Advanced-stage cervix cancer: rapid tumour growth rather than late diagnosis

Either diagnostic delay or tumour biology are possible factors governing th e degree of spread at diagnosis of cervical cancer. To try to identify the most important parameter contributing to advanced stage, the duration of sy mptoms were recorded from patients scheduled for radiotherapy (n = 141) or radical hysterectomy (n = 36). In 146 cases tumour proliferation rates were evaluated following in vivo labelling with the DNA precursor BrdUrd, For s ymptomatic patients there was no association between duration of symptoms a nd stage at presentation. There was a significant trend for patients with i ncreasing tumour stage to have more rapidly proliferating tumours with high er mean labelling index (LI) measurements (P = 0.001) and a shorter mean po tential doubling time (Tpot) (P = 0.023), Socio economic deprivation may be associated with shorter Toot values. The conclusion from this data is that stage at diagnosis is more dependent on the biological behaviour of the tu mour, as expressed by proliferation rates, than delay in presentation. (C) 2000 Cancer Research Campaign.