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Cervical carcinoma in the elderly†
An analysis of patterns of care and outcome
Article first published online: 11 NOV 2004
Copyright © 2004 American Cancer Society
Volume 103, Issue 1, pages 85–91, 1 January 2005
How to Cite
Wright, J. D., Gibb, R. K., Geevarghese, S., Powell, M. A., Herzog, T. J., Mutch, D. G., Grigsby, P. W., Gao, F., Trinkaus, K. M. and Rader, J. S. (2005), Cervical carcinoma in the elderly. Cancer, 103: 85–91. doi: 10.1002/cncr.20751
See related editorial on pages 1–4, this issue.
- Issue published online: 17 DEC 2004
- Article first published online: 11 NOV 2004
- Manuscript Accepted: 2 JUL 2004
- Manuscript Revised: 29 JUN 2004
- Manuscript Received: 17 MAY 2004
- cervical carcinoma;
- radiation therapy;
- patterns of care
Advanced age often is considered a poor prognostic factor for cervical carcinoma. The authors investigated the patterns of care and treatment outcomes of elderly women with cervical carcinoma.
A hospital-based tumor registry was used to identify patients with invasive cervical carcinoma who were treated between 1986 and 2003. Patients were divided into 2 cohorts: women age < 70 years and women age ≥ 70 years. Survival was examined using the Kaplan–Meier method. Single and multivariate Cox proportional hazards modeling was used to estimate hazard ratios with 95% confidence intervals (95% CI).
In total, 1582 patients were identified, including 1385 patients age < 70 years and 197 patients age ≥ 70 years. The elderly patients presented with more advanced stage tumors at diagnosis (P < 0.0001) and were more likely to have nonsquamous neoplasms (P = 0.002). A marked difference in treatment was noted for the elderly cohort, even after stratifying by disease stage. Only 16% of the older patients underwent surgical treatment compared with 54% of the younger patients (P < 0.0001). Elderly women were 9 times more likely to receive no treatment (P < 0.0001). In a multivariate model of known prognostic factors, the hazard ratio for death from any cause in women age > 70 years was 2.1 (95% CI, 1.5–3.0). The hazard ratio for death from cervical carcinoma in the elderly women was 1.6 (95% CI, 1.1–2.5).
Age is an important factor in the allocation of treatment and survival for patients with cervical carcinoma. Elderly women with cervical carcinoma are more likely to receive primary radiotherapy, to forego treatment, and to die from their disease. Cancer 2005. © 2004 American Cancer Society.