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Poster session 11

811P - Epidemiological landscape of cervical cancer in Latin America: EVITA LATAM (LACOG 0820)

Date

21 Oct 2023

Session

Poster session 11

Topics

Tumour Site

Cervical Cancer

Presenters

Graziela Zibetti Dal Molin

Citation

Annals of Oncology (2023) 34 (suppl_2): S507-S542. 10.1016/S0923-7534(23)01937-3

Authors

G. Zibetti Dal Molin1, A. dos Santos2, M. Olivera3, R. Ribeiro4, J.J. Zarba5, A.P. Guerrero6, A.M. Reyes Morales7, A.C. de Melo2, G. Werutsky8, H. de Andrade Carvalho2, E.H.C. Silva9, R.L. Schmidt10, M. Acevedo Zarzar de Melo11, F.B. Damian12, M.G. Raimondo13, A. Mattar14, R. de Jesus15, G.C.D.L. Gossling8, R. Colombo Bonadio16

Author affiliations

  • 1 Oncology, Beneficencia Portuguesa de Sao Paulo, 01323-001 - Sao Paulo/BR
  • 2 Clinical Research, INCA - Instituto Nacional de Cancer, 20230-240 - Rio de Janeiro/BR
  • 3 Medical Oncology, INEN - Instituto Nacional de Enfermedades Neoplasicas, 15038 - Lima/PE
  • 4 Oncology, Hospital Erasto Gaertner, 81520-060 - Curitiba/BR
  • 5 Oncology Dept., Centro Médico San Roque SRL, 4000 - San Miguel De Tucuman/AR
  • 6 Knowledge Management Department, INCART - Instituto Nacional de Cáncer Rosa E. Sánchez Pérez de Tavares, 101103 - Santo Domingo/DO
  • 7 Oncology, CELAN, Guatemala City/GT
  • 8 Medical Oncology, Latin American Cooperative Oncology Group (LACOG), 90619-900 - Porto Alegre/BR
  • 9 Clinical Research, CRIO - Centro Regional Integrado de Oncologia, 60335-480 - Fortaleza/BR
  • 10 Oncology, Hospital de Amor (Hospital De Cancer De Barretos) - Fundacao Pio XII, 14784-400 - Barretos/BR
  • 11 Clinical Research, ICESP - Instituto do Cancer do Estado de Sao Paulo, 01246-000 - Sao Paulo/BR
  • 12 Clinical Research, CPO - Hospital São Lucas da PUCRS, Porto Alegre/BR
  • 13 Oncology, Sanatorio De La Mujer, S2000 - Rosario/AR
  • 14 Oncology, Hospital Pérola Byington, Sao Paulo/BR
  • 15 Statistics, Latin American Cooperative Oncology Group, 90619-900 - Porto Alegre/BR
  • 16 Medical Oncology Department, ICESP - Instituto do Cancer do Estado de Sao Paulo, 01246-000 - Sao Paulo/BR

Resources

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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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