Five-year overall survival and prognostic factors in patients with cervical cancer in Bulgaria.
OBJECTIVE
To perform a population-based analysis on the 5-year survival rate and to analyse the significance of various prognostic factors for survival in patients with cervical cancer in Bulgaria for the period 1993-2002.


METHODS
A total of 9,457 women were analyzed using the data of the National Cancer Registry. Their mean age was 51.41 years. Survival analysis was performed using the life table method. Analysis of factors affecting survival was performed by the Cox proportional hazards regression model. The statistical processing was carried out with the SPSS program/PC+v.11.01 for Windows.


RESULTS
The overall cumulative 5-year survival was 47.12%. According to age, higher survival was observed in women younger than 35 years. Women in towns had better survival than those in villages. Significant difference was observed between squamous cell carcinoma and adenocarcinoma and some rare histological types. According to stage, survival was higher for stages I and II and was decreasing with advancing disease stage. Better survival was achieved with surgical treatment. In the Cox regression analysis, the highest relative risk was associated with advanced clinical stage, with symptomatic therapy only, with rare histological types, age over 65 years, and village residents.


CONCLUSIONS
According to these results, Bulgaria is among the countries with low 5-year cervical cancer survival. Survival at the population level depends on several factors. The most important among them could be attributed to the absence of organized cervical screening.
Kostova
P
P
Gynecology Clinic, National Oncological Hospital, and Medical University, Department of Obstetrics and Gynecology, Sofia, Bulgaria. petyakostova@yahoo.com
Zlatkov
V
V
Danon
S
S
D000230:Adenocarcinoma / Q000453:epidemiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002031:Bulgaria / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult