Abstract
Socioeconomic factors are associated with screening in terms of reducing the risk of cervical cancer. This study aimed to clearly establish the effect of screening on variation in socio-economic factor-specific survival estimates. Survival estimates were calculated using the life table method for 165 women from the routine care control arm and 67 from the visual inspection with acetic acid screening arm diagnosed with cervical cancer during 2000-2006 in rural south India. Kaplan-Meier survival curves were plotted to compare the variation in survival by socioeconomic factors. Whereas there was a significant variation in survival estimates of the different categories of age at diagnosis among the screen-detected cancers with women aged<50 years having an improved survival, no significant variation was noted among women diagnosed with cervical cancer from the control arm. Compared to the variation among the cancer cases detected in the unscreened control group, screening widened the variation in survival estimates by age and type of house, and reduced the variation by education. The direction of the magnitude of the survival estimates was reversed within the different categories of occupation, marital status and household income in the screen-detected cancer cases compared to control group cancer cases. Also, women diagnosed with stage 1 disease had a very good survival. Screening changed the pattern of survival by socio-economic factors. We found improved survival rates in screened women aged <50 years, with no formal education, manual workers and married women.
Highlights
The capability of health services to provide early diagnosis, treatment and clinical follow-up improves cancer survival (Sankaranarayanan et al, 2010)
Whereas there was a significant variation in survival estimates of the different categories of age at diagnosis among the screen-detected cancers with women aged
The comparison of survival estimates between screendetected and control women showed that screening modified the survival of cervical cancer patients according to socio-economic factors
Summary
The capability of health services to provide early diagnosis, treatment and clinical follow-up improves cancer survival (Sankaranarayanan et al, 2010). The role of socio-economic factors in cervical cancer survival has not been clearly established in many of the survival studies done in India and abroad mainly because the studies were done within a group of patients with similar socioeconomic characteristics and/or similar accessibility or inaccessibility to cervical cancer screening, diagnosis and treatment facilities (Schrijvers.,1994; Nandakumar et al, 1995; Coker et al, 2006; Munagala et al ., 2010). Results: Whereas there was a significant variation in survival estimates of the different categories of age at diagnosis among the screen-detected cancers with women aged
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