Predictors of outcomes for women with cervical carcinoma.
BACKGROUND
To determine the impact of race and other factors on the management and outcomes of women treated for cervical cancer in a rural state.


METHODS
Following IRB approval, a retrospective review identified 434 eligible women treated for cervical cancer from 1994 to 2000. Collected data included: demographics, clinicopathologic data, primary and adjuvant therapy, recurrence, and survival. Statistical analyses were performed with the Chi-square test, Kaplan-Meier method, and Cox regression.


RESULTS
304 (70%) of the women were white and 130 (30%) were non-white. Non-whites were more likely to present with advanced stage disease [Stage IIB-IVB] (25% vs. 13%; P < 0.01). Whites were more likely to smoke, be married, be employed, and have private insurance. Non-whites were more likely to have medical co-morbidities such as diabetes and hypertension. Although whites with early stage disease were more likely to undergo surgery as their primary therapy than non-whites (93% vs. 84%; P < 0.01), survival was similar. Survival outcomes for advanced stage disease were similar between groups.


CONCLUSIONS
Non-whites diagnosed with cervical cancer are more likely to present with advanced stage disease than whites; however, overall survival was similar between groups. Non-whites with early stage disease were more likely to receive primary radiation therapy than whites. The decision to use radiation therapy vs. surgery does not appear to have a detrimental effect on overall survival, but may impact quality of life.
Leath
Charles A
CA
Department of Obstetrics and Gynecology, Division of Gynecology Oncology, University of Alabama at Birmingham, 619 19th Street South, OHB538, Birmingham, AL 35249-7333, USA. Trey_Leath@yahoo.com
Straughn
J Michael
JM
Kirby
Tyler O
TO
Huggins
Adam
A
Partridge
Edward E
EE
Parham
Groesbeck P
GP
D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012424:Rural Population; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy*