Journal article
Risk of memory impairment in gynecologic cancer survivors in the Women's Health Initiative: Untangling effects of age, comorbidities, and cancer
Gynecologic oncology, v 206, pp 1-8
01 Mar 2026
PMID: 41592519
Featured in Collection : Drexel's Newest Publications
Abstract
To assess whether gynecologic cancer history predicts worsened self-reported memory outcomes, accounting for the interaction of age and comorbidities.
Nested case-control study of cancer survivors enrolled in the ancillary Life and Longevity After Cancer (LILAC) study of the Women's Health Initiative (WHI) and matched cancer-free WHI participants, longitudinally followed after initial enrollment from 1993 to 1998. Postmenopausal women with incident endometrial or ovarian cancer during the WHI were compared to cancer-free women matched up to 5:1 to survivors. Participants with pre-existing cognitive dysfunction, neurodegenerative disease, or multiple cancers were excluded. The primary outcome was self-reported “moderate/severe memory problems” ≥12 months following cancer diagnosis of the index survivor. Associations of pre-diagnosis conditions with later memory problems were examined through cause-specific hazards models, accounting for competing mortality risk.
Primary analyses included 1395 survivors and 5364 cancer-free controls. In multivariable analysis, cancer history was associated with decreased self-reported memory problems (cause-specific hazard ratio [csHR] 0.71 [0.57–0.87], p = 0.001). The only factors independently predictive of future memory concerns were increasing age (5-year increase; csHR 1.96 [1.84–2.09], p < 0.001), cardiovascular disease (hypertension csHR 1.24 [1.03–1.50]; major cardiovascular events csHR 1.85 [1.28–2.68], p = 0.002), diabetes (csHR 1.47 [1.10–1.96], p = 0.01), and depression (csHR 1.47 [1.11–1.95], p = 0.008).
After accounting for mortality differences, gynecologic cancer survivors experienced reduced hazard for self-reported moderate/severe memory problems. In this population, significant memory symptoms may represent aging and comorbidity effects more than cancer-related outcomes.
•Developing self-reported moderate/severe memory problems occurred in 7.4% of survivors, 14.1% of matched cancer-free women.•Moderate/severe memory problems were associated with age, cardiovascular disease, diabetes, and depression at diagnosis.•Adjusting for survival and comorbidities, survivors reported less moderate/severe memory problems than matched controls.•No significant differences between memory outcomes in endometrial versus ovarian cancer survivors were noted.
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Details
- Title
- Risk of memory impairment in gynecologic cancer survivors in the Women's Health Initiative: Untangling effects of age, comorbidities, and cancer
- Creators
- Benjamin J. Matthews (Corresponding Author) - Johns Hopkins HospitalElectra D. Paskett - The Ohio State UniversityEric McLaughlin - The Ohio State UniversityDiane Von Ah - The Ohio State UniversityRowan Chlebowski - The Lundquist InstituteChloe M. Hery - The Ohio State UniversityMichael Pennell - The Ohio State UniversityTracy Vannorsdall - Johns Hopkins UniversityLongjian Liu - Drexel UniversityAladdin H. Shadyab - Human Longevity (United States)Kathy Pan - Kaiser PermanenteStephanie L. Wethington - Johns Hopkins University
- Publication Details
- Gynecologic oncology, v 206, pp 1-8
- Publisher
- Elsevier Inc
- Number of pages
- 8
- Grant note
- National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services: N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42129-32, 44221, 42107-26 Breast Cancer Research Foundation
The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122,42107-26, 42129-32, and 44221; The WHI Life and Longevity After Cancer (LILAC) study is funded by UM1 CA173642. This work was also supported by a grant from the Breast Cancer Research Foundation.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001679664200001
- Scopus ID
- 2-s2.0-105028269193
- Other Identifier
- 991022158367604721