Mental disorders and socioeconomic outcomes in women with cervical cancer, and their children and co-parents.
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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.