In patients with cervical cancer, stress-related disorders and stressful life events may be associated with an increased risk for cancer-specific mortality, according to study results published in Cancer Research.

Researchers utilized the national Swedish Cancer Register to identify all patients (N=4533) diagnosed with invasive cervical cancer between January 1, 2002 and December 31, 2011. Psychological disorders that are relatively common in patients with cervical cancer — such as stress reaction and adjustment disorders, depression, and anxiety disorders — were included if the patient was diagnosed with the disorder from 1 year before cancer diagnosis onward, with a particular focus on disorders diagnosed within 1 year before or after cancer diagnosis. Stressful life events included the death of a family member, divorce, and being between jobs.

All deaths occurring in the patients during follow-up were identified by both the date and underlying cause of death. The primary outcome was cervical cancer-specific mortality; secondary outcomes included overall mortality.

A total of 1797 patients (42.3%) were defined as exposed to either stress-related disorders (9.2%) or stressful life events (37.4%) from the year before cancer diagnosis onward; of which 860 (48%) occurred within 1 year before or after diagnosis. Mean age at diagnosis was 53.9 years. During follow-up, 1392 (32.8%) patients died and 1005 of those patients (72.2%) died due to cervical cancer specifically.

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Patients with psychological distress — either a stress-related disorder or a stressful life event — from the year before cancer diagnosis onward had an increased risk for cancer-specific mortality compared with patients without psychological distress. Stress-related disorders were associated with an increased risk for cancer-specific mortality regardless of when the disorder was diagnosed, whereas stressful life events were associated with a higher risk only when they occurred within the year before or after cancer diagnosis.

“In this nationwide cohort study of women with cervical cancer, we found that psychologic[al] distress, defined as either a clinical diagnosis of stress-related disorders or an occurrence of stressful life events around the time of cancer diagnosis, was associated with an increased risk of cervical cancer-specific mortality,” the investigators concluded.

Reference

Lu D, Andrae B, Valdimarsdóttir U, et al. Psychological distress is associated with cancer-specific mortality among patients with cervical cancer [published online June 28, 2019]. Cancer Res. doi:10.1158/0008-5472.CAN-19-0116