Abstract
ABSTRACTOBJECTIVE To determine the distribution of sociodemographic, reproductive, clinical and lifestyle habits in the cohort of women diagnosed with cervical cancer, assisted at Inca between 2012 and 2014, according to the histological type.METHODS Retrospective observational study of a hospital cohort of 1,004 women diagnosed with cervical cancer. Data were obtained from the Inca hospital cancer registry, physical and electronic records.RESULTS The most frequent histological type was squamous cell carcinoma (83.9%). Approximately 70% of the women aged more than 40 years. The study includes non-white women (67.4%), with less than 8 years of education (51.9%), with onset of sexual activity up to 16 years of age (40.7%), who were pregnant before (95.5%), with more than one pregnancy (82.9%), and more than two children (52.7%); 45.8% of the women were smokers or former smokers. Cervical adenocarcinoma was positively associated with earlier staging (IA-IIA) (OR = 1.79; 95%CI 1.03–3.13), as well as women with ≥ 12 years of education (OR = 6.30; 95%CI 1.97–20,13), who had no children (OR = 3.81; 95%CI 1.20 – 12,08) or who had up to two children (OR = 1.74; 95%CI 1.05 – 2,87).CONCLUSIONS The difference between histological types is highlighted, suggesting that women with cervical adenocarcinoma may represent a distinct clinical entity of cervical neoplasia, which may require different approaches from those used in squamous cell carcinoma.
Highlights
Cervical cancer is one of the main causes of cancer death among women worldwide, especially in developing countries, where 83% of new cases and 86% of deaths occur
The difference between histological types is highlighted, suggesting that women with cervical adenocarcinoma may represent a distinct clinical entity of cervical neoplasia, which may require different approaches from those used in squamous cell carcinoma
Human papillomavirus (HPV) infection is the necessary but not sufficient cause of uterine cervix cancer, and exposure to cofactors is required for the tumor phenotype to occur[4,7]
Summary
Cervical cancer is one of the main causes of cancer death among women worldwide, especially in developing countries, where 83% of new cases and 86% of deaths occur. The implementation of screening and treatment programs of cervical cancer precursor lesions has declined both the incidence and mortality rates of cervical squamous cell cancer in the last 50 years in developed countries[2,3] and, in most recent decades, in some developing countries[4,5]. This neoplasia may present different histological types, of which squamous cell carcinoma (SCC) is the most frequent (80%), while cervical adenocarcinoma (AC) and adenosquamous carcinoma (ASC) represent 10-15% of the cases[6]. Besides immunosuppression[8] and factors related to sexual behavior[9], which are common to both histological types, use of oral contraceptive pills (OCP)[4,9], obesity[10] and nulliparity[9] are related to this subtype
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