Hamid Reza Khalkhali1, Rasool Gharaaghaji1, Rohollah Valizadeh2, Zahra Kousehlou3, Haleh Ayatollahi4. 1. Patient Safety Research Center, Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran. 2. Student Research Committee, Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran. 3. Maternal and Childhood Obesity Research Center, Shahid Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran. 4. Solid Tumor Research Center, Urmia University of Medical Sciences, Urmia, Iran. Email: ayatollahi.h@umsu.ac.ir
Abstract
Objective: There are two basic ways to analyze survival data including nonparametric and parametric methods. Considering that cervical cancer is the fourth most common cancer among women, this study was conducted using a suitable regression model for survival data for patients with cervical cancer in Urmia. Material and Methods: In this historical retrospective study, all patients with cervical cancer who referred to Motahhari Hospital of Urmia during 2004 and 2015 were included in the study and consisted of 109 women with cervical cancer. The data were collected using checklist which filled with records of patients. The data were described with percent, mean and standard deviation. The survival function was computed with the Kaplan-Meier method. The adjusted Hazard Ratio for variables were estimated after fitting the Cox proportion hazard model using Forward Stepwise Likelihood Ratio method with PE=0.1, PR=0.15. Results: Of the 109 patients, the mean (SD) time of diagnosis was 50.1% (11.7) years. The mean (SD) and median of follow-up time was 38.23 (32.50) and 27.1 months (Mim:2 months and Max:132 months). Ninty-Three of patients (88.7%) were in urban area. Using Log-Rank test, the mean score of survival in patients with recurrence of 38.8 months was significantly lower than those without recurrence (102.5 months) (P <0.001). The results of the COX model showed that the adjusted relative risk of mortality with a diagnostic age of 50 years or more compared to those under 50 years of age was 1.978. The risk for marriage under age 20 was 3.189 compared to the marriage age of 20 years or more. Conclusion: According to results, the low age of marriage increases the occurrence of advanced stages of cancer in older ages and as a social and cultural factor has a significant effect on the survival of patients with cervical cancer. Creative Commons Attribution License
Objective: There are two basic ways to analyze survival data including nonparametric and parametric methods. Considering that cervical cancer is the fourth most common cancer among women, this study was conducted using a suitable regression model for survival data for patients with cervical cancer in Urmia. Material and Methods: In this historical retrospective study, all patients with cervical cancer who referred to Motahhari Hospital of Urmia during 2004 and 2015 were included in the study and consisted of 109 women with cervical cancer. The data were collected using checklist which filled with records of patients. The data were described with percent, mean and standard deviation. The survival function was computed with the Kaplan-Meier method. The adjusted Hazard Ratio for variables were estimated after fitting the Cox proportion hazard model using Forward Stepwise Likelihood Ratio method with PE=0.1, PR=0.15. Results: Of the 109 patients, the mean (SD) time of diagnosis was 50.1% (11.7) years. The mean (SD) and median of follow-up time was 38.23 (32.50) and 27.1 months (Mim:2 months and Max:132 months). Ninty-Three of patients (88.7%) were in urban area. Using Log-Rank test, the mean score of survival in patients with recurrence of 38.8 months was significantly lower than those without recurrence (102.5 months) (P <0.001). The results of the COX model showed that the adjusted relative risk of mortality with a diagnostic age of 50 years or more compared to those under 50 years of age was 1.978. The risk for marriage under age 20 was 3.189 compared to the marriage age of 20 years or more. Conclusion: According to results, the low age of marriage increases the occurrence of advanced stages of cancer in older ages and as a social and cultural factor has a significant effect on the survival of patients with cervical cancer. Creative Commons Attribution License
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Keywords:
Survival analysis; cervical cancer; Cox Proportion Hazard model; West Azerbaijan Province