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Survival and prognostic factors of endometrial cancer patients in Iceland 1964–1985: Can attendance at population‐based pap‐smear screening affect survival?
Author(s) -
Sigurdsson Kristján,
Sigurdardottir Bergthóra,
Steinsson Stefán,
Benediktsdottir Kristrún,
Sigurvinsson Trausti,
Sigvaldason Helgi
Publication year - 1998
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(19980417)79:2<166::aid-ijc12>3.0.co;2-8
Subject(s) - medicine , grading (engineering) , proportional hazards model , endometrial cancer , univariate analysis , cancer registry , oncology , population , cancer , gynecology , stage (stratigraphy) , multivariate analysis , paleontology , civil engineering , environmental health , engineering , biology
After histological review of all cases registered during the period 1964–1985 at the Cancer Registry, 260 cases with endometrial carcinoma were eligible for analyses of survival rates and prognostic factors, as well as the association of Pap‐smear screening attendance with these factors and survival. The total age‐adjusted 5‐ and 10‐year relative survival rates were 76% and 75%, respectively. The prognostic factors were tested by univariate analysis and simultaneously by a multivariate analysis using the Cox proportional hazards model. Factors that independently gave a less favorable prognosis were non‐attendance at screening, older age at diagnosis, deep myometrial invasion, advancing stages and tumor grading, radiotherapy only, extra‐genital symptoms and histology types of serous, clear cell and undifferentiated tumors (histologic type 3). Tested simultaneously with the Cox proportional hazards model, parameters that maintained a less favourable prognosis were grade 3, stage III‐IV, deep myometrial invasion, older age, radiotherapy only and extra‐genital symptoms. In addition, screening attendance showed significant interaction with age. In stages III and IV only grade 3 maintained a significantly less favorable prognosis. We conclude that our results indicate that attendance at Pap‐smear screening (taking Pap smears and screening for genital symptoms) has a favorable prognostic value, especially among women under the age of 62. Int. J. Cancer (Pred. Oncol) 79:166–174, 1998. © 1998 Wiley‐Liss, Inc.