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Death of a child and mortality after cancer: A nationwide cohort study in Sweden

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Yujie Wang, Karolinska Institutet, Southeast University
  • ,
  • Dang Wei, Karolinska Institutet
  • ,
  • Hua Chen, Department of Global Public Health, Karolinska Institutet
  • ,
  • Baoan Chen, Southeast University
  • ,
  • Jiong Li
  • Krisztina D. László, Department of Global Public Health, Karolinska Institutet

Background: The death of a child is a traumatic life event that may influence mortality in patients with cancer. Only a few studies investigated this association and their findings have been mixed. We analyzed whether the death of a child is associated with mortality in patients with cancer. Methods: We conducted a cohort study of 371,673 parents who were diagnosed with cancer in Sweden during 1973 to 2014 by linking several population-based registers. We analyzed the association between the death of a child after the diagnosis of cancer andmortality using Cox proportional hazards models with time-varying exposure. Results: The death of a child was associated with an increased risk of mortality [HR, 1.27; 95% confidence intervals (CI), 1.17-1.39]. The association was present not only in case of children's death due to cancer or other natural deaths, but also in case of unnatural deaths. Mortality was increased only in the long-term follow-up period (HR, 1.42; 95% CI, 1.29-1.56), but not in the short-term (HR, 0.95; 95% CI, 0.78-1.15). The association was most pronounced following loss of an adult child and for patients with reproductive cancers. Conclusions: Death of a child is associated with increased risks of overall and long-term mortality in patients with cancer. The findings that the association was present not only in case of natural but also in case of unnatural deaths suggests that stress-related mechanisms may also operate. Impact: Our findings highlight the importance of psychosocial support for patients with cancer experiencing severe stress.

OriginalsprogEngelsk
TidsskriftCancer Epidemiology Biomarkers and Prevention
Vol/bind30
Nummer1
Sider (fra-til)150-157
ISSN1055-9965
DOI
StatusUdgivet - jan. 2021

Bibliografisk note

Funding Information:
K.D. László reports grants from Swedish Council for Working Life and Social Research during the conduct of the study, as well as grants from KI Research Foundation, Swedish Heart and Lung Foundation, Clas Groschinsky Foundation, and Swedish Society of Medicine and other from Karolinska Institutet (salary) outside the submitted work. No disclosures were reported by the other authors.

Funding Information:
Financial support for the study was obtained from the Swedish Council for Working Life and Social Research granted to K.D. László (grant no. 2015-00837) and from the China Scholarship Council granted to Y. Wang (grant no. 201806090228), to D. Wei (grant no. 201700260276), and to H. Chen (grant no. 201700260296). J. Li is supported by the Novo Nordisk Foundation (grant no. NNF18OC0052029), the Danish Council for Independent Research (grant no. DDF-6110-00019B and 9039-00010B), and the Karen Elise Jensens Fond (grant no. 2016).

Publisher Copyright:
© 2020 American Association for Cancer Research.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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