ONCOmmunity

Cervical cancer in women under 25 years of age and outside the screening age: Diagnosis profile and long-term outcomes.

By: Julio Cesar Teixeira, Daniel Zaidan Santos, Cirbia Silva Campos, Diama Bhadra Vale, Joana Froes Bragança, Luiz Carlos Zeferinor

Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
2020-12-20; doi: 10.1002/ijgo.13553

Abstract

Objective

This study aims to evaluate the pattern of cervical cancer (CC) diagnosis and outcomes in women under 25.

Methods

Thirty-two women younger than 25 years treated between 2001-2016 were studied and considered the year, symptom or cytology prior to diagnosis, time since sexual debut, age group, histology, and stage. Data were compared with older age groups, and survival analysis using a subset of them was done.

Results

Thirty-two CC diagnoses (1.5%) exhibited a positive linear trend (P=0.075). Driven by cytology, 18 were asymptomatic. Fourteen were symptomatic (vaginal bleeding in 11). The mean time since sexual debut was 6.9y. The advanced stage (44% vs. 29%) and adenosquamous histology (12.5% vs. 1.7-5.0%) were higher in younger. 5-year overall survival rate was 76%, better for squamous cell carcinoma (SCC) (86% vs. 43% for other histologies; P=0.018). Seven deaths were observed, all up to 15 months. Age groups of <25y (53%) and 25-29y (48.5%) had similar proportions of Stage IA1.

Conclusion

The rate of CC diagnosed women under 25 years was 1.5%, exhibiting more advanced stage and non-SCC histology. For asymptomatic, cytology allowed the diagnosis at an early-stage. Being symptomatic and non-SCC was associated with higher proportion of advanced stages and poor survival.