Patterns of care for cervical cancer patients treated in the U.S. Military Health Care System

John H. Farley, Linda C. Harlan, Limin X. Clegg, Wilma I. Larsen, Edward L. Trimble

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine whether women diagnosed with cervical cancer within the U.S. Department of Defense (DOD) Military Health Care System received treatment within standard guidelines and whether survival was influenced by implementation of these guidelines. STUDY DESIGN: We identified 621 women treated from 1994 to 2002. Guideline therapy was defined as hysterectomy or radiation for FIGO stage ≤ IB, and hysterectomy or chemoradiation for advanced localized FIGO stage > IB. Survival analysis was performed using Cox Proportional Hazards models. RESULTS: Of those 621 women, 25% received no surgery, while 41% received radiation therapy. 6% of all patients received chemoradiation therapy prior to the Clinical Announcement received versus 26% of patients after the announcement. Variables associated with significant increased risk of death were advanced age, advanced stage and poorly differentiated lesions, p < 0.01. The lack of guideline therapy was associated with an increased risk of death, p < 0.005. Those patients who did not re ceive guideline therapy were twice as likely to die (HR 2.11, p = 0.005). CONCLUSION: Our study suggests that chemoradiation was rapidly introduced in the DOD care system after the 1999 National Cancer Institute's Clinical Announcement. However, some patients did not receive guideline therapy.

Original languageEnglish (US)
Pages (from-to)1040-1045
Number of pages6
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume52
Issue number11
StatePublished - Nov 1 2007
Externally publishedYes

Keywords

  • Cervix cancer
  • Chemotherapy
  • National institutes of Health
  • Radiotherapy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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