Characteristics and survival of cervical cancer patients managed at adjacent urban public and university medical centers

Kian Behbakht, Nadeem R. Abu-Rustum, Suzette Lee, Armando San Juan, L. Stewart Massad

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Objective. The goal of this work was to compare characteristics and survival of cervical cancer patients at adjacent public and university hospitals to define the effects of poverty and ethnicity on disease. Methods. A retrospective chart review was conducted of cervical cancer patients managed by gynecologic oncologists at two adjacent urban hospitals between 1992 and 1998. Continuous variables were compared by t test, categorical variables by X2, and survival by the Kaplan-Meier and log-rank methods. Results. In all, 372 patients were identified, with 209 (56%) at the public hospital and 163 (44%) at the adjacent university hospital. Ethnic distribution differed between the two hospitals: 100 (52%) versus 46 (28%) African-American, 56 (29%) versus 13 (8%) Hispanic, 31 (16%) versus 96 (60%) Caucasian, and 5 (3%) versus 6 (4%) other (P < 0.001). In addition, public hospital patients presented with more advanced cancers (stages II-IV) than those managed at the university hospital, 96 (48%) versus 53 (34%) (P = 0.008), and squamous cancers were more common at the public hospital, 154 (89%) versus 120 (76%) (P = 0.03). However, with a median follow-up of 17 months, stage-adjusted survival did not differ between the two institutions. Conclusions. The higher proportions of advanced and squamous cervical cancers encountered at the public hospital likely reflect suboptimal screening. Equal access to gynecologic oncologists eliminated disparities in stage-adjusted survival. Efforts at earlier diagnosis should be directed at indigent, especially minority women.

Original languageEnglish
Pages (from-to)40-46
Number of pages7
JournalGynecologic oncology
Volume81
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Cervix
  • Ethnicity
  • Socioeconomic status
  • Survival

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