TY - JOUR
T1 - Reasons for low cervical cancer survival in new accession European Union countries
T2 - a EUROCARE-5 study
AU - EUROCARE-5 Working Group
AU - Bielska-Lasota, Magdalena
AU - Rossi, Silvia
AU - Krzyżak, Michalina
AU - Haelens, Annemie
AU - Domenic, Augius
AU - De Angelis, Roberta
AU - Maciejczyk, Adam
AU - Rodríguez-Barranco, Miguel
AU - Zadnik, Vesna
AU - Minicozzi, Pamela
AU - Hackl, M.
AU - Ihle, P.
AU - Van Eycken, E.
AU - Henau, K.
AU - Valerianova, Z.
AU - Dimitrova, N.
AU - Sekerija, M.
AU - Cukelj, P.
AU - Dušek, L.
AU - Zvolský, M.
AU - Mägi, M.
AU - Aareleid, T.
AU - Malila, N.
AU - Seppä, K.
AU - Velten, M.
AU - Guizard, A. V.
AU - Faivre, J.
AU - Woronoff, A. S.
AU - Tretarre, B.
AU - Bossard, N.
AU - Uhry, Z.
AU - Colonna, M.
AU - Molinié, F.
AU - Cowppli-Bony, A.
AU - Bara, S.
AU - Lapôtre-Ledoux, B.
AU - Grosclaude, P.
AU - Stabenow, R.
AU - Luttmann, S.
AU - Eberle, A.
AU - Brenner, H.
AU - Nennecke, A.
AU - Engel, J.
AU - Schubert-Fritschle, G.
AU - Heidrich, J.
AU - Holleczek, B.
AU - Katalinic, A.
AU - Rashbass, J.
AU - Broggio, J.
AU - Verne, J.
N1 - Funding Information: The authors declare that they have no conflict of
interest.
Open Access: No Open Access licence.
Publisher Copyright: © Springer-Verlag GmbH Germany, part of Springer Nature 2019.
Citation: Bielska-Lasota, M., Rossi, S., Krzyżak, M. et al. Reasons for low cervical cancer survival in new accession European Union countries: a EUROCARE-5 study. Arch Gynecol Obstet 301, 591–602 (2020).
DOI: https://doi.org/10.1007/s00404-019-05412-5
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Purpose: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients’ age. Methods: We analysed 101,714 CC women diagnosed in 2000–2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. Results: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. Conclusion: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.
AB - Purpose: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients’ age. Methods: We analysed 101,714 CC women diagnosed in 2000–2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5 years after diagnosis were computed. Results: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. Conclusion: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.
KW - Cervical cancer
KW - Europe
KW - Morphology
KW - Population-based study
KW - Stage at diagnosis
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85076879334&partnerID=8YFLogxK
U2 - 10.1007/s00404-019-05412-5
DO - 10.1007/s00404-019-05412-5
M3 - Article
C2 - 31853712
AN - SCOPUS:85076879334
VL - 301
SP - 591
EP - 602
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
SN - 0932-0067
IS - 2
ER -
