Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Department of Obstetrics and Gynecology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Asian Pac J Cancer Prev. 2023 May 1;24(5):1759-1767. doi: 10.31557/APJCP.2023.24.5.1759.
Cervical cancer (CC) is the third most common cancer in women globally, including Thailand, where the incidence rate was 16.2 cases per 100,000 individuals in 2018. Survival rates for patients with this condition have not improved over recent years. This study evaluated the survival rate and median survival time after diagnosis among CC patients, and investigated factors associated with survival in Northeast Thailand.
This study included CC patients admitted to the gynecological ward at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand from 2010 to 2019. Survival rates and median survival time since the date of diagnosis and 95% confidence intervals (CIs) were calculated. Multiple cox regression was performed to investigate factors associated with survival which were quantified by adjusted hazard ratios (AHR) and their 95% CIs.
Of 2,027 CC patients, the overall mortality incidence rate was 12.44 per 100 person-years (95% CI: 11.7 - 13.22), median survival time was 4.82 years (95% CI: 3.92 - 5.72), and 10-year survival rate was 43.16% (95% CI: 40.71 - 45.59). The highest 10-year survival rate was 87.85% (95% CI: 82.23 - 91.78) found among those with stage I CC, followed by those who received surgical treatment, which was 81.22% (95% CI: 74.47 - 86.35). Factors that were associated with decreased survival included age ≥60 years (AHR = 1.25; 95% CI: 1.07 - 1.46), health insurance with the Universal Health Coverage Scheme (UCS) (AHR = 6.26; 95% CI: 5.13 - 7.64), malignant neoplasms histopathology (AHR = 1.36; 95% CI: 1.07 - 1.74), and treatment with supportive care (AHR = 7.48; 95% CI: 5.22 - 10.71).
Among patients diagnosed with CC, those with stage I had the highest 10-year survival rate. CC patients with older age, UCS, malignant neoplasms histopathology, and received supportive care showed the highest survival association.
宫颈癌（CC）是全球女性中第三大常见癌症，包括泰国，2018 年其发病率为每 10 万人中有 16.2 例。近年来，该疾病患者的生存率没有提高。本研究评估了泰国东北部 CC 患者的生存率和诊断后中位生存时间，并调查了与生存相关的因素。
本研究纳入了 2010 年至 2019 年在泰国孔敬大学医学院诗琳通医院妇科病房住院的 CC 患者。计算了自诊断日期起的生存率和中位生存时间以及 95%置信区间（CI）。采用多 Cox 回归分析与生存相关的因素，通过调整后的危险比（AHR）及其 95%CI 进行量化。
在 2027 例 CC 患者中，总死亡率为 12.44/100 人年（95%CI：11.7-13.22），中位生存时间为 4.82 年（95%CI：3.92-5.72），10 年生存率为 43.16%（95%CI：40.71-45.59）。I 期 CC 患者的 10 年生存率最高，为 87.85%（95%CI：82.23-91.78），其次是接受手术治疗的患者，为 81.22%（95%CI：74.47-86.35）。与生存率降低相关的因素包括年龄≥60 岁（AHR=1.25；95%CI：1.07-1.46）、参加全民健康覆盖计划（UCS）医疗保险（AHR=6.26；95%CI：5.13-7.64）、恶性肿瘤组织病理学（AHR=1.36；95%CI：1.07-1.74）和接受支持性护理（AHR=7.48；95%CI：5.22-10.71）。
在诊断为 CC 的患者中，I 期患者的 10 年生存率最高。年龄较大、参加 UCS、恶性肿瘤组织病理学和接受支持性护理的 CC 患者的生存率最高。
