Psychiatric disorders and stressful life events that occur around a cervical cancer diagnosis are associated with increased cancer-specific mortality, independent of tumor characteristics and treatment modality, according to a study published in Cancer Research.
“These findings support the integration of psychologic screening and intervention in the clinical management of patients with cervical cancer, particularly around the time of cancer diagnosis,” the researchers noted.
Researchers conducted a nationwide cohort study that included 4,245 patients with newly diagnosed cervical cancer between 2002 and 2011 in Sweden. Psychologic distress was indicated by a clinical diagnosis of depression, anxiety, or stress reaction and adjustment disorders, or the experience of a stressful life event, including death or severe illness of a family member, divorce, or being between jobs, from one year before cancer diagnosis and onwards.
They assessed cancer-specific mortality among the patients exposed to psychologic distress compared with patients who were not exposed to such stress.
— Armin Shahrokni (@MSK_GeriOnc) August 2, 2019
Stress associated with increased mortality
Using Sweden’s Causes of Death Register, after a mean 4.4 years of follow-up, 1,392 of the women died, 1,005 of whom died due to cervical cancer. Close to half of women (n=1,797; 42.3%) had either a stress-related disorder or faced stressful life events one year before cancer diagnosis or later. The mean age at cancer diagnosis was 53.9 years.
Patients who were exposed to psychologic distress had a 33% increased risk of cancer-specific mortality (hazard ratio [HR], 1.33; 95% CI, 1.14-1.54). Women with stress-related disorders had a 55% greater likelihood of dying of cervical cancer (HR=1.55; 95% CI, 1.2-1.99), while those exposed to a stressful life event were 20% more likely to die of cervical cancer (HR=1.2; 95% CI, 1.02-1.41). The association was primarily driven by distress experienced within one year before or after diagnosis (HR=1.30; 95% CI, 1.11-1.52), but this association did not continue a year after diagnosis (HR=1.12; 95% CI, 0.84-1.49).