title: Comparison of adenocarcinoma (ACA) and squamous cell carcinoma (SCC) of the uterine cervix in a sub-optimally screened cohort: a population-based epidemiologic study of 51,842 women in Brazil.
abstract: BACKGROUND
  Most cancers of the uterine cervix are SCC, but the relative and absolute incidence of ACA has risen in recent years, and ACA now accounts for approximately 20% of invasive cervical cancers in the screened populations worldwide.
  
  
  OBJECTIVE
  To compare the epidemiological, clinical characteristics, and treatment outcomes of ACA with those of SCC of the cervix in a sub-optimally screened population.
  
  
  METHODS
  Data from cervical cancer patients with SCC and ACA treated from 2000 through 2009 were obtained from the Brazilian Hospital Cancer Register databases. The summary odds ratios and chi-square tests were estimated.
  
  
  RESULTS
  A total of 51,842 patients including 45,540 (87.8%) cases of SCC and 6302 (12.2%) of ACA were analyzed. Compared with the ACA patients, the SCC patients were younger and more frequently black and had a higher degree of illiteracy and alcohol and tobacco consumers. The tumor stage at the time of diagnosis was also significantly different between the two groups. However, initial therapeutic response and death rate after the first course of treatment were similar in both groups.
  
  
  CONCLUSIONS
  Differences between ACA and SCC were observed for all demographic and clinical variables analyzed but not for responses to treatment and death at the end of the first course of treatment. Irrespective of the histological subtype, the quality of screening and treatment must be improved in developing countries, since initial therapeutic response of ACA and SCC is similar.
authors.affiliation: Federal University of Minas Gerais, Belo Horizonte (MG), Brazil; Clinical Epidemiology, Brazilian National Cancer Institute, Rio de Janeiro , RJ, Brazil. Electronic address: angelica.onco@uol.com.br.
authors.forename: Angélica
authors.initials: A
authors.lastname: Nogueira-Rodrigues
authors.affiliation: Clinical Epidemiology, Brazilian National Cancer Institute, Rio de Janeiro , RJ, Brazil.
authors.forename: Carlos Gil
authors.initials: CG
authors.lastname: Ferreira
authors.affiliation: Clinical Epidemiology, Brazilian National Cancer Institute, Rio de Janeiro , RJ, Brazil; Masters Program in Rehabilitation Sciences, University Centre Augusto Motta - UNISUAM, Rio de Janeiro, RJ, Brazil.
authors.forename: Anke
authors.initials: A
authors.lastname: Bergmann
authors.affiliation: Clinical Epidemiology, Brazilian National Cancer Institute, Rio de Janeiro , RJ, Brazil.
authors.forename: Suzana Sales
authors.initials: SS
authors.lastname: de Aguiar
authors.affiliation: Clinical Epidemiology, Brazilian National Cancer Institute, Rio de Janeiro , RJ, Brazil; Masters Program in Neuroscience, Federal University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
authors.forename: Luiz Claudio Santos
authors.initials: LC
authors.lastname: Thuler
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D044383:Black People / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007199:Indians, South American / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D012907:Smoking / Q000453:epidemiology*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Adenocarcinoma; Brazil; Cervical cancer; Epidemiology; Squamous cell carcinoma