Reasons for low cervical cancer survival in new accession European Union countries: a EUROCARE-5 study. Archives of gynecology and obstetrics

Magdalena Bielska-Lasota, Silvia Rossi, Michalina Krzyżak, Annemie Haelens, Augius Domenic, Roberta De Angelis, Adam Maciejczyk, Miguel Rodríguez-Barranco, Vesna Zadnik, Pamela Minicozzi

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients' age. METHODS: We analysed 101,714 CC women diagnosed in 2000-2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. RESULTS: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. CONCLUSION: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.
Original languageEnglish
Pages (from-to)591-602
Number of pages12
JournalArchives of Gynecology and Obstetrics
Volume301
Issue number2
DOIs
Publication statusPublished - 2020

Keywords

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Survival Rate
  • Adolescent
  • Aged
  • Retrospective Studies
  • Aged, 80 and over
  • *Cervical cancer
  • *Europe
  • *Morphology
  • *Population-based study
  • *Stage at diagnosis
  • *Survival
  • European Union
  • Uterine Cervical Neoplasms/*epidemiology/mortality

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