Late-stage diagnosis and its impact on survival in Pakistani women with cervical cancer: Findings from an institutional cancer registry

Abstract

Objective: This study aimed to analyze mean age, clinicopathological characteristics, and survival rates of cervical cancer patients in Karachi, Pakistan.

Methodology: A retrospective cohort study was conducted using data from the Cancer Registry at Aga Khan University Hospital (AKUH) between January 1, 2010 to December 31, 2020. Kaplan-Meier estimates were used to calculate one-, three-, and five-year survival rates. Cox proportional hazards regression was employed to identify factors associated with survival. The analysis included 310 women diagnosed with primary cervical cancer between 2010 and 2020.

Results: The mean age at diagnosis was 51.3 years (SD ± 11.3), with most women (83.9%) diagnosed at an advanced stage. Kaplan-Meier survival analysis revealed an overall mean survival time of 176.3 months (SD 18.1), with one-, three-, and five- years survival rates of 86.6%, 78.5%, and 54.4%, respectively. Cox proportional hazards regression identified late-stage diagnosis (HR = 3.64, 95% CI: 1.25-10.59) and smoking history (HR = 3.37, 95% CI: 1.27-8.97) as independent predictors of poorer survival.

Conclusion: The high frequency of late-stage disease and its impact on poor survival in our study highlight the critical challenge and the urgent need for targeted public health interventions. Strategies such as enhanced community awareness campaigns, the implementation of HPV vaccination, improved cervical cancer screening programs, and the promotion of timely medical consultations are essential to facilitate earlier diagnosis and improve survival outcomes.