Mental disorders and socioeconomic outcomes in women with cervical cancer, and their children and co-parents
Abstract
Background
Cervical cancer often affects women who are in the middle of life and may carry substantial mental and socioeconomic impact also on families. We performed a generation-spanning study to elucidate this burden.
Methods
We used nationwide registers during 1991-2018 in Sweden to perform 2 matched cohort studies based on a source population of more than 5 million women. The individual sub-study included 6060 cases of cervical cancer diagnosed during 2006-2018 and 5 population comparators individually matched to each case by age, birth year, and region (n = 30 300). The family sub-study included 9332 cases of cervical cancer diagnosed during 1991-2016 and 45 674 matched population comparators and all their children and co-parents.
Results
We found an increased risk for mental disorders in cases compared with comparators, particularly during the first 2 years postdiagnosis (HR = 3.74, 95% CI = 3.45 to 4.06). Socioeconomic status changed negatively in cases after their diagnosis: a decreased income and increased need for financial aid appeared within 2 years, whereas unemployment escalated from 2 years after cancer diagnosis. We further found an increased risk of mental disorders in both children and co-parents of the cases, compared with the children and co-parents of the comparators. Furthermore, we observed negative socioeconomic trajectories in the co-parents and lower educational attainment in the children of the cases, especially if the case had died.
Conclusions
Women with cervical cancer, and their close family members, display increased risk of negative mental health and socioeconomic outcomes after diagnosis. The lower educational attainment in children appears particularly worrying.