TY - JOUR
T1 - Treatment compliance as a major barrier to optimal cervical cancer treatment in Guatemala
AU - Zamorano, Abigail S.
AU - Barnoya, Joaquin
AU - Gharzouzi, Eduardo
AU - Robbins, Camaryn Chrisman
AU - Orozco, Emperatriz
AU - Guerra, Sarita Polo
AU - Mutch, David G.
N1 - Publisher Copyright:
© 2019 by American Society of Clinical Oncology.
PY - 2019
Y1 - 2019
N2 - PURPOSE Despite being the only hospital to provide comprehensive cervical cancer treatment to many medically underserved Guatemalan women, no assessment of the cervical cancer patient population at the Guatemala Cancer Institute has been performed. To understand the demographics of the patient population, their treatment outcomes, and access to care, we sought to assess treatment compliance of patients with cervical cancer at the Guatemala Cancer Institute and its effects on patient outcomes. METHODS A retrospective chart review was conducted of patients with cervical cancer between 2005 and 2007 and assessed for follow-up through December 2015. Demographics and clinical characteristics were tabulated. A Kaplan-Meier curve to model compliance was generated. RESULTS Ninety-two patients with invasive cancer were analyzed. Most presented with squamous cell carcinoma (73%) and at locally advanced stages (IIB, 51%; IIIB, 33%). Most (75 of 92, 81.5%) initiated treatment after diagnosis, but 18.5% (17 of 92) were lost to follow-up before treatment initiation. For treatment, 97% received external beam radiation, 84% brachytherapy, and 4% concomitant chemotherapy. Nearly 20% of patients were lost to follow-up in the first 6 months and 65% in the first 5 years. Of the 67 patients who completed treatment, only 15 (16% of the initial cohort) were diagnosed with a recurrence. No deaths were recorded. CONCLUSION The low recurrence rate and no documented deaths suggest a correlation with the low compliance rate and poor follow-up. This finding highlights the need to examine more fully the barriers to compliance and access to care among this population to optimize the treatment of cervical cancer.
AB - PURPOSE Despite being the only hospital to provide comprehensive cervical cancer treatment to many medically underserved Guatemalan women, no assessment of the cervical cancer patient population at the Guatemala Cancer Institute has been performed. To understand the demographics of the patient population, their treatment outcomes, and access to care, we sought to assess treatment compliance of patients with cervical cancer at the Guatemala Cancer Institute and its effects on patient outcomes. METHODS A retrospective chart review was conducted of patients with cervical cancer between 2005 and 2007 and assessed for follow-up through December 2015. Demographics and clinical characteristics were tabulated. A Kaplan-Meier curve to model compliance was generated. RESULTS Ninety-two patients with invasive cancer were analyzed. Most presented with squamous cell carcinoma (73%) and at locally advanced stages (IIB, 51%; IIIB, 33%). Most (75 of 92, 81.5%) initiated treatment after diagnosis, but 18.5% (17 of 92) were lost to follow-up before treatment initiation. For treatment, 97% received external beam radiation, 84% brachytherapy, and 4% concomitant chemotherapy. Nearly 20% of patients were lost to follow-up in the first 6 months and 65% in the first 5 years. Of the 67 patients who completed treatment, only 15 (16% of the initial cohort) were diagnosed with a recurrence. No deaths were recorded. CONCLUSION The low recurrence rate and no documented deaths suggest a correlation with the low compliance rate and poor follow-up. This finding highlights the need to examine more fully the barriers to compliance and access to care among this population to optimize the treatment of cervical cancer.
UR - http://www.scopus.com/inward/record.url?scp=85065761982&partnerID=8YFLogxK
U2 - 10.1200/JGO.18.00243
DO - 10.1200/JGO.18.00243
M3 - Article
C2 - 31067142
AN - SCOPUS:85065761982
SN - 2378-9506
VL - 2019
JO - Journal of Global Oncology
JF - Journal of Global Oncology
IS - 5
ER -