Cervical cancer in older women: Does age matter?

Objectives: Cervical cancer is frequently diagnosed in older women, but few studies have focused on cervical cancer in this specific population. The objectives of this study were to provide an overview of the demographic profile and therapeutic care of women with cervical cancer, and to identify whether age is a prognostic factor. Study design: Retrospective population-based study from a gynecological cancer registry in a French Regional University Hospital and Comprehensive Cancer Center. 292 women diagnosed with cervical cancer between January 1, 2005, and December 31, 2015, were included. They were classified into younger women (YW), that is, under 70 years of age (N = 228), and older women (OW), that is, aged 70 years or more (N = 64). Main outcome measures: The primary outcome was overall survival (OS). Cox proportional hazards models were developed to assess the impact of age on OS. Results: Compared with YW, larger proportions of OW had comorbidities (14% vs 7% with a score >= 2 on the Charlson Comorbidity Index, P < 0.001) and more advanced tumors (37.3% vs 19.7% with FIGO IV, P < 0.001); the OW group had a lower treatment rate (81.3% vs 95.6%, P < 0.001), and a smaller proportion had undergone surgery (37.5% vs 81.7%, P <.001) but a larger proportion had radiotherapy (67.2% vs 49.6%, P = .01). One-year, 5-year and 10-year OS rates were: 91.6%, 74.1% and 63.9% for YW, and 69.9%, 36.4% and 12.3% for OW, respectively (P < 0.001). The hazard ratio for death was twice as high in OW compared with YW with cervical cancer (HR = 2.19 [1.41 - 3.40], P < 0.001), independently of FIGO stage, histology, and comorbidities. Conclusions: The prognosis for cervical cancer depends on age. Screening with the G8 tool followed by a comprehensive geriatric assessment could lead to more suitable treatment being offered to older patients.

Automated summary

Cervical cancer is more commonly diagnosed in older women and is associated with more advanced tumors and comorbidities in this population. Older women have lower treatment rates, a smaller proportion undergo surgery but a larger proportion receive radiotherapy. Age is a prognostic factor for cervical cancer.