Ten Years’ Survival in Patients with Cervical Cancer and Related Factors in West Azerbaijan Province: Using of Cox Proportion Hazard Model

Abstract

Objective:There are two basic ways to analyze survival data including nonparametric and parametric methods. Considering that cervical cancer is the fourth most common cancer among women, this study was conducted using a suitable regression model for survival data for patients with cervical cancer in Urmia.Material and Methods:In this historical retrospective study, all patients with cervical cancer who referred to Motahhari Hospital of Urmia during 2004 and 2015 were included in the study and consisted of 109 women with cervical cancer. The data were collected using checklist which filled with records of patients. The data were described with percent, mean and standard deviation. The survival function was computed with the Kaplan-Meier method. The adjusted Hazard Ratio for variables were estimated after fitting the Cox proportion hazard model using Forward Stepwise Likelihood Ratio method with PE=0.1, PR=0.15.Results:Of the 109 patients, the mean (SD) time of diagnosis was 50.1% (11.7) years. The mean (SD) and median of follow-up time was 38.23 (32.50) and 27.1 months (Mim: 2 months and Max: 132 months). Ninty-Three of patients (88.7%) were in urban area. Using Log-Rank test, the mean score of survival in patients with recurrence of 38.8 months was significantly lower than those without recurrence (102.5 months) (P <0.001). The results of the COX model showed that the adjusted relative risk of mortality with a diagnostic age of 50 years or more compared to those under 50 years of age was 1.978. The risk for marriage under age 20 was 3.189 compared to the marriage age of 20 years or more.Conclusion:According to results, the low age of marriage increases the occurrence of advanced stages of cancer in older ages and as a social and cultural factor has a significant effect on the survival of patients with cervical cancer.

Survival Analysis of Cervical Cancer Patients: A Case Study of Bhutan

“…If cervical cancer is diagnosed at the early stages it can be treated and has a higher survival rate. This result is consistent with other findings (Razak et al, 2013;Gurmu, 2018;Khalkhali et al, 2019). It should also be emphasized that there is 36.4% of patients with unknown FIGO stages in this study.…”

“…The overall estimated 1, 3 and 5-year survival rates are 82.1%, 65.2% and 55.4%, respectively. According to the recent results, the overall survival rates at 1, 3 and 5 years of 5,859 cervical cancer patients in Malaysia during 2000 and 2015 (Muhamad et al, 2015) were 97%, 85% and 73%, of 109 patients in Azerbaijan during 2004 and 2015 (Khalkhali et al, 2019) were 94%, 79% and 71%, and of 558 patients diagnosed in an extensive screening program in rural India during 2000 and 2013 (Jayant et al, 2016) were 82%, 68% and 60%, respectively. In this present study, the patients diagnosed with cervical cancer in Bhutan have a lower life expectancy than those in the aforementioned reports.…”

“…Though the method does not assume any particular "survival model", it is not truly nonparametric because no assumptions are made that the effects of the predictor variables upon survival are constant over time and are additive in one scale. Example of applications of Cox regression and survival analyses can be seen in (Mascarello et al, 2013;Saikia and Barman, 2016;Dankner et al, 2019;Khalkhali et al, 2019). In (Dankner et al, 2019), a discrete form of weighted cumulative metformin exposure was utilized to discover the association between metformin and cancer incidence.…”

Supportive Intervention Challenges for Patients with Breast Cancer: A Systematic Review

“…The study of Tabrizi and Alizadeh demonstrated that the support of family members for patients with breast cancer plays a main role for coping with cancer [19], which was consistent with the conclusion of our study. Now we beilve that survival and management of cancer is multifactorial affected by geography, being supported by others, medicine, mental help and so on [30][31][32][33][34][35][36]. Family can be the first effective step for treating problems due to cancer treatment given their emotional relationships and sympathy with patient and the times spending along with family members.…”

Evaluation of the Effect of Patient Education on the Quality of Life Cancer Patients Undergoing Radiotherapy: A Review Article

“…Different treatments of breast cancer may limit patient's daily activities leading to long-term disturbance in the life situation [12]. These disorders include nausea, vomiting, loss of sexual quality, pain and fatigue in women with breast cancer [13]. Additionally, any prostate cancer treatment is associated with side effects: active treatments such as prostatectomy or radiotherapy often causes urinary, bowel, and sexual complication and thus reducing health-related quality of life and increases mental and physical anxiety [14].…”