Abstract 811P
Background
Cervical cancer disproportionately affects patients (pts) in developing countries and is one of the leading causes of death in Latin America (LatAm). Understanding the epidemiological landscape of cervical cancer is warranted to plan prevention and treatment strategies for the continent.
Methods
The EVITA LATAM (LACOG 0820) study is a multicenter retrospective and prospective cohort of pts with cervical cancer FIGO Stage IB2 to IVA diagnosed after January 2018. Its primary objective is to describe the histologic subtypes and stages of cervical cancer in Latin America. We hereby describe demographic, clinical, and pathologic characteristics, and explore factors associated with diagnosis in earlier stages.
Results
From Nov/2021 to Jan/2023, 516 pts were included in 12 centers across Brazil, Argentina, Peru, and the Dominican Republic. Median age was 45.0 (range: 21.8 – 90.5) years, 213 (41.3%) were white and 244 (47.3%) were of mixed race. Current or former smoking was reported by 133 (25.7%) pts; 265 (51.3%) pts did not complete secondary education, and 441 (85.5%) were treated in public institutions. Four (0.8%) pts had received HPV vaccination and 73 (14.1%) never used contraception. PAP smear had never been performed by 62 (12.0%) patients and 126 (24.4%) received PAP smear regularly. Regarding histology, 420 (81.4%) pts presented with squamous cell carcinoma, and 66 (12.8%) with adenocarcinoma. Stages are described in the table. ECOG PS was 2 or worse in presentation for 58 (11.2%). Performing PAP smears regularly was associated with diagnosis at earlier stages (OR 1.69, 95%CI 1.15 - 2.49, P-value 0.0072).
Table: 811P
FIGO stages and screening program adherence
| Overall | Regular PAP smear | Not regular PAP smear | |
| N = 508 | N = 122 | N = 386 | |
| Stage (N, %)a | |||
| I | 32 (6.3%) | 12 (9.8%) | 20 (5.2%) |
| II | 170 (33.5%) | 48 (39.3%) | 122 (31.6%) |
| III | 247 (48.6%) | 52 (42.6%) | 195 (50.5%) |
| IV | 59 (11.6%) | 10 (8.20%) | 49 (12.7%) |
Ordinal regression, OR 1.69, 95%CI 1.15 - 2.49, P-value 0.0072.aEight patients did not have stage information so they were excluded from this table.
.Conclusions
This large study in LatAm findings showed that low rates of HPV vaccination and PAP smear coverage remain alarming, and less than half of pts received PAP smear regularly. More efficient HPV vaccination strategies synchronized with well-conducted Pap smear-based screening should be prioritized in LatAm countries.
Clinical trial identification
NCT04947605.
Editorial acknowledgement
Legal entity responsible for the study
Latin American Cooperative Oncology Group (LACOG).
Funding
AstraZeneca.
Disclosure
All authors have declared no conflicts of interest.
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