CERVICAL-CARCINOMA IN THE GRAMPIAN REGION (1980-1991) - A POPULATION-BASED STUDY OF SURVIVAL AND CERVICAL CYTOLOGY HISTORY

Objectives To study survival in women treated for cervical carcinoma i n Grampian region, to identify clinical and pathological prognostic fa ctors, and to correlate survival with cytology history. Design A retro spective study of all cases of cervical carcinoma using a prospectivel y gathered database. Data validated by 1 in 10 randomised retrospectiv e case note sampling. Setting Aberdeen Royal Infirmary Subjects Three hundred sixty-three women resident within Grampian diagnoses as having cervical carcinoma between 1980 and 1991, with five-year survival dat a on the 206 diagnosed by the end of 1986. Main outcome measure Five-y ear survival rates. Results The mean annual incidence of cervical carc inoma in our population was 11.2 per 100 000 women, with an overall fi ve-year survival of 67 % in those under 40 years of age and 60 % in th ose aged 40 years and over. On univariate analysis, survival was signi ficantly adversely affected by tumour stage, grade and absence of prev ious smears. On multivariate analysis, the effect of previous smear hi story was lost, but stage and grade remained strong independent risk f actors for survival. There was no significant difference in five-year survival by age or tumour type. Conclusions The prognosis of cervical carcinoma in Grampian region was independently affected only by stage of disease and tumour grading and cervical smear history.