Age-specific differences in the treatment of cervical cancer in the east and the south of The Netherlands 1989–2004

• Published in: European journal of obstetrics & gynecology and reproductive biology 2009-11, Vol.147 (1), p.78-82
• Main Authors: van der Aa, Maaike A, Siesling, Sabine, Poll-Franse, Lonneke V. v.d, Schutter, Eltjo M, Lybeert, Marnix L, Coebergh, Jan Willem W
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Cervical cancer; Chemoradiation; Combined Modality Therapy; Drug Therapy - methods; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy; Hysterectomy - methods; Medical sciences; Middle Aged; Neoplasm Staging; Netherlands - epidemiology; Obstetrics and Gynecology; Radiotherapy; Radiotherapy - methods; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Survival; Survival Rate; Treatment Outcome; Tumors; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - therapy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2009.07.006

Abstract Objective This study aims to describe trends and variation in treatment and survival of cervical cancer in two regions in The Netherlands and to relate this to adherence to the treatment recommendations. Study design Patient characteristics, tumour characteristics, treatment and follow-up data were collected for 1954 cervical cancer cases diagnosed in the period 1989–2004. Results In FIGO stages IB-IIA 93% of patients were treated according to the recommendations of The Netherlands Working Group Gynaecologic Oncology. Older patients received radiotherapy more often than younger patients: 48% (95%CI 40–57) of patients older than 70 compared to 15% (95%CI 10–20) of patients aged 50–69 and 5% (95%CI 3–7) of patients aged 50 or younger ( p < 0.05). In FIGO stages IIB-IVA 76% of patients were treated according to the recommendations of the Working Group. Chemoradiation was given to older patients less often than to younger patients: 2% (95%CI 0.5–5) versus 23% (95%CI 16–29). A decreased risk of death was found for patients receiving chemoradiation (RER 0.6, 95%CI 0.3–0.9) compared to those receiving “radiotherapy only”. Conclusion Far from being always followed, the treatment recommendations were better implemented for treatment of patients with FIGO IB-IIA. Elderly patients received different treatment compared to younger patients in this study and showed an independent increased risk of death in the lower stages, which confirms that the need becomes stronger for paying attention to treatment of elderly patients.