Abstract
ABSTRACT Background: The Caribbean ranks seventh among world regions most affected by cervical cancer. Social health inequalities, such as differences in access to screening services, engender disparities in incidence and mortality between low- and middle-income countries and industrialized countries. The French National Cancer Plan 2014–2019 focuses on reducing inequalities in cervical cancer. Objective: The aim of this study was to describe the geographical distribution and overall survival of cervical cancer, based on data from a population-based cancer registry in Martinique (French West-Indies). Methods: We included all cases of cervical cancer diagnosed between 2002 and 2011. The geographical distribution was described by zone of residence and by aggregated units for statistical information (IRIS). Based on the results of the model, standardized incidence rates (SIRs) were calculated using a Gamma Poisson model. Survival rates were calculated using the Kaplan–Meier method. Cox proportional hazards models were used to investigate the risk factors for cervical cancer mortality. Results: A total of 1253 cases were analyzed (947 in situ tumors and 306 invasive cancers). 1230 cases with geolocalization were used to map the distribution of the incidence of in situ and invasive cervical cancers. Five IRIS were significantly over-incident. The 5-year overall survival rate was 55%, with a median survival of 6.5 years [95% CI: 4.9–10.1]. Multivariate analysis confirmed age at diagnosis (HR = 2.15 [1.50–3.09]; p < 0.0001), FIGO stage (HR = 3.53 [2.50–4.99]; p < 0.0001) and zone of residence (HR = 1.51 [1.06–2.13]; p = 0.02) as risk factors. Conclusions: Prognostic factors suggest that cervical cancer needs to be diagnosed at an early stage. Our results could allow cervical cancer screening programs to clearly identify geographical areas that would benefit from targeted interventions with a view to reducing incidence and mortality of cervical cancer in the Caribbean.
Highlights
The Caribbean ranks seventh among world regions most affected by cervical cancer
We examined a total of 1253 cervical cancers (947 in situ tumors and 306 invasive cancers) for the study period 2002–2011
The strategic Cancer Plan in the French West-Indies will focus on infectious cancers to explore in greater depth the risk factors for cervical cancer, and the role of the HPV genotype in cohort studies
Summary
The Caribbean ranks seventh among world regions most affected by cervical cancer Social health inequalities, such as differences in access to screening services, engender disparities in incidence and mortality between low- and middle-income countries and industrialized countries. Improvements in hygiene and living conditions, as well as the introduction 50 years ago of a cytological screening test (the Pap smear test), have helped to decrease incidence and mortality of this type of cancer. Social health inequalities, such as differences in access to screening services and quality of treatment, engender disparities in incidence and mortality between low- and middle-income countries and industrialized countries. 3000 new cases of cervical cancer are detected in France each year, and 1100 women die from it [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
