Cervical cancer: psychologic distress tied to higher mortality risk

  • Lu D & al.
  • Cancer Res
  • 28 Jun 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Stress-related disorders and stressful life events around cancer diagnosis raise the risk for cancer-specific mortality in patients with cervical cancer, independent of tumor characteristics and treatment modality.

Why this matters

  • Psychological screening and intervention may improve outcomes in patients with cervical cancer.

Study design

  • 4245 patients diagnosed with cervical cancer during 2002-2011.
  • Funding: Swedish Cancer Society; Swedish Research Council for Health, Working Life, and Welfare; others.

Key results

  • 42.3% of patients experienced psychologic distress:
    • Stress-related disorders (stress reaction and adjustment disorders, depression, and anxiety disorder), 9.2%.
    • Stressful life events (death or severe illness of a family member, divorce, and being between jobs), 37.4%.
  • Patients exposed to psychologic distress showed significantly higher risk for cancer-specific mortality (aHR, 1.26; 95% CI, 1.08-1.46) than unexposed patients after adjusting for tumor stage and histology, year of diagnosis, treatment, mode of detection, and comorbidities.
    • Risk was significantly higher with stress-related disorders (aHR, 1.55; 95% CI, 1.20-1.99) and stressful life events (aHR, 1.20; 95% CI, 1.02-1.41).
  • The association was significant for psychologic distress experienced within 1 year before or after diagnosis (aHR, 1.30; 95% CI, 1.11-1.52), but not beyond.

Limitations

  • Observational design.