Effect of Age at Diagnosis on Cervical Cancer Patient Prognoses in Georgia

Abstract

The current incidence of cervical cancer varies around 17.0/100,000 women per year. The study aims to describe the effect of age at diagnosis on CC patient prognosis in Georgia. Methods. Univariable and Multivariable survival analysis using Cox’s regression model was constructed. All women aged ≤80 years,  diagnosed with invasive CC (ICD10-site code C53) from 2015 to 2019,  were eligible for inclusion in the analysis. During analysis a hazard (mortality) ratio for the patients, who were diagnosed at different ages was estimated. Survival period was determined from the date of diagnosis until the date of death or the date of last follow up visit. High risk of death was defined as a mortality of CC patients whose survival period was less than 5 years.The level of statistical significance of the study findings is estimated by using p-value andthe 95% of confidence interval (95%CI). A p value < 0.05 was considered as statistically significant. In estimation of hazard ratio, the patients under 41 years were selected as a reference group. Data was analyzed using Statistical Package of SPSS version 23. Results.Totally 1646 CC patients were enrolled in the study. The median age at diagnosis was 54years and age range was 25 - 80 years. Univariable statistical analysis has revealed that cancer diagnosed over 60 years of age had a higher death hazard (HR=1.80, p<0.001), compared to cancer detected under 60 years (HR=3.30, p<0.001). Multivariable statistical analysis has detected that stage and age at diagnosis are independent, statistically significant predictors for high mortality in patients diagnosed with cervical cancer, while the role of histological grade has not been revealed. In addition, older age generally is related to a high prevalence of comorbidities. The reasons for the unfavourable cervical cancer prognosis in older patients that was detected  during statistical analysis might be explained by tumor stage at diagnoses and with higher ratesof comorbidity among the elderly. Conclusions: Finally, our study results are in concordance with numerous studies, which confirm that the age of patients at the moment of diagnosis is an independent predictor for cervical cancer early mortality.