Factors associated with tumour stage at presentation in invasive cervical cancer.

OBJECTIVE

The main objective of the study was to determine the demographic, social, clinical, laboratory and histologic factors associated with late stage presentation in cervical cancer.

DESIGN

A cross sectional study.

SETTING

Government tertiary referral institutions, Harare, Zimbabwe

STUDY POPULATION

One hundred consecutive cases of histology proven cervical cancer that presented for treatment between November 2001 and April 2002.

MAIN OUTCOME MEASURES

The patients were categorized as early invasive cancer (stage I and II) and late invasive cancer (stage III and IV).

RESULTS

The median age of the patients was 48 years (Q1=39 and Q3= 60). Eighty percent presented with late stage disease. Squamous cell carcinoma was the commonest histology (96%) with adenocarcinoma constituting only 4% of all tumours. Poorly differentiated tumour histology and no history of prior cervical cancer screening were found to be significantly associated with late tumour stage at presentation. The odds of presenting with late stage disease in women with a poorly differentiated tumour were 12.97 (95% CI 2.03 to 82.55; p = .007), whilst the odds of late stage presentation in the absence of a history of screening were 11.13 (95% CI 1.33 to 93.21; p = .026).

CONCLUSIONS

Intrinsic tumour characteristics were the most important in this population in determining late stage at diagnosis and the value of screening was also highlighted by the results. The odds ratios had wide 95% confidence intervals, thus limiting their usefulness as point estimates.