title: Survival of cervical cancer patients in Germany in the early 21st century: a period analysis by age, histology, and stage.
abstract: OBJECTIVE
  Population-based studies on cervical cancer providing survival estimates by age, histology, and stage have been sparse. We aimed to derive most up-to-date and detailed survival estimates for cervical cancer patients in Germany.
  
  
  METHODS
  We used a pooled German national dataset including data from 11 cancer registries covering a population of 33 million people. Included were 15 685 patients diagnosed with cervical cancer from 1997 to 2006. Period analysis was performed to calculate the five-year relative survival (RS) 2002-2006. Trends in survival between 2002 and 2006 were examined using model-based period analysis. Age-adjustment was done using five age groups (15-44, 45-54, 55-64, 65-74, and 75 + years).
  
  
  RESULTS
  Overall, age-adjusted five-year relative survival in 2002-2006 was 64.7%. A strong age gradient was observed, with five-year RS decreasing from 81.7% in age group 15-49 years to 46.3% in age group 70 + years. Prognosis furthermore strongly varied by stage, with age-adjusted five-year RS reaching 84.6% for localized, 48.2% for regional, and 17.9% for distant stage. From 2002 to 2006, a significant improvement (4.7 percent units) in overall age-adjusted five-year RS was seen. The improvement was most pronounced for age groups 55-64 years (from 54.2 to 65.6%) and 65-74 years (from 50.0 to 58.1%).
  
  
  CONCLUSIONS
  In this first comprehensive population-based study from Germany, prognosis of cervical cancer strongly varied by age and stage. Prognosis continued to improve, in particular in age range 55-74 years, in the five-year period assessed.
authors.affiliation: Institute of Social and Family Medicine, School of Public Health, Zhejiang University ,  Hangzhou ,  China.
authors.forename: Tianhui
authors.initials: T
authors.lastname: Chen
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.forename: Adam
authors.initials: A
authors.lastname: Gondos
authors.forename: Katharina
authors.initials: K
authors.lastname: Emrich
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.forename: Sabine
authors.initials: S
authors.lastname: Luttmann
authors.forename: Annika
authors.initials: A
authors.lastname: Waldmann
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology*