Cervical cancer in Paraiba: description of the pathologic and epidemiologic profile and comparative analysis between therapeutic approaches and survival rate

Introduction: Despite being preventable and having a well-known natural course, cervical cancer remains one of the leading causes of cancer-related death among women, being the third most common malignant disease among Brazilian women and the fourth worldwide. In the Northeast of Brazil, its adjusted incidence is 13.85 cases per 100,000 inhabitants, highlighting the influence of socioeconomic levels on access to healthcare. With 95% of cases attributed to HPV, early detection is essential but often fails due to limited access to healthcare, worsening treatment costs and outcomes. The clinical staging updated by FIGO in 2018 and chemoradiotherapy are crucial for treatment. This article explores how these factors impact survival in a reference cancer hospital in Paraíba.

Objective: To characterize the epidemiological and clinical profile of women with cervical cancer in Paraíba, their survival, and the relationship between survival and the therapeutic approach used.

Methods: An observational, retrospective, cross-sectional study with 126 medical records of women with cervical cancer treated between 2015 and 2020 at the reference oncology hospital in Paraíba. Data were analyzed using SPSS software, with descriptive statistics parameters, Relative Risk, survival analysis by the Actuarial method, Kaplan-Meier test, Odds Ratio, and Cox Regression, using a significance level of 5%.

Results: Two-thirds of the occupations were housewives and farmers, the majority were mixed-race, with only incomplete primary education or were illiterate. Smokers were 16 times more likely to develop poorly differentiated tumors. The most prevalent FIGO stages were IIB and IIIB. Stages I or II had a median survival of 176 months, with 10.3% of deaths in the period, while in stages III and IV, the median survival was 70 months, with 40.4% of deaths. Patients treated for more than 5 months had a 4.6 times higher risk of death, and those who only received brachytherapy/radiotherapy had a hazard ratio of 0.11 compared to those who also received chemotherapy and/or surgery.

Conclusion: Lower socioeconomic levels were more strongly associated with cervical cancer. Most diagnoses are still made in more advanced stages of the disease, requiring longer treatment times with more combined therapies, which is associated with higher morbidity and mortality.

Corresponding author: Ana Barbosa de Oliveira (e-mail: ana.barbosa2@academico.ufpb.br).