The natural history of carcinoma of the cervix in young women.

Invasive carcinoma of the cervix was treated in 1,522 patients over a 10-year period at Groote Schuur Hospital. Data for each patient included place of residence, pathological characteristics of the tumour, nodal spread, histological evidence of human papillomavirus (HPV) infection, disease stage, treatment type, treatment complications, site of recurrence and survival time. Patients aged under 35 years comprised 11.6% of the total patient group. A retrospective cohort study compared women aged under 35 years of age at the time of entry into the study and women aged 35 years or more. In all, 82 eligible young patients were compared with random sample of 82 eligible older patients. Contingency tables, life tables and proportional hazards analysis were used where appropriate. There was no significant difference across the two age groups in the incidence of non-squamous tumours, or in the grades of squamous tumours. Similarly there was no evidence of differences in lymph node involvement or HPV infection. Young patients appeared to enter the study at significantly earlier stages of the disease, and a greater proportion of them underwent surgical treatment (diff = 36.4% +/- 13.5%). In both groups treatment complications were less frequently observed after surgery than after radiotherapy. Sites of tumour recurrence were similar in both groups, and there was no apparent difference in survival times.