

Quality of Life and Stress-Related Psychological Distress Among Patients with Cervical Cancer: A Cross-Sectional Analysis

Razvan Betea et al. Diseases. .

Abstract

Background and objectives: Cervical cancer places substantial burdens on physical and psychosocial health. This study evaluated changes in quality of life (QoL) and perceived stress in patients with cervical cancer before and six months after initiating standard treatment. Four validated instruments were used: the 36-Item Short Form Survey (SF-36), the Perceived Stress Scale (PSS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).

Methods: Ninety-six women (mean age: 48.3 ± 7.4 years) with histologically confirmed cervical cancer were enrolled. Baseline (pre-treatment) assessments included SF-36, PSS, WHOQOL-BREF, and EORTC QLQ-C30. Follow-up was conducted six months after initiating either surgery or chemoradiation. Paired t-tests (or Wilcoxon signed-rank for non-parametric data) compared baseline and follow-up scores. Subgroup analyses were performed by disease stage (early vs. advanced) and marital status (married vs. unmarried).

Results: Post-treatment assessments showed significant improvements in SF-36 physical functioning (from 61.9 ± 11.6 to 66.7 ± 12.3, p = 0.015) and mental health (from 63.4 ± 12.2 to 68.1 ± 12.4, p = 0.022). PSS scores declined from 23.2 ± 5.7 to 20.6 ± 5.5 (p = 0.001). WHOQOL-BREF physical and psychological domains increased, with physical health rising from 56.4 ± 12.0 to 60.7 ± 12.5 (p = 0.032). EORTC QLQ-C30 global health improved from 61.4 ± 13.8 to 66.3 ± 14.2 (p = 0.014). Advanced-stage patients exhibited greater absolute QoL gains yet remained below the early-stage scores. Married patients reported sharper reductions in PSS and higher final QoL scores.

Conclusions: Over six months of standard cervical cancer treatment, these patients demonstrated significant QoL improvements and reduced perceived stress. While advanced-stage disease remained associated with lower post-treatment scores, these individuals benefited from notable gains compared to baseline. Marital status emerged as a protective factor. Ongoing psychosocial support may amplify these beneficial effects, warranting further longitudinal studies to optimize integrative survivorship care.

Keywords: EORTC QLQ-C30; SF-36; WHOQOL-BREF; cervical cancer; perceived stress scale; psychological; quality of life; stress.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Changes in Perceived Stress Scale (PSS) and WHOQOL-BREF scores.
Figure 2
Figure 2
Subgroup analysis: early vs. advanced stage.
See this image and copyright information in PMC

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