Characteristics and survival of cervical cancer patients managed at adjacent urban public and university medical centers

Objective. The goal of this work was to compare characteristics and surviva l of cervical cancer patients at adjacent public and university hospitals t o define the effects of poverty and ethnicity on disease. Methods. A retrospective chart review was conducted of cervical cancer pati ents managed by gynecologic oncologists at two adjacent urban hospitals bet ween 1992 and 1998. Continuous variables were compared by t test, categoric al variables by chi (2), and survival by the Kaplan-Meier and log-rank meth ods. Results. In all, 372 patients were identified, with 209 (56%) at the public hospital and 163 (44%) at the adjacent university hospital. Ethnic distrib ution differed between the two hospitals: 100 (52%) versus 46 (28%) African -American, 56 (29%) versus 13 (8%) Hispanic, 31 (16%) versus 96 (60%) Cauca sian, and 5 (3%) versus 6 (4%) other (P < 0.001), In addition, public hospi tal patients presented with more advanced cancers (stages II-IV) than those managed at the university hospital, 96 (48%) versus 53 (34%) (P = 0.008), and squamous cancers were more common at the public hospital, 154 (89%) ver sus 120 (76%) (P = 0.03). However, with a median follow-up of 17 months, st age-adjusted survival did not differ between the two institutions. Conclusions. The higher proportions of advanced and squamous cervical cance rs encountered at the public hospital likely reflect suboptimal screening. Equal access to gynecologic oncologists eliminated disparities in stage-adj usted survival. Efforts at earlier diagnosis should be directed at indigent , especially minority women, (C) 2001 Academic Press.