RESUMO
The cervical cancer, which is a reliable indicator of social inequality, remains a major public health issue in Argentina. It is generally accepted that its frequency among young women is low, being the most exposed those over 35 years old. Nevertheless, as gynecologic oncologists, we have been accompanying young patients to their death, mostly women with neither access to screening strategies nor timely or suitable treatment. Such a situation motivated the present analysis of our data on frequency, survival, and demography of cervical cancer collected at the referral cancer hospital of Buenos Aires City. Of 748 cases retrospectively assessed (2007-2011), 84.0% (n = 627) resided in the Metropolitan Area of Buenos Aires; 76.9% (n = 576) were admitted at a locoregionally advanced stage. Regarding tumor size, 53.6% (n = 401) had tumors > 4 cm diameter and 24.2% (n = 181) > 6 cm. The lowest rates of disease-free survival and cause-specific survival were observed for tumor sizes > 6 cm and the age subgroup < 35 years old. Both tumor size and age retained their prognostic value after multivariate analysis adjustment. When focusing in patients under 35 years old, 48% (n = 70) died within 5 years following diagnosis and their probability of surviving 5 years more was < 50%. These figures raise a public health alert on young women with cervical cancer living in the Metropolitan Area of Buenos Aires, which concentrates almost one third of the country population.
Assuntos
Neoplasias do Colo do Útero/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Análise de Sobrevida , População Urbana , Adulto JovemRESUMO
El cáncer cérvico-uterino, fiel indicador de inequidad social, sigue siendo un grave problema de salud pública en la República Argentina. Se suele afirmar que su frecuencia en mujeres jóvenes es baja y que las más expuestas son aquellas mayores de 35 años. Sin embargo, como ginecólogos oncólogos, con frecuencia acompañamos a morir a mujeres jóvenes que no han tenido acceso a tamizaje ni a tratamiento oportuno y adecuado del cáncer invasor. Esto ha motivado el presente análisis de frecuencia y supervivencia del cáncer cérvico-uterino en el contexto demográfico de las mujeres asistidas en el hospital de referencia en cáncer ginecológico de Buenos Aires. De los 748 casos analizados retrospectivamente (2007-2011), el 84.0% (n = 627) residía en el Área Metropolitana de Buenos Aires y el 76.9% (n = 576) fue admitido en estadios loco-regionalmente avanzados. El 53.6% (n = 401) presentó un diámetro tumoral > 4 cm y el 24.2% (n = 181) > 6 cm. Las tasas más bajas de supervivencia se observaron en tumores > 6 cm y en el subgrupo etario < 35 años. Tanto el tamaño tumoral como la edad conservaron su valor pronóstico tras ser ajustados en el análisis multivariado. En el subgrupo < 35 años, el 48% (n = 70) murió durante los 5 años siguientes al diagnóstico y la probabilidad de sobrevivir otros 5 años fue < 50%. Estos resultados representan una alerta sanitaria sobre la situación de mujeres jóvenes con cáncer cérvico-uterino en el Área Metropolitana de Buenos Aires, la cual concentra casi un tercio de la población del país.
he cervical cancer, which is a reliable indicator of social inequality, remains a major public health issue in Argentina. It is generally accepted that its frequency among young women is low, being the most exposed those over 35 years old. Nevertheless, as gynecologic oncologists, we have been accompanying young patients to their death, mostly women with neither access to screening strategies nor timely or suitable treatment. Such a situation motivated the present analysis of our data on frequency, survival, and demography of cervical cancer collected at the referral cancer hospital of Buenos Aires City. Of 748 cases retrospectively assessed (2007-2011), 84.0% (n = 627) resided in the Metropolitan Area of Buenos Aires; 76.9% (n = 576) were admitted at a locoregionally advanced stage. Regarding tumor size, 53.6% (n = 401) had tumors > 4 cm diameter and 24.2% (n = 181) > 6 cm. The lowest rates of disease-free survival and cause-specific survival were observed for tumor sizes > 6 cm and the age subgroup < 35 years old. Both tumor size and age retained their prognostic value after multivariate analysis adjustment. When focusing in patients under 35 years old, 48% (n = 70) died within 5 years following diagnosis and their probability of surviving 5 years more was < 50%. These figures raise a public health alert on young women with cervical cancer living in the Metropolitan Area of Buenos Aires, which concentrates almost one third of the country population.
