Mortality Among Women With Cervical Cancer During or Shortly After a Pregnancy in Denmark 1968 to 2006

Objective: Cervical cancer diagnosed in relation to a pregnancy is rare; however, the current trend to have children later in life increases the risk of pregnancy and cervical cancer coinciding. We investigated the mortality of women diagnosed with cervical cancer during or in relation to a pregnancy. Materials and Methods: From the nationwide Danish Cancer Registry, we identified women diagnosed with a primary cervical cancer at ages 15 to 44 years during 1968 to 2006 born after April 1, 1935. The women were linked to several Danish national registries to obtain information on births and abortions. In addition, linkage was made to the Cause of Death Register. Overall and cause-specific hazards ratios (HRs) were assessed by Cox proportional hazards regression with adjustment for age, calendar year, and extent of disease. Results: A total of 6135 cervical cancers were identified. Among these, 126 women were diagnosed with cervical cancer during pregnancy, 1856 were diagnosed with cervical cancer 0 to 4 years after a pregnancy, and 4153 were diagnosed with cervical cancer more than 30 days before or 5 years or more after a pregnancy or had no known pregnancies. The latter group was used as reference. The adjusted HR for death due to cervical cancer was 1.77 (95% confidence interval, 1.21-2.60) among women diagnosed with cervical cancer during pregnancy compared with that in the reference group, while the corresponding HR among women with cervical cancer 0 to 4 years after pregnancy was 0.96 (95% confidence interval, 0.83-1.10) compared with that in the reference group. Conclusions: Our results suggest an increased mortality for women diagnosed with cervical cancer during pregnancy, but not among those diagnosed shortly after pregnancy. This finding should be explored further in larger populations.