Survival and prognostic factors of endometrial cancer patients in Iceland 1964-1985: can attendance at population-based Pap-smear screening affect survival?
After histological review of all cases registered during the period 1964-1985 at the Cancer Registry, 260 cases with endometrial carcinoma were eligible for analyses of survival rates and prognostic factors, as well as the association of Pap-smear screening attendance with these factors and survival. The total age-adjusted 5- and 10-year relative survival rates were 76% and 75%, respectively. The prognostic factors were tested by univariate analysis and simultaneously by a multivariate analysis using the Cox proportional hazards model. Factors that independently gave a less favorable prognosis were non-attendance at screening, older age at diagnosis, deep myometrial invasion, advancing stages and tumor grading, radiotherapy only, extra-genital symptoms and histology types of serous, clear cell and undifferentiated tumors (histologic type 3). Tested simultaneously with the Cox proportional hazards model, parameters that maintained a less favourable prognosis were grade 3, stage III-IV, deep myometrial invasion, older age, radiotherapy only and extra-genital symptoms. In addition, screening attendance showed significant interaction with age. In stages III and IV only grade 3 maintained a significantly less favorable prognosis. We conclude that our results indicate that attendance at Pap-smear screening (taking Pap smears and screening for genital symptoms) has a favorable prognostic value, especially among women under the age of 62.
Sigurdsson
K
K
The Icelandic Cancer Society, Reykjavík. krabb@krabb.is
Sigurdardottir
B
B
Steinsson
S
S
Benediktsdottir
K
K
Sigurvinsson
T
T
Sigvaldason
H
H
D000368:Aged; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D006801:Humans; D007055:Iceland; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014626:Vaginal Smears