This epidemiological survey was undertaken to estimate the burden of hospitalization related to cervical cancer in Spain during a five year period (2009-2013).
Retrospective survey by reviewing data of the National Surveillance System for Hospital Data (Conjunto Mínimo Básico de Datos), including more than 98% of Spanish hospitals. All hospitalizations related to malignant neoplasm of cervix uteri or carcinoma in situ of cervix uteri, reported during 2009-2013 period, were analysed. Codes for cervical cancer and carcinoma in situ were selected by using the 9th International Classification of Diseases: ICD-9-CM 180, 180.0, 180.1, 180.8, 180.9 y 233.1. The annual incidence of hospitalization, average length of hospitalization and in-hospital case-fatality rate were calculated using municipal register data.
A total of 30,749 hospital discharges for cervical cancer were reported during the study period. Of those, 10,460 were coded as carcinoma in situ (CIS), corresponding to 9,389 women (1,1 hospitalizations per woman) and 20,527 were coded as malignant neoplasm (MN), corresponding to 11,864 women, (1,7 hospitalizations per woman). CIS was coded as main cause of hospitalization in the 86,30% of the registers (9,022), versus only 40,38% of the MN (12,416). The cause of hospitalization for the remaining 60% of the patients was related to the MN- i.e. chemotherapy, haemorrhages-. Mean age of hospitalization was 42,14 years old (SD=12,13) in CIS and 54,76 years old (SD=14,86) in MN and significantly increased in the study period. Average length of hospitalization was 3,07 (SD 4,21) and 7,85 (SD 10,33) days, for CIS and MN respectively.
The annual incidence of hospitalizations was 8,96 per 100,000 (CI95%: 8,79-9,13) for CIS and 17,57 per 100,000 (CI95%: 17,33-17,81) for MN, reaching the maximum rate -17,98 per 100,000 (CI95%: 17,49-18,47)- in the 30-44 year old group in CIS and 33,40 per 100,000 (CI95%: 32,66-34,15) in the 45-59 year old group in MN.
In-hospital case-fatality rate was 0,22% (CI95%: 0,13-0,31) for CIS and 7,95% (CI95%: 7,58-8,32) for MN.
Almost all the hospitalizations had at least one procedure associated. Most frequent procedures were conization, cauterization, salpingoophorectomy, hysterectomy, radiotherapy and blood transfusions.
Hospitalizations related to cervical cancer pose a significant health threat in Spain with an important number of medical and surgical procedures and an important re-admission rate.