Mental disorders and socioeconomic outcomes in women with cervical cancer, 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 utilized nationwide registers during 1991-2018 in Sweden to perform two 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 = 30300). 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 to comparators, particularly during the first two years post-diagnosis (HR = 3.74, 95% CI = 3.45-4.06). 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 two years after cancer diagnosis. We further found an increased risk of mental disorders in both children and co-parents of the cases, compared to 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 of her cancer.

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.