Sociodemographic and clinicopathological factors affecting survival in young women: Real-world data from Brazil.

Abstract

e17515 Background: Cervical cancer (CC) typically develops years after persistent HPV infection, yet its prevalence has been rising globally until recently, resulting in significant morbidity. This study sought to assess the influence of sociodemographic and clinicopathological factors on survival outcomes in young women with CC treated at a comprehensive public cancer center in Brazil. Methods: Data were retrieved from medical records of women diagnosed with CC (adenocarcinoma, squamous, or adenosquamous), aged between 18 and 39 years, and enrolled at the Brazilian National Cancer Institute (INCA) between January 2017 and December 2021. Continuous variables were analyzed using Student's t-test, and categorical variables with Pearson's chi-square test. Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Multivariate analysis included variables with p < 0.05 from univariate analysis. Results: A total of 475 patients met the eligibility criteria. The mean age was 33.6 years (SD 4.3). Most of the patients were non-white (67.7%), single (68.0%), had lower education (< 8 years) (86.1%), grade 2 tumors (61.6%), and squamous cell carcinoma (83.1%). Advanced-stage (III/IV) compromised 42.3% of cases. Multivariate analysis indicated that lower education was associated with advanced-stage (p=0.001). Recurrence or disease progression occurred in 224 patients (47.2%), predominantly as distant metastases (56.7%). The median follow-up was 59.1 months (95% CI, 56.0-61.4) for the overall population, and the median PFS was 19.8 months (95% CI, 17.1-24.8). The estimated 2-year PFS for stages I, II, III, and IV was 81.6%, 45.7%, 28.2%, and 6.2%, respectively. Factors associated with shorter PFS included lower education (p=0.009), alcohol consumption (p=0.026), high-grade carcinoma (p=0.007), and advanced-stage (p<0.001). The median OS was 35.1 months (95% CI, 28.2-51.4) for the overall population. The estimated 5-year OS for stages I, II, III, and IV was 82.9%, 42.7%, 23.7%, and 9.7%, respectively. Lower education (p=0.005), high grade carcinoma (p=0.006) and advanced-stage (p<0.001) were associated with shorter OS. Conclusions: High-grade carcinomas and advanced-stage negatively impact prognosis in young women with CC. Sociodemographic factors, such as lower education and alcohol consumption, are supposed to be associated with poorer outcomes. Comprehensive public health initiatives focused on education, early detection, and equitable treatment are essential to reduce disease burden and improve survival outcomes.