Abstract 812P
Background
Gynecological cancer in women may have negative mental and societal consequences impacting not only patients, but also their family members. The impact may differ between families afflicted by cervical and endometrial cancer, as the two cancers develop at different ages (median age at diagnosis 49 vs. 60 years, respectively), and is not well understood. We assessed the health and education status of family members to a woman with cervical or endometrial cancer, to elucidate potential mental and socioeconomic consequences in these.
Methods
We performed a population-based nested case-control study in Sweden, identifying 11,602 cases of cervical cancer and 34,007 cases of endometrial cancer diagnosed during 1991-2016. Each cancer case was matched with five healthy controls randomly selected from the population with same birth year. Their children and respective co-parents were identified through the Swedish multi-generation register and mental health and educational outcomes traced through the Swedish Patient Register and Statistics Sweden. A comprehensive set of mental disorders of co-parents and children and attained highest level of education of the children after mother’s diagnosis, were assessed.
Results
Co-parents and children of cervical cancer patients had 30-40% increased risk of mental disorders after women’s cancer diagnosis compared to relatives of healthy controls. The increase among children emerged right after cancer diagnosis (OR=1.32, 95%CI=1.05-1.65), whereas among the co-parents emerged from 2 years after (OR=1.42, 95%CI=1.02-1.98). For endometrial cancer, the association was present but weaker. Children aged 0-18 at mothers’ cervical cancer diagnosis were less likely to reach a higher level of education as compared to children to women without cervical cancer (OR 0.87, 95%CI 0.83-0.91). The corresponding educational impact on children of women with endometrial cancer was inconclusive.
Conclusions
Children and co-parents of women with cervical or endometrial cancer are affected adversely mentally after the cancer diagnosis, and children to mothers with cervical cancer display a generational impact in terms of lower education attainment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Karolinska Institutet.
Funding
MSD Sweden.
Disclosure
K. Sundström: Financial Interests, Institutional, Research Funding: Merck. G. Bencina, M. Andersson, S. Salomonsson: Financial Interests, Personal, Full or part-time Employment: MSD. J. Wang: Financial Interests, Institutional, Funding: MSD. All other authors have declared no conflicts of interest.
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