809P - Mental and socioeconomic burden in endometrial and cervical cancer patients: A Swedish population-based study of survivorship

Background

Gynecological cancer may have severe implications in women, as these diagnoses are likely to have negative consequences on mental health and socioeconomic status. We used the Swedish national population and healthcare registries to assess the association between diagnosis of endometrial or cervical cancer and risk for mental disorders, as well as for socioeconomic consequences.

Methods

We performed a population-based nested case-control study based on more than 5 million women in Sweden, identifying 6,060 cases of cervical cancer and 17,932 cases of endometrial cancer diagnosed during 2006-2018. Each cancer case was matched with five healthy controls randomly selected from the population born in the same year. Data on comprehensive set of mental disorders, loss of employment, early retirement or need for sickness benefit, family receipt of financial assistance, decrease of individual income and family income before versus after cancer diagnosis were retrieved from population registries. Conditional logistic regression and stratified Cox regression models with confounder adjustment were conducted to estimate odds ratios (OR) and 95% confidence intervals (CI).

Results

Mental disorders were prevalent to a moderate degree before diagnosis among cervical cancer patients, but less prevalent in endometrial cancer patients. After cancer diagnosis, incident (i.e. new) mental disorders started emerging within the first 2-5 years and then persisted. The risk was higher following cervical cancer (OR=3.7, 95% CI=3.5-4.1) as compared to endometrial cancer (OR=2.1, 95% CI=2.0-2.2). Before cancer diagnosis, economic status was comparable between cancer patients and control women. Financial assistance and income decrease rose early after diagnosis, with 1.2-2.1 times increased risk among cancer patients. Unemployment, early retirement and need for sickness benefit doubled from two years after cancer diagnosis and onwards. Impact was more pronounced among cervical cancer patients.

Conclusions

Women with cervical cancer and endometrial cancer are affected mentally and financially after the cancer diagnosis. The impact is more pronounced among cervical cancer patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

MSD Sweden.

Disclosure

J. Wang, K. Sundström: Financial Interests, Institutional, Research Funding: MSD. A.L. Feldman: Financial Interests, Institutional, Other: Has been part of research collaborations within partnership programs between Karolinska Institutet and respectively MSD Sweden/Merck and Janssen Pharmaceutica NV. G. Bencina, M. Andersson, S. Salomonsson: Financial Interests, Personal, Full or part-time Employment: MSD. All other authors have declared no conflicts of interest.