Factors Affecting Survival of Patients with Cervical Cancer

Mohammadreza Balooch Hasankhani; Yunes Jahani; Azam Bazrafshan; Ashraf Yazdizadeh; Ali Karamoozian

doi:10.18502/ijph.v52i10.13860

Factors Affecting Survival of Patients with Cervical Cancer

Iran J Public Health. 2023 Oct;52(10):2216-2224. doi: 10.18502/ijph.v52i10.13860.

Authors

Mohammadreza Balooch Hasankhani¹, Yunes Jahani^{1

2}, Azam Bazrafshan³, Ashraf Yazdizadeh⁴, Ali Karamoozian^{1

2}

Affiliations

¹ Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
² Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran.
³ HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
⁴ Deputy of Health, Kerman University of Medical Sciences, Kerman, Iran.

Abstract

Background: Cervical cancer is the fourth leading cause of cancer-related death among women worldwide. We aimed to identify the factors affecting the survival rate of cervical cancer patients, as these factors are vital for preventing the progression and effective treatment of cancer.

Methods: In this retrospective cohort study, 254 patients with cervical cancer who were registered in The Kerman Population-Based Cancer Registry (KPBCR) between 2012 and 2022 and whose status was known to be alive or dead were enrolled. Since the proportional hazard assumption was not established for the type of treatment, the extended Cox model was used to determine the variables influencing the survival of the patients.

Results: The mean survival time of the patients was 91.28 ± 3.02 months. The results of fitting the extended Cox model showed that the risk of death increases by 1.02 per year of age at diagnosis (HR=1.02; 95% CI: 1.00, 1.04). Moreover, for a one-unit increase in body mass index (BMI), the risk of death increased by 0.93 (HR=0.93; 95% CI: 0.88, 0.98). The risk of death in patients with disease stages III&IV was 3.08 times that of patients with disease stages I&II (HR=3.08; 95% CI: 1.05, 9.03). The risk of death in patients receiving at least one of the radiotherapy and chemotherapy treatments after 18 months was 7.11 times that of patients undergoing surgery (HR=7.11; 95% CI: 1.69, 29.91).

Conclusion: The age of diagnosis, BMI, disease stage, and type of treatment significantly affect the survival of patients. Thus, raising women's awareness of periodical examinations and early diagnosis can reduce the risk of death and prevent cervical cancer progression.

Keywords: Cervical cancer; Extended cox model; Prognostic factor; Survival; Time-dependent covariate.