National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
Department of Gynaecology, Copenhagen University Hospital, Copenhagen, Denmark; Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Gynecol Oncol. 2022 Aug;166(2):300-307. doi: 10.1016/j.ygyno.2022.05.019. Epub 2022 Jun 6.
Previous studies suggest that sleeping problems are frequent after cervical cancer. However, the evidence on the use of hypnotics is sparse. We investigated if women diagnosed with cervical cancer have an increased risk of using hypnotics and identified risk factors for prolonged use.
In this nationwide register-based cohort study, 4264 women diagnosed with cervical cancer from 1997 to 2013 and 36,632 cancer-free women were followed in registers until 2016. Prolonged use of hypnotics was defined as more than three prescriptions with no more than three months in between. Data were analysed using Cox proportional hazards regression models and multistate Markov models separately for women with localized and advanced cervical cancer.
The rate of first use of hypnotics was substantially increased during the first year after cervical cancer diagnosis compared to cancer-free women (HR 4.4, 95% CI 3.9-5.1; HR 8.9, 95% CI 7.5-10.6) and remained markedly increased for up to five years after diagnosis. Dependent on stage of disease and age, 1.4 to 4.7 excess women per 100 with cervical cancer were prolonged users of hypnotics compared to cancer-free women one year after diagnosis. Risk factors for prolonged use of hypnotics were higher age, short education, previous use of antidepressants or anxiolytics, and advanced disease.
Women diagnosed with cervical cancer are at increased risk of prolonged use of hypnotics. For the majority, treatment with hypnotics is initiated within the first year after cancer diagnosis, but the rate of first use is increased for up to five years.
先前的研究表明，宫颈癌患者常伴有睡眠问题。然而，关于催眠药物使用的证据很少。我们调查了宫颈癌患者是否有使用催眠药物的风险增加，并确定了延长使用催眠药物的风险因素。
在这项全国范围内基于登记的队列研究中，我们随访了 1997 年至 2013 年间被诊断为宫颈癌的 4264 名女性和 36632 名无癌女性，随访至 2016 年。长时间使用催眠药物定义为开具超过三张处方，且每张处方的间隔不超过三个月。分别使用 Cox 比例风险回归模型和多状态 Markov 模型对局限性和晚期宫颈癌患者的数据进行分析。
与无癌女性相比，宫颈癌诊断后第一年首次使用催眠药物的比率显著增加（HR 4.4，95%CI 3.9-5.1；HR 8.9，95%CI 7.5-10.6），并且在诊断后长达五年的时间内仍显著增加。根据疾病的分期和年龄，与无癌女性相比，每 100 名宫颈癌患者中就有 1.4 至 4.7 名患者会成为催眠药物的长期使用者。长时间使用催眠药物的风险因素包括年龄较大、受教育程度较低、之前使用过抗抑郁药或抗焦虑药，以及疾病进展。
诊断为宫颈癌的女性有长期使用催眠药物的风险增加。对于大多数患者来说，治疗性催眠药物的使用是在癌症诊断后的一年内开始的，但首次使用的比率在五年内都有所增加。
