In a retrospective cohort study reported in JAMA Network Open, Suk et al identified the association of survival with receipt of recommended treatment and nonreceipt of nonrecommended treatment among patients aged ≥ 65 years with newly diagnosed early-stage cervical cancer.
Study Details
The study involved data from 17 Surveillance, Epidemiology, and End Results (SEER) cancer registries in the United States from 2000 to 2020. Survival outcomes were assessed according to receipt of recommended treatment with surgery or radiotherapy.
Key Findings
Of 2,236 women included in the analysis, 1,482 (66.3%) were between the ages of 65 and 74 years, 565 (25.3%) were between the ages of 75 and 84 years, and 189 (8.4%) were aged 85 years or older.
In the 65-to-74-year age group, patients who received recommended surgery had significantly better 5-year overall survival rates (91.2%, 95% confidence interval [CI] = 88.4%–93.4%) than did those not recommended for surgery who did not receive surgery (69.6%, 95% CI = 62.8%–75.4%) and those recommended for surgery who did not receive it (52.3%, 95% CI = 24.2%–74.3%). Patterns were similar in the 75-to-84-year age group, with receipt of recommended surgery being associated with significantly higher 5-year overall survival (88.6%, 95% CI = 79.8%–93.7%). No significant differences were found in those aged 85 or older.
In the 65-to-74-year age group, patients without recommendation for radiotherapy who did not receive radiotherapy had significantly better 5-year survival (91.0%, 95% CI = 87.6%–93.5%) than did those who received recommended radiotherapy (79.7%, 95% CI = 75.1%–83.6%) and those who did not receive recommended radiotherapy (53.2%, 95% CI = 24.0%–75.7%). No significant differences were observed in other age groups.
In multivariable analyses, receiving recommended surgery (adjusted hazard ratio [HR] = 0.28, 95% CI = 0.16–0.50) and recommended radiotherapy (adjusted HR = 0.48, 95% CI = 0.26–0.87) were significantly associated with lower cervical cancer–specific mortality compared with not receiving recommended treatment.
The investigators concluded: “In this cohort study, receipt of recommended treatment was associated with higher survival rates among older patients with early-stage cervical cancer. Addressing barriers to treatment adherence and improving early detection and preventive measures in this older population may enhance population health and reduce cervical cancer mortality in the aging population.”
Ryan Suk, PhD, MS, of Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, is the corresponding author of the JAMA Network Open article.
Disclosure: For full disclosures of all study authors, visit jamanetwork.com.
