Population analysis of factors predicting survival in cervical cancer according to the Arkhangelsk Cancer Registry

Relevance. Cervical cancer (CC) is one of the most frequently registered gynecological tumors in Russia and in the world. In Russia in the age group 20-40 years old, CC is the leading cause of death among all patients with malignant neoplasms of the female genitalia. Objective of the study: to investigate epidemiological factors of the survival prognosis of CC patients based on a population-based sample of the Arkhangelsk Regional Cancer Registry (ARCR) in the period 2000-2021. Materials and methods. Data on all CC cases registered in the Arkhangelsk region for the period from 2000 to 2021 were extracted from the ARCR database. Cancer-specific survival (CSS) was calculated as a time interval between morphological confirmation of cancer and death from CC. We used life-tables, Kaplan-Meier method with assessment of differences between individual subgroups by log-rank. Predictive value of selected factors available in ARCR was assessed using Cox proportional hazards regression model. Results. A total of 2880 cases of CC were selected from the ARCR database. One- and 5-year survival rates were 81.3% (95% CI 79.8-82.7) and 66.0% (95% CI 64.1-67.8), respectively. In a univariate analysis, five-year CSS was significantly reduced in more advanced stages, lack of evidence of special antitumor treatment, rare morphological variants of RRM, and in elderly and rural patients. In multivariate regression analysis, the risk of death was 6, 15 and 32 times higher in stages II, III and IV than in stage I; 1.7 times higher in rare forms of RSCC compared to squamous cell cancer; 1.8 times higher in palliative treatment compared to radical treatment; 16% higher in rural area residents compared to urban area residents. The five-year survival rateof CC patients increased from 55.3% between 2000-2006 to 71.3% between 2013-2019. The risk of death from CC during the COVID-19 pandemic was similar to the previous 2013-2019 surveillance period.Conclusion. Population analysis revealed that along with stage, histological variant and treatment assignment, rural residence and advanced age of patients have a significant adverse effect on survival prognosis in CC. Survival of patients during the COVID-19 pandemic did not decrease. Further follow-up and high-resolution epidemiological analysis are required.