Cervical cancer in women under 25 years old registered in a regional referral hospital: an 18-year evolutive analysis

Resumo

Cervical cancer is the third leading cancer in Brazil and national screening program targets women from 25 to 64 years, with the Papanicolaou (Pap) test as the standard method. A few countries or medical associations recommend the start of the screening at age 21, a policy that remains controversial, for the higher risk of unnecessary treatment and morbidities related. Previous studies reported that 1% of the cases diagnosed before the age of 25. The aim of this study is to assess evolution of cases diagnosed among females younger than 25 years old in a regional hospital and their evolution. Cases selected were diagnosed from 2001 to 2015 and medical records were analysed until 2018 in a cohort study, gathering 32 cases (1,6% of 2041 cervical cancer registries, only 2 of them under 20 years old). Data gathered was registered and survival was measured by Kaplan-Meier estimates. There was an increasing trend of cervical cancers (p=0,04), with a higher rate of adenocarcinomas (19%) and stage I cancers (56%). Five-year overall survival rate was 76%, with worse rates among females under 22 years old (66% vs. 82%) and adenocarcinomas (43% vs. 86%). Survival rates between stage I cancer were 100%, in contrast with 46% observed in advanced stages. Therefore, although less frequent, cervical cancer in younger females tend to rise; these findings also suggest a higher rate of adenocarcinoma, with worse survival rates in this histological type and in advanced clinical stages.