Highlights
- •Cervical cancer is a major concern in older women.
- •Older women are frequently undertreated.
- •Age is a prognostic factor for death independently of FIGO stage, comorbidities, and histology.
Abstract
Objectives
Cervical cancer is frequently diagnosed in older women, but few studies have focused
on cervical cancer in this specific population. The objectives of this study were
to provide an overview of the demographic profile and therapeutic care of women with
cervical cancer, and to identify whether age is a prognostic factor.
Study design
Retrospective population-based study from a gynecological cancer registry in a French
Regional University Hospital and Comprehensive Cancer Center. 292 women diagnosed
with cervical cancer between January 1, 2005, and December 31, 2015, were included.
They were classified into younger women (YW), that is, under 70 years of age (N = 228), and older women (OW), that is, aged 70 years or more (N = 64).
Main outcome measures
The primary outcome was overall survival (OS). Cox proportional hazards models were
developed to assess the impact of age on OS.
Results
Compared with YW, larger proportions of OW had comorbidities (14% vs 7% with a score
≥ 2 on the Charlson Comorbidity Index, P <0.001) and more advanced tumors (37.3% vs 19.7% with FIGO IV, P <0.001); the OW group had a lower treatment rate (81.3% vs 95.6%, P <0.001), and a smaller proportion had undergone surgery (37.5% vs 81.7%, P<.001) but a larger proportion had radiotherapy (67.2% vs 49.6%, P = .01). One-year, 5-year and 10-year OS rates were: 91.6%, 74.1% and 63.9% for YW,
and 69.9%, 36.4% and 12.3% for OW, respectively (P <0.001). The hazard ratio for death was twice as high in OW compared with YW with
cervical cancer (HR = 2.19 [1.41 – 3.40], P <0.001), independently of FIGO stage, histology, and comorbidities.
Conclusions
The prognosis for cervical cancer depends on age. Screening with the G8 tool followed
by a comprehensive geriatric assessment could lead to more suitable treatment being
offered to older patients.
Keywords
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Article info
Publication history
Published online: November 30, 2021
Accepted:
November 16,
2021
Received in revised form:
November 3,
2021
Received:
May 16,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
