Diagnosis of advanced cervical cancer, missed opportunities?

Abstract

Background Cervical cancer is common worldwide. Despite the existence of primary and secondary prevention strategies, the survival rate is decreasing in France due to an increasing proportion of advanced-stage cancer. Our objective was to determine the factors associated with a diagnosis of cervical cancer at advanced stages in an urban population in France. Methods A retrospective study was conducted on all consecutive records of patients diagnosed with cervical cancer between January 2006 and December 2018 in a single center in Paris. The data collected were demographic characteristics, medical and gynecological history, circumstances of diagnosis, diagnostic and therapeutic management. The patients were divided into two groups according to the FIGO 2018 stage at diagnosis: group A stages IA1 to IB2 and group B advanced stages IB3 to IVB. Results Among 96 patients who were diagnosed with cervical cancer, 25 (26%) were in group A and 71 (74%) in group B. Women in group B had less frequently received regular gynecological care than in group A (36% vs 84.2%, p < 0.001) and fewer had Pap test screening in the previous 3 years (30.4% vs 95.0%, p < 0.001). Parity greater than 3 was more frequent in group B (69.6% vs 42.9%, p = 0.031). The diagnosis was made during a routine examination or cervical smear in only 9.23% and 16.18% respectively in group B, versus 60% of cases in 45.82% of cases in group A (p < 0.001 and p = 0.003). Vaginal bleeding was observed in 85.29% in group B versus 36% in group A (p < 0.001). Histological type was squamous cell carcinoma 87.32% of group B and 56% of group A (p < 0.001). Conclusion Diagnosis of cervical cancers at advanced stages occurred mostly in women who did not benefit from the recommended screening. Universal access to screening is necessary for the prevention and early treatment of cervical cancer.

USP7 promotes cervical cancer progression by stabilizing MTDH expression through deubiquitination

“…Cervical cancer (CC) is a common malignant tumor in the female reproductive system, with a high incidence and mortality rate (Sung et al 2021 ). Although the basic popularization of CC screening in clinical work, most patients are still diagnosed at the late stage, posing a fatal threat to the survival rate of patients (Allahqoli et al 2022 ; Mattern et al 2022 ). In addition, over one-third of CC patients are still prone to local recurrence, lymph node metastasis or distant metastasis after first-stage treatment, which is one of the main reasons for the poor prognosis of CC patients (Cohen et al 2019 ).…”

Dynamic Nomogram Based on the Metastatic Number and Sites and Therapy Strategies Predicting the Prognosis of Patients with Metastatic Cervical Cancer

“…1 Although precancerous lesions screening and vaccination against human papilloma virus are becoming common in developed areas, cervical cancer still is the most commonly diagnosed cancer in 23 countries and is the leading cause of cancer death in 36 countries. 1,2 Despite much cervical cancer being localized due to vagina bleeding or abnormal leucorrhea, approximately 2-7.6% of patients are diagnosed with synchronous distant metastases with a 5-year prognosis of 16.5% compared to 91.5% for localized cervical cancer. 3,4 Due to the overall rarity and heterogeneity of metastatic cervical cancer (mCC), accurate survival prediction is crucial for risk stratification and International Journal of Women's Health 2022:14 1807-1819 individualized precision therapy strategy for the advanced tumor.…”