Association of Educational Levels with Survival in Indian Patients with Cancer of the Uterine Cervix

  • Krishnatreya, Manigreeva (Department of Cancer Epidemiology and Biostatistics, Dr.B Borooah Cancer Institute) ;
  • Kataki, Amal Chandra (Department of Cancer Epidemiology and Biostatistics, Dr.B Borooah Cancer Institute) ;
  • Sharma, Jagannath Dev (Department of Pathology, Dr.B Borooah Cancer Institute) ;
  • Nandy, Pintu (Department of Cancer Epidemiology and Biostatistics, Dr.B Borooah Cancer Institute) ;
  • Gogoi, Gayatri (Department of Cancer Epidemiology and Biostatistics, Dr.B Borooah Cancer Institute)
  • Published : 2015.04.29


The main objective of this paper was to assess the influence of educational level on the survival of uterine cervix cancer patients in our population. A total of 224 patients were registered in our registry, of which 178 had information on stage and different educational levels. The overall median survival (MS) was 23 months, with values of 18.5, 20.7 and 41.3 months for the illiterate, literate and qualified groups, respectively. In the illiterate patients, stage I was seen in 2.6% and stage IV in 11.8%, while in other 2 groups stage I was seen in 10% to 17% of patients at the time of diagnosis. The survival probability at around 50 months was around 42%, 30% and 26% (approximately) for qualified, literates and illiterates respectively [Log Rank (Mantel-Cox) showed p=0.023]. Emphasis on imparting education to females can be a part of comprehensive cancer control programme for improving the overall survival in patients with carcinoma of the uterine cervix in our population.


  1. Allemani C, Weir HK, Carreira H, et al (2014). Global surveillance of cancer survival 1995-2009: analysis of individual data for 25, 676, 887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet Available at (Last accessed 2014 December 6).
  2. Antic LG, Djikanovic BS, Antic DZ, Aleksopulos HG, Trajkovic GZ (2014). Differencies in the level of knowledge on cervical cancer among health care students, midwives and patients in Serbia. Asian Pac J Cancer Prev, 15, 3011-15.
  3. Arbyn M, Castellsague X, de Sanjose S, et al (2011). Worldwide burden of cervical cancer in 2008. Annal Oncol, 22, 2675-86.
  4. Bayrami R, Taghipour A, Ebrahimipour H (2014). Challenges of providing cervical cancer prevention programs in Iran:a qualitative study. Asian Pac J Cancer Prev, 15, 10071-7.
  5. Census of India 2011. Registrar General of India. (Last accessed 2014 October 6).
  6. Ferlay J, Shin HR, Bray F, et al (2014). GLOBOCAN 2012, Cancer Incidence and Mortality Worldwide. Lyon, France:International Agency for Research on Cancer. (Last accessed 2014 October 6).
  7. Gadducci A, Guerrieri ME, Greco C (2013). Tissue biomarkers as prognostic variables of cervical cancer. Crit Rec Oncol Hematol, 86, 104-29.
  8. Herndorn JE, Kornblith AB, Holland JC et al, (2008). Patient education level as a predictor of survival in lung cancer clinical trials. J Clin Oncol, 26, 4116-23.
  9. Höckel M, Hentschel B, Horn LC (2014). Association between developmental steps in the organogenesis of the uterine cervix and locoregional progression of cervical cancer: a prospective clinicopathological analysis. Lancet Oncol, 15, 445-6.
  10. Hussain SK, Lenner P, Sundquist J, et al (2008). Influence of education level on cancer survival in Sweden. Annals Oncol, 19, 156-62.
  11. Kane CJ, Lubeck DP, Knight SJ, et al (2003). Impact of patient educational level on treatment for patients with prostate cancer: data from CaPSURE. Urology, 62, 1035-9.
  12. Krusun S, Pesee M, Supakalin M, et al (2014). Treatment interruption during concurrent chemoradiotherapy of uterine cervical cancer; analysis of factors and outcomes. Asian Pac J Cancer Prev, 15, 5653-7.
  13. Milner PC, Watts M (1987). Effect of socioeconomic status on survival from cervical cancer in Sheffield. J Epidemiol Community Health, 41, 200-3.
  14. National Cancer Registry Programme (2013). Consolidated report of population based cancer registries of India 2009-2011. NCDIR;ICMR, Bangalore.
  15. Oliveira AG, Snitcovsky IM, Fregnani JH, et al (2010). Influence of socioeconomic status and education level in the prognosis of breast cancer patients. Appl Cancer Res, 30, 240-4.
  16. Razak NA, Khattak MN, Zubairi YZ, Naing NN, Zaki NM (2013). Estimating the five-year survival of cervical cancer patients treated in hospital Universiti Sains Malaysia. Asian Pac J Cancer Prev, 14, 825-8.
  17. Schrijvers CT, Mackenbach JP (1994). Cancer patient survival by socioeconomic status in seven countries: a review for six common cancer sites [corrected]. J Epidemiol Community Health, 48, 441-6.
  18. Schwartz KL, Crossley-May H, Vigneau FD, et al (2003). Race, socioeconomic status and stage at diagnosis for five common malignancies. Cancer Causes Control, 14, 761-6.
  19. Singh GK, Miller BA, Hankey BF, Edwards BK (2004). Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975-2000. Cancer, 101, 1051-7.