ASPO Abstracts
Self-collection of microbiome samples and leg circumference measurements among endometrial cancer survivors: A pilot study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose: Endometrial cancer survivors experience declines in quality of life from lymphedema and sexual and bowel dysfunction following cancer treatment. We conducted a pilot study to assess feasibility and acceptability of self-collection of gut and vaginal microbiome samples, self-measurement of leg circumference, and to collect preliminary data on lymphedema, bowel and sexual function. Methods: Endometrial cancer survivors were mailed gut and vaginal microbiome self-collection kits; measuring tapes and instructions for leg measurements; and bowel and sexual function and lower extremity lymphedema (LEL) surveys prior to a nurse home visit. Measures of feasibility included completion of microbiome kits and leg measurements. Descriptive feedback was used to assess acceptability. The threshold for LEL was a 10% difference between right and left leg measurements; or > 4 symptoms on the Gynecologic Cancer Lymphedema Questionnaire (GCLQ). The Colorectal Anal Distress Inventory was used to assess bowel function [CRADI-8: 0 (no symptoms) to 100 (maximum symptom severity)]. Lower scores on the Sexual Function Vaginal Questionnaire (SVQ) indicated worse function. Results: Among 50 participants, 44% were Black women. Mean age was 60.8 years and time from cancer diagnosis was 15.5 months. Mean BMI was 34.9 kg/m2. Most women submitted gut (N=43) or vaginal swab (N=47) samples; fewer (N=17) submitted leg measurements. Participants reported moderate to high comfort with microbiome sample collection. Leg self-measurement was difficult due to limited guidance and physical barriers. Among 17 women with nurse and self leg measurements, 24% met criteria for LEL. Sensitivity, specificity, and PPV for self-measurements were 50%, 92%, and 67%, respectively. In the full sample, 24% met criteria for LEL by nurse measurement and 54% met criteria by GCLQ. CRADI-8 scores (mean=54.6) indicated moderate bowel distress. SVQ intimacy and satisfaction scores were on the favorable half of the possible range; 34% of participants reported sexual activity. Conclusions: Self-collection of microbiome samples, but not lower leg measurements, was feasible and acceptable. Prevalence of LEL was high and bowel distress moderate. Sexual activity was low; but intimacy scores were often favorable.
Keywords: endometrial cancer; quality of life; microbiome