Abstract 5797: Genitourinary disease risks among ovarian cancer survivors in a population-based cohort study
Authors: Chang Chun-Pin , Chen Yuji , Blackburn Brenna , Abdelaziz Sarah , Rowe Kerry , Snyder John , Dodson Mark , Deshmukh Vikrant , Newman Michael , Stanford Joseph B. , Porucznik Christina A. , Ose Jennifer , Fraser Alison , Smith Ken , Doherty Jennifer , Gaffney David , Hashibe Mia 
Published: September 2020

Abstract
Background. While genitourinary complications during treatment for ovarian cancer are well known, long-term adverse outcomes in the growing population of ovarian cancer survivors have yet to be characterized. The aim of our study is to describe the incidence of genitourinary diseases among ovarian cancer survivors after ovarian cancer diagnosis, compared to the general female population.
Methods. We identified a cohort of 1,270 ovarian cancer survivors diagnosed between 1996 and 2012 in the Utah Cancer Registry, and up to five cancer-free women were matched to ovarian cancer survivors on birth year and state from the Utah Population Database (N=5,286). Genitourinary disease diagnoses were identified with ICD-9 codes from electronic medical records and statewide healthcare facilities data. Cox proportional hazards models were used to compute hazard ratios (HR) and 95% confidence intervals (CI) for genitourinary outcomes at 1 to &lt;5 years after cancer diagnosis and 5+ years after cancer diagnosis with adjustment for potential confounders (e.g., race, baseline body mass index (BMI), and baseline Charlson Comorbidity Index (CCI)).
Results. Urinary system disorders were diagnosed more frequently in ovarian cancer survivors compared to women without cancer (34.6% vs 19.3%, p-value &lt;0.001) in years 1-5 of follow up (HR: 2.53, 95% CI: 2.12-3.01). More than 5 years after cancer diagnosis, ovarian cancer survivors had a higher risk of hydronephrosis compared to the general population (HR: 9.10, 95% CI: 4.29-19.33). Genital organ disorders were also more common among ovarian cancer survivors (22.0%) compared to women in the general population (16.3%; HR: 1.89, 95% CI: 1.57-2.27). The risk of pelvic peritoneal adhesions was highest 1-5 years after cancer diagnosis (HR: 16.59, 95% CI: 7.00-39.34) and persisted 5+ years after cancer diagnosis (HR: 8.88, 95% CI: 1.88-41.91). A higher risk of urinary system disorders among ovarian cancer patients was associated with advanced cancer stage (HRadvanced vs. localized: 3.11, 95% CI: 2.18-4.45), older age at cancer diagnosis (HR80+ vs. 18-49: 2.85, 95% CI: 1.62-5.01), and higher baseline CCI score (HR2+ vs. 0: 2.71, 95% CI: 1.84-3.99). The associations remained when we restricted analyses to ovarian cancer survivors with high-grade serous ovarian cancer.
Conclusions. In this population-based cohort study, ovarian cancer survivors experienced increased risks of various genitourinary diseases for many years after cancer diagnosis. Understanding the multimorbidity trajectory for ovarian cancer survivors after cancer treatment is needed to ultimately improve clinical care after cancer diagnosis. The present results point to the importance of monitoring for genitourinary diseases among ovarian cancer survivors.
Citation Format: Chun-Pin Chang, Yuji Chen, Brenna Blackburn, Sarah Abdelaziz, Kerry Rowe, John Snyder, Mark Dodson, Vikrant Deshmukh, Michael Newman, Joseph B. Stanford, Christina A. Porucznik, Jennifer Ose, Alison Fraser, Ken Smith, Jennifer Doherty, David Gaffney, Mia Hashibe. Genitourinary disease risks among ovarian cancer survivors in a population-based cohort study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5797.