Abstract
Cervical cancer is the 2nd most common malignant tumour in women worldwide. Previous research studies have given little attention to its prognostic factors in the rapidly growing Asian American population. In the present study, we explored prognostic factors in Asian and white American patients with cervical cancer, considering competing risks. The study included 58,780 patients with cervical cancer, of whom 54,827 were white and 3953 were Asian American, and for all of whom complete clinical information was available in the U.S. Surveillance, Epidemiology, and End Results database. Death from cervical cancer was considered to be the event of interest, and deaths from other causes were defined as competing risks. The cumulative incidence function and the Fine-Gray method were applied for univariate and multivariate analysis respectively. We found that, for all patients (white and Asian American combined), the cumulative incidence function was associated with several factors, such as age at diagnosis, figo (Fédération internationale de Gynécologie et d'Obstétrique) stage, registry area, and lymph node metastasis. Similar results were found when considering white patients only. However, for Asian American patients, registry area was not associated with the cumulative incidence function, but the other factors (for example, figo stage) remained statistically significant. Similarly, in multivariate analyses, we found that age at diagnosis, figo stage, lymph node metastasis, tumour histology, treatment method, and race were all associated with prognosis. Survival status differs for white and Asian American patients with cervical cancer. Our results could guide the treatment of, and facilitate prognostic judgments about, white and Asian American patients with cervical cancer.
Highlights
Cervical cancer is the 2nd most common malignant tumour in women worldwide and ranks 3rd among the causes of mortality in women[1]
For Asian American patients, registry area was not associated with the cumulative incidence function, but the other factors remained statistically significant
The difference in figo stage was significantly different for the white and Asian American patients (p < 0.001), and the rate of carcinoma in situ was much higher in white patients than in Asian American patients (71.1% vs. 47.4%)
Summary
Cervical cancer is the 2nd most common malignant tumour in women worldwide and ranks 3rd among the causes of mortality in women[1]. There are 500,000 new cases of cervical cancer and 290,000 deaths from the disease worldwide each year, posing a serious threat to the health of women[1]. Epidemiology studies have determined that the incidence of and mortality from cervical cancer differ significantly by region and race[2,3]. The age-adjusted incidence of cervical cancer was 8.1 per 100,000 women, which is lower than the incidence in Latina and African American women (11.1 per 100,000 and 10.0 per 100,000 respectively). Cervical cancer is the 2nd most common malignant tumour in women worldwide. We explored prognostic factors in Asian and white American patients with cervical cancer, considering competing risks
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