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Survival and socioeconomic factors in patients with cervical cancer undergoing palliative care: a retrospective cohort study

Year: 2026

Type: article

Abstract: Introduction Social determinants of health influence outcomes in cervical cancer. This study aimed to characterize the socioeconomic factors affecting survival in patients with cervical cancer receiving palliative care. Material and methods We conducted a retrospective cohort study of 368 women who attended social work services at an oncology hospital in Quito, Ecuador, between 2017 and 2021. Descriptive statistics, bivariate analysis, Kaplan-Meier survival curves, and Cox regression models were applied. Results The median age was 52.5 years (IQR 45–65), with 46.5% identifying as mestizo and 46.5% as indigenous. Most patients (80.4%) had incomes below the basic salary, and the proportion of married individuals declined from 53.3% to 38.9% upon transition to palliative care. The average stay in palliative care was 46 days. Tertiary education was associated with a higher mortality risk (adjusted HR: 3.16; 95% CI: 1.51–6.60; p = 0.002). In contrast, having children was linked to lower mortality risk (one child: HR 0.56; 95% CI: 0.31–0.99; p = 0.046; two or more children: HR 0.47; 95% CI: 0.27–0.82). Patients with middle income had reduced mortality risk (HR: 0.71; 95% CI: 0.53–0.97; p = 0.032). No significant differences in survival were observed based on ethnicity or province of residence. Conclusion Survival among cervical cancer patients in palliative care is short. Socioeconomic factors—particularly education, income, and family structure—significantly influence mortality. Integrating social support into cancer care is essential to improve health outcomes and equity in this population.

Source: Frontiers in Cancer Control and Society

DOI: 10.3389/fcacs.2025.1656863

Authors: Carmen Jessenia Apolo, Sara Valeria Almeida, María Fernanda García, Yunqi Yu, Harold A. Alexander-León

Institutions: SOLCA Núcleo de Quito, Central University of Ecuador, Universidad Peruana Cayetano Heredia, Universidad Indoamérica

Language: English

Topic: Palliative and Oncologic Care

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities, No poverty

Open Access status: gold

Estimated APC paid: $2,353