A study published in the journal Cancer Research has reported that psychological stress has been found to be associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
“Patients receiving a cancer diagnosis are at increased risk of several stress-related psychiatric disorders, such as depression, anxiety, and stress-reaction and adjustment disorders,” said lead author, Donghao Lu.
“Emerging evidence from both experimental and epidemiological studies indicates that psychological distress might affect the progression of many cancer types.”
In this study, researchers examined the potential influence of stress on the cancer-specific mortality of patients with cervical cancer.
They examined records of 4,245 patients diagnosed with cervical cancer in Sweden between January 1 2002 and December 31 2011.
Using Swedish personal identification numbers, they linked the patients to the Swedish Patient Register, which collects nationwide information on hospital discharge records and specialist visits.
Data from this register were used to identify patients who had been clinically diagnosed with any of three psychiatric disorders: stress-reaction and adjustment disorders, depression, and anxiety.
The researchers also identified patients who had experienced a stressful life event, such as the death or severe illness of a family member, divorce, or being between jobs, as these events would further reflect an emotional burden on patients.
The researchers used Sweden’s Causes of Death Register to identify women who had cervical cancer or unspecified uterine cancers as the underlying cause of death.
During the follow-up period, 1,392 patients died, and cervical cancer was listed as the cause of death for 1,005 of them.
In all, the researchers found that 1,797 patients either had stress-related disorders or had undergone stressful life events.
Patients with either a stress-related disorder or a stressful life event were 33 percent more likely to die of the disease than those who had not reported stress.
Those who had stress-related disorders were 55 percent more likely to die of their cervical cancer, and those who had experienced a stressful life event were 20 percent more likely to die of their disease.
Lu pointed out that the association of stress with higher risk of dying of cervical cancer remained, independent of tumour characteristics, mode of diagnosis, and type of treatment.
The associations were also consistent across demographic groups and clinical characteristics.
“There are several possible explanations for the link between psychological stress and cervical cancer-specific mortality. For one, a woman suffering from a psychological disorder may be less likely to seek treatment and may be diagnosed at a later stage. Biologically, previous research has shown that chronic stress may reduce cellular immune response, which may affect the progression of infection-related cancers, such as cervical cancer,” Lu explained.
Many patients do not receive emotional support, partially because of lack of awareness of the toll emotional stress can take
Fellow author Karin Sundström said: “In Sweden, psychological support is available for patients at large, university-based clinics, but not in smaller regional facilities. Many patients do not receive emotional support, partially because of lack of awareness of the toll emotional stress can take.”
“Our findings support that oncologists or gynecologists perform active evaluation of psychiatric status on return visits to see how patients with cervical cancer are doing, not only somatically, but also mentally,” Sundström concluded. “If confirmed in other populations and countries, psychological screening and intervention may be considered as an integral component in cervical cancer care.”
Lu also pointed out that this study suggests an association between stress and cervical cancer prognosis and should not be interpreted as a causal link.