Comorbidity and age affect treatment policy for cervical cancer: a population-based study in the south of The Netherlands, 1995-2004

Eur J Gynaecol Oncol. 2008;29(5):493-8.

Abstract

Objective: The aim of this study was to estimate the effects of age and comorbidity on the choice of treatment modalities and prognosis for patients with cervical cancer.

Methods: All patients with cervical cancer newly diagnosed between 1995 and 2004 (n=775) were selected from the population-based Eindhoven Cancer Registry. Time trends in treatment modalities and differences in treatment between older and younger patients, and those with and without comorbidity were evaluated.

Results: Older patients with FIGO Stages IB-IIA, elderly and those with comorbidity underwent less surgery. In multivariate survival analysis, age had independent prognostic value. For patients with FIGO Stages IB2, IIB-IVA, age affected the choice of chemoradiation significantly. According to multivariate survival analysis, comorbidity and FIGO stage were independent prognostic factors.

Conclusion: Older patients with cervical cancer and those with comorbidity were treated less aggressively. Because of the ever-increasing role of comorbidity in clinical decision-making for increasingly older patients in the near future, development of age-specific guidelines incorporating levels and management of specific comorbidity seems warranted.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Netherlands
  • Survival Rate
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / therapy*