Recommended Cervical Cancer Treatment Enhances Survival in Older Patients

Receipt of recommended treatment, including surgery and radiotherapy, for early-stage cervical cancer appears to be associated with significant survival benefits in older patients, according to a study published in JAMA Network Open.¹

Among patients aged 65 to 74 years, those who had surgery were 91.2% (95% CI, 88.4%–93.4%) as likely to survive 5 years following diagnosis as individuals in the general US population, a significantly higher rate compared with those not recommended for surgery (69.6%; 95% CI, 62.8%–75.4%) and those who were recommended but did not receive surgery (52.3%; 95% CI, 24.2%–74.3%). A similar pattern followed in patients aged 75 to 85 years, in which receiving surgery was also associated with improved survival (88.6%; 95% CI, 79.8%–93.7%).

Furthermore, when adjusted for treatment- and diagnosis-related covariates, the findings show reduced cervical cancer-specific mortality risk when receiving surgery (adjusted HR [AHR], 0.28; 95% CI, 0.16–0.50) and radiotherapy (AHR, 0.48; 95% CI, 0.26–0.87) compared with refusing or not receiving recommended treatment.

These results highlight the clinical benefits of early detection, as well as personalized care strategies that account for older patients’ medical characteristics and preferences.

“These findings emphasize the need for more sophisticated decision aids for tailored treatment strategies that consider the unique needs and circumstances of older patients with cervical cancer,” said study investigators, Suk et al, in the paper.¹

What Prompted This Research?

Although the incidence of cervical cancer in the US has declined in the past 30 years,² it remains a disease of substantial public health concern, particularly among older patients who are beyond the age of routine screening. Cervical cancer screening is widely recommended for women between the ages of 21 and 65;³ older women are more likely to be diagnosed at an advanced stage, which may have ramifications on prognosis.¹

At the treatment stage, patient experiences during surgical procedures, chemotherapy, and radiation therapy may vary significantly depending on existing comorbidities and the overall health condition of older patients, which can impact treatment preferences and adherence.

“By addressing the barriers to treatment adherence and optimizing care strategies, we can improve the survival outcomes and overall management of cervical cancer in the aging population,” added the investigators.¹

What Was the Study Methodology?

This retrospective cohort study analyzed data of 2236 patients diagnosed with localized cervical cancer between 2000 and 2020, utilizing data from 17 cancer registries under the Surveillance, Epidemiology, and End Results (SEER) database. Patients were included if they were female, 65 years or older when diagnosed, and had malignant, microscopically diagnosed localized cervical cancer. They were then stratified into 3 age groups: 65 to 74 years, 75 to 84 years, and 85 years or older, comprising 66.3%, 25.3%, and 8.4% of the cohort, respectively.

Investigators estimated survival outcomes, namely 5-year relative survival rates by treatment recommendations and receipt of procedure, and related risk measures, including cumulative risk rates by treatment status and multivariable-adjusted cervical cancer mortality risk.

REFERENCES:

1. Suk R, Lin YY, Dilley S, et al. Survival by Treatment Recommendation and Receipt Among Older Patients With Early-Stage Cervical Cancer. JAMA Netw Open. 2025;8(9):e2532206-e2532206. doi:10.1001/jamanetworkopen.2025.32206

2. Cancer Stat Facts: Cervical Cancer. NIH. 2018. Accessed October 15, 2025. https://tinyurl.com/mse36zmz

3. White MC, Shoemaker ML, Benard VB. Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening. Am J Prev Med. 2017;53(3):392-395. doi:https://doi.org/