Survival and prognostic factors of endometrial cancer patients in Iceland 1964-1985: can attendance at population-based Pap-smear screening affect survival?

• Main Authors: Sigurdsson, K, Sigurdardottir, B, Steinsson, S, Benediktsdottir, K, Sigurvinsson, T, Sigvaldason, H
• Other Authors: The Icelandic Cancer Society, Reykjavík. [e-mail]
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley-Liss 2010
• Subjects: Aged; Combined Modality Therapy; Endometrial Neoplasms; Female; Humans; Iceland; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Registries; Retrospective Studies; Risk Factors; Survival Rate; Time Factors; Vaginal Smears
• Online Access: http://hdl.handle.net/2336/108535; https://doi.org/10.1002/(SICI)1097-0215(19980417)79:2<166::AID-IJC12>3.0.CO;2-8

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field After histological review of all cases registered during the period 1964-1985 at the Cancer Registry, 260 cases with endometrial carcinoma were eligible for analyses of survival rates and prognostic factors, as well as the association of Pap-smear screening attendance with these factors and survival. The total age-adjusted 5- and 10-year relative survival rates were 76% and 75%, respectively. The prognostic factors were tested by univariate analysis and simultaneously by a multivariate analysis using the Cox proportional hazards model. Factors that independently gave a less favorable prognosis were non-attendance at screening, older age at diagnosis, deep myometrial invasion, advancing stages and tumor grading, radiotherapy only, extra-genital symptoms and histology types of serous, clear cell and undifferentiated tumors (histologic type 3). Tested simultaneously with the Cox proportional hazards model, parameters that maintained a less favourable prognosis were grade 3, stage III-IV, deep myometrial invasion, older age, radiotherapy only and extra-genital symptoms. In addition, screening attendance showed significant interaction with age. In stages III and IV only grade 3 maintained a significantly less favorable prognosis. We conclude that our results indicate that attendance at Pap-smear screening (taking Pap smears and screening for genital symptoms) has a favorable prognostic value, especially among women under the age of 62.