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#93 Anxiety and depression in women with newly diagnosed vulvar cancer – a nationwide prospective longitudinal study
  1. Diana Zach1,2,
  2. Elisabeth Åvall Lundqvist3,
  3. Henrik Falconer1,
  4. Preben Kjølhede3,
  5. Zuzana Kolkova4,
  6. Katja Stenström Bohlin5,
  7. Johan Zetterqvist2,
  8. Pernille T Jensen6 and
  9. Angelique Flöter Rådestad1
  1. 1Karolinska University Hospital, Stockholm, Sweden
  2. 2Karolinska Institutet, Stockholm, Sweden
  3. 3Linköping University, Linköping, Sweden
  4. 4Lund University Hospital Skåne, Lund, Sweden
  5. 5Sahlgrenska Academy, Gothenburg, Sweden
  6. 6Aarhus University Hospital, Aarhus, Denmark


Introduction/Background A cancer diagnosis can cause psychological stress. Knowledge about risk factors and the trajectory of anxiety and depression in women with vulvar cancer is pertinent to allow the development of intervention programs.

Methodology This prospective longitudinal nationwide cohort study investigated anxiety and depression by validated patient reported outcome measures. Women with primary vulvar cancer diagnosed between 2019 and 2021 completed the Hospital Anxiety and Depression Scale, the European Organization of Research and Treatment of Cancer Quality of Life Core Questionnaire C30 and the Vulvar Module VU34 at diagnosis and 3 and 12 months post-treatment. Multivariate log-linear regression models and generalized estimated equations with repeated measurements were employed for longitudinal analyses to evaluate associations and changes over time.

Results In total, 105 (72%) women completed the questionnaires at all time-points. Median age was 69 years and most (74%) were diagnosed at FIGO stages IA-II, 97% underwent surgery.

The proportion of women with elevated anxiety levels decreased significantly from 42% at diagnosis to 30% after 12 months. 14% of the women showed elevated depression levels which remained stable during follow-up (figure 1).

A higher level of anxiety was significantly associated with a higher prevalence of insomnia (RR 2.1, 95% CI 1.2–3.7) and vulvar symptoms (pain, itching, tearing, irritation, or sore skin) (RR 2.8, 95% CI 1.7–4.6). No associations were found with stage of disease, type of treatment, or partner status. There was a trend towards higher levels of anxiety and younger age (< 65 years, RR 1.5, 95% CI 1.0–2.5).

Abstract #93 Figure 1

Proportions of women with normal, borderline, and pathological levels of anxiety (A) and depression (B) at baseline (i.e., before start of treatment), 3 months and 12 months after completed treatment, n=105.

Conclusion Almost every second woman with vulvar cancer experiences high levels of anxiety at diagnosis. Despite a significant improvement over time, still almost every third woman reports high levels of anxiety 12 months post treatment and may benefit from psychosocial intervention. Targeting insomnia and vulvar symptoms could decrease anxiety.

Disclosures No disclosures

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