No improvement in survival of older women with cervical cancer-A nationwide study

Hans H. B. Wenzel*, Ruud L. M. Bekkers, Valery E. P. P. Lemmens, Maaike A. Van der Aa, Hans W. Nijman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Web of Science)

Abstract

Aim: This study aims to report trends in primary treatment and survival in cervical cancer (CC) to identify opportunities to improve clinical practice and disease outcome. Methods: Patients diagnosed with CC between 1989 and 2018 were identified from the Netherlands Cancer Registry (N = 21,644). Trends in primary treatment and 5-year relative survival were analysed with the Cochran-Armitage trend test and multivariable Poisson regression, respectively. Results: In early CC, surgery remains the preferred treatment for ages 15-74. Overall, it was applied more often in younger than in older patients (92% in 15-44; 64% in 65-74). For 75+, surgery use was stable over time (38%-41%, p=0.368), while administration of radiotherapy decreased (57%-29%, p < 0.001). In locally advanced CC, chemoradiation use increased over time (5%-65%, p < 0.001). It was applied least often for 75+, in which radiotherapy remains most common (54% in 2014-2018). In metastatic CC, chemotherapy use increased over time (11%-28%, p < 0.001), but varied across age groups (6%-40% in 2014-2018). In patients treated with primary chemoradiation, regardless of stage, brachytherapy use increased over time (p < 0.001). Full cohort 5-year survival increased from 68% to 74% (relative excess risk 0.55; 95% confidence interval [0.50-0.62]). Increases were most significant in locally advanced CC (38%-60%; 0.55 [0.47-0.65]). Survival remained stable in 75+ (38%-34%; 0.82 [0.66 -1.02]).

Original languageEnglish
Pages (from-to)159-167
Number of pages9
JournalEuropean Journal of Cancer
Volume151
DOIs
Publication statusPublished - Jul 2021

Keywords

  • Uterine cervical neoplasms
  • Trends
  • Therapy
  • Surgery
  • Radiotherapy
  • Survival
  • CONCURRENT CHEMORADIOTHERAPY
  • RADIATION-THERAPY
  • RADIOTHERAPY
  • BRACHYTHERAPY
  • MORTALITY
  • TRENDS
  • POPULATION
  • PATTERNS
  • OUTCOMES
  • IMPACT

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