Hospital of the University of Pennsylvania, Philadelphia, PA
S. Grover , L. L. Lin , G. Suneja
Background: Radical surgery and radiation offer similar survival outcomes for treatment of early stage cervical cancer. Younger women tend to have surgery more than radiation to preserve ovarian function. The goal of this study was to understand the factors that may impact the type of treatment delivered to young women with early stage cervical cancer. Methods: We identified 1368 women with early stage cervical cancer aged 15-39, treated between 1988 and 2007 from the Surveillance, Epidemiology, and End Results [SEER] database. Results: Of the 1368 women with early stage cervical cancer, 1199 (80%) were white, 152 (11%) black and 117 (8%) other. 894 (65%) had surgery only 154 (11%) had radiation (RT) only, 302 (22%) had a combination of RT+surgery and 18 (1%) had no treatment. Of the 1199 white women, 738 (67%) had surgery, 109 (10%) had RT, 244 (22%) had both and 8 (0.7%) had no treatment. Of the 152 black women, 80 (53%) had surgery, 38 (25%) had RT, 27 (18%) had both and 7 (5%) had no treatment. On univariate and multivariate analysis, black race (p=0.0009), squamous histology (p=0.0006) and being single (p< 0.0001) were significantly related to receiving RT (OR MV 2.32, 2.09 and 2.18 respectively.) On univariate analysis, percent of population less than high school educated was related to receiving RT (p=0.0006 OR 0.31). Conclusions: Higher percentage of young black women received RT as opposed to surgery for treatment of early stage cervical cancer compared to young white women. Significant predictors of RT being the primary modality for treatment of early stage cervical cancer were black race, being single, squamous histology and living in a county with higher percentage of population with less than high school education.
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