SURVIVAL AND PROGNOSTIC FACTORS OF ENDOMETRIAL CANCER-PATIENTS IN ICELAND 1964-1985 - CAN ATTENDANCE AT POPULATION-BASED PAP-SMEAR SCREENING AFFECT SURVIVAL

After histological review of all cases registered during the period 19 64-1985 at the Cancer Registry, 260 cases with endometrial carcinoma w ere eligible for analyses of survival rates and prognostic factors, as well as the association of Pap-smear screening attendance with these factors and survival. The total age-adjusted 5- and 10-year relative s urvival rates were 76% and 75%, respectively. The prognostic factors w ere tested by univariate analysis and simultaneously by a multivariate analysis using the Cox proportional hazards model. Factors that indep endently gave a less favorable prognosis were non-attendance at screen ing, older age at diagnosis, deep myometrial invasion, advancing stage s and tumor grading, radiotherapy only, extra-genital symptoms and his tology types of serous, clear cell and undifferentiated tumors (histol ogic type 3). Tested simultaneously with the Cox proportional hazards model, parameters that maintained a less favourable prognosis were gra de 3, stage III-IV, deep myometrial invasion, older age, radiotherapy only and extra-genital symptoms. In addition, screening attendance sho wed significant interaction with age. In stages III and IV only grade 3 maintained a significantly less favorable prognosis. We conclude tha t our results indicate that attendance at Pap-smear screening (taking Pap smears and screening for genital symptoms) has a favorable prognos tic value, especially among women under the age of 62. (C) 1998 Wiley- Liss, Inc.