Fertility anxiety partially mediates depression and recurrence fear in reproductive-age cervical cancer patients - A cross-sectional study

Q: What was the study’s primary aim?

To test whether reproductive concerns partially mediate the relationship between depressive symptoms and fear of recurrence in reproductive-age cervical cancer patients.

Q: How was reproductive anxiety measured and analyzed?

Participants completed validated scales for reproductive concerns, depression (PHQ-9), and fear of cancer recurrence, and structural equation modeling assessed mediation effects.

Q: What did the results show about mediation?

Reproductive concerns correlated positively with both depression and fear of recurrence, and the indirect effect through reproductive concerns was significant, accounting for 28.1% of the total effect.

Sep 24, 2026

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Cervical cancer survivors of reproductive age often experience elevated fertility-related anxiety driven by the disease and its treatments, which can intensify psychological distress. This cross-sectional study examines whether reproductive concerns partially mediate the association between depressive symptoms and fear of recurrence. Using convenience sampling, 208 eligible patients completed validated questionnaires covering reproductive concerns, depression severity, and recurrence fear. Structural equation modeling evaluates the mediating pathway and quantifies the indirect effect contributing 28.1% of the total relationship.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Aim

Methods

Results

Conclusion

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| W | J | C | O | World Journal of
Clinical Oncology | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Clin Oncol 2025 September 24; 16(9): 110031 DOI: 10.5306/wjco.v16.i9.110031 ISSN 2218-4333 (online) ORIGINAL ARTICLE Observational Study Fertility anxiety partially mediates depression and recurrence fear in reproductive-age cervical cancer patients: A cross-sectional study Xin-Ying He, Ying Huang, Cheng-Ping Qiao, Jiao Ma, Xue Han, Xue-Mei Fan, Qin Chen Specialty type: Oncology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade C Novelty: Grade B, Grade C Creativity or Innovation: Grade B, Grade C Scientific Significance: Grade B, Grade C P-Reviewer: Zhan Y, PhD, PsyD, Academic Fellow, Doctorate Student, China Received: May 28, 2025 Revised: June 18, 2025 Accepted: July 31, 2025 Published online: September 24, 2025 Processing time: 118 Days and 14.8 Hours Xin-Ying He, Cheng-Ping Qiao, Jiao Ma, Xue Han, Xue-Mei Fan, Qin Chen, Department of Gynecological Oncology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing 210004, Jiangsu Province, China Ying Huang, Department of Obstetrics and Gynecology, Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nantong 226600, Jiangsu Province, China Co-first authors: Xin-Ying He and Ying Huang. Corresponding author: Qin Chen, Chief Nurse, Department of Gynecological Oncology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, No. 123 Tianfei Lane, Mochou Road, Qinhuai District, Nanjing 210004, Jiangsu Province, [China.](China. qin@njmu.edu.cn)[ qin@njmu.edu.cn](China. qin@njmu.edu.cn) Abstract BACKGROUND Cervical cancer survivors of childbearing age often face heightened reproductive anxiety due to the direct impact of the disease and its treatments on fertility. This anxiety may exacerbate psychological burdens, including depressive symptoms and fear of recurrence, significantly impacting quality of life. AIM To examine whether reproductive concerns partially mediate the relationship between depressive symptoms and fear of recurrence in cervical cancer patients of childbearing age. METHODS Utilizing a cross-sectional design with convenience sampling, 208 eligible cervical cancer patients (aged 18-45 years, stable condition, and aware of diagnosis) from three tertiary hospitals completed validated questionnaires: The Reproductive Concerns After Cancer Scale, Patient Health Questionnaire-9, and Fear of Cancer Recurrence Questionnaire. Structural equation modeling was used to assess the mediating role of reproductive concerns in the relationship between depression and fear of recurrence. RESULTS Reproductive concerns demonstrated significant positive correlations with de- WJCO [https://www.wjgnet.com](https://www.wjgnet.com) 1 September 24, 2025 Volume 16 Issue 9 He XY et al. Repro. concerns mediate CC depression pression (r = 0.477, P < 0.001) and fear of recurrence (r = 0.426, P < 0.001) . Structural equation modeling analysis revealed that reproductive concerns acted as a significant partial mediator between depression and fear of recurrence. The indirect effect via reproductive concerns was significant (β_indirect = 0.152, P < 0.001), accounting for 28.1% of the total effect of depression on fear of recurrence. CONCLUSION Identified path reveals fertility anxiety links depression to recurrence fear. Targeted psych interventions for repro concerns may ease both in childbearing cervical cancer survivors. Key Words: Uterine cervical neoplasms; Depression; Fear; Fertility preservation; Mediation analysis; Reproductive age ©The Author(s) 2025. Published by Bais

FAQs

What was the study’s primary aim?

To test whether reproductive concerns partially mediate the relationship between depressive symptoms and fear of recurrence in reproductive-age cervical cancer patients.

How was reproductive anxiety measured and analyzed?

Participants completed validated scales for reproductive concerns, depression (PHQ-9), and fear of cancer recurrence, and structural equation modeling assessed mediation effects.

What did the results show about mediation?

Reproductive concerns correlated positively with both depression and fear of recurrence, and the indirect effect through reproductive concerns was significant, accounting for 28.1% of the total effect.

Sep 24, 2026

Upload by Well Done