Cervical cancer survival in high-risk region: Trujillo, Peru

Natalie Channell1, Ashley N. Elsensohn, MSIII2, Antonio Zavaleta, MD1, Jane H. Ricks, MD1, Daniel J. Ricks, MSc, MD1

University of Utah1, University of Utah School or Medicine2

Background:  Cervical cancer is a largely preventable and curable disease. In the United States cervical cancer is not listed among the top 10 cancers or top ten cancer mortalities in women. In contrast, cervical cancer in Peru is the leading cancer in women accounting for 20% of cancer diagnoses and 15% of cancer mortalities annually. The purpose of our study was to determine the cervical cancer survival in women from a high-risk region of Peru. This was done using the only known cancer registry in Northern Peru; it is the first study in Peru to look at long term outcomes for patients diagnosed with cervical cancer.

Methods:  The study utilized a survey methodology. Records on cervical cancer diagnoses in Trujillo, Peru (from 1997-2002) were collected using the Trujillo Cancer Registry. We visited homes of study participants to assess whether individuals were alive or deceased. Age at time of diagnosis was calculated using date of diagnosis and date of birth. An independent t-test was performed comparing age at diagnosis between alive and deceased groups. A survival curve of those surveyed was plotted in excel using the time at diagnosis and mortality information.

Results:  Overall 122 women were diagnosed with cervical cancer during this period. Average age at diagnosis was 54.8 (s.d.=13.8). Forty-two percent (51/122) of surveys were completed. Of those contacted, 53% (27/51) were alive and 47% were deceased (24/51), with an average age at diagnosis of 50.4 (s.d.=11.6) and 60.6 (s.d.=14.2) respectively. ((50) = .007, p < .05). The average age at diagnosis of those not contacted was 54.5 (s.d.=13.9). The 10-year survival rate was 61% (United States 67.2%, UK 63.0%).

Conclusion:  Mortality of women with cervical cancer in the Trujillo region of Peru at 10-years is roughly that of the United States and UK. This suggests that the high mortality from cervical cancer in Peru is due to the high incidence and late stage diagnosis. We therefore recommend efforts be focused on prevention with tools such as the HPV vaccine and screening Pap smears, which are proven effective for the prevention and early recognition of cervical cancer, respectively.

Author Contact: ashley.elsensohn@hsc.utah.edu