title: Carcinoma of cervix, the King Faisal Specialist Hospital & Research Center experience--the need for screening for cervical cancer in developing countries.
abstract: The King Faisal Specialist Hospital and Research Center opened in 1975 to provide specialized medical treatment to the citizens of Saudi Arabia and to promote prevention of disease through research and education. It is a national and middle eastern tertiary care hospital for oncology and a principle center for radiation therapy in Saudi Arabia. In this retrospective study, 504 patients with carcinoma of the cervix were analysed. Of the 504 patients, 410 received treatment with curative intent, which comprised radical surgery alone, radical radiation alone or combination surgery and radiation. The overall 3, 5 and 10 years survival of all 504 patients was 64%, 55% and 40%, respectively and for 410 patients treated with curative intent it was 74%, 61% and 51%, respectively. Multivariate analysis, using the Cox regression method, showed that the stage of the disease is the only significant prognostic factor influencing relapse-free survival. Stage for stage, treatment outcomes at King Faisal Specialist Hospital and Research Center match those achieved in the First world, but two-thirds of patients (rather than one-third) present with advanced disease at diagnosis. Therefore, any improvement in overall outcomes will require earlier diagnosis, achievable only through an effective screening program in the Kingdom of Saudi Arabia and similarly in the other Third world countries where patients present with advanced stage disease.
authors.affiliation: Department of Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
authors.forename: M F
authors.initials: MF
authors.lastname: Manji
authors.forename: D
authors.initials: D
authors.lastname: Pradhan
authors.forename: M
authors.initials: M
authors.lastname: El-Senoussi
authors.forename: Y
authors.initials: Y
authors.lastname: Bakri
authors.forename: J
authors.initials: J
authors.lastname: Subhi
authors.forename: A
authors.initials: A
authors.lastname: Ezzat
authors.forename: F
authors.initials: F
authors.lastname: Zwan
authors.forename: C
authors.initials: C
authors.lastname: Ramirez
mesh_terms: D003131:Combined Modality Therapy; D003906:Developing Countries; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008403:Mass Screening; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy