Israel Medical Association Journal

Background: Differences in socioeconomic status and ethnicity are linked to disparities in health outcomes, which can affect how consistently patients treat abnormal screening results and cause minority groups to be diagnosed at more advanced stages of disease.

Objective: To compare epidemiological and clinical parameters between Jewish and Arab women who were diagnosed with cervical cancer at Ziv Medical Center during a 10-year period.

Methods: We conducted a retrospective study of consecutive women diagnosed with cervical cancer at a single institution between 2014 and 2024.

Results: Overall, 83 women diagnosed with cervical cancer in the last 10 years at Ziv Medical Center were included in the study: 53 Jewish (64.6%), 30 Arab (36.2%). The groups were similar in mean age at diagnosis, body mass index, smoking status, Pap history performance prior to the diagnosis, menopause status at diagnosis, stage at diagnosis, and treatment. Arab women had higher parity (< 0.001). According to the results of our study, the percentage of cervical cancer patients undergoing Pap screening, prior to diagnosis from the Arab and Jewish sectors, were 16.7% and 17%, respectively, compared to the national screening rate of 54%. Most of the women were diagnosed at an advanced stage (≥ IIB): 83.3% and 69.8%, respectively, compared to 25% in developed countries.

Conclusions: Jewish and Arab women diagnosed with cervical cancer in northern Israel do not differ in epidemiological and clinical parameters, including age at diagnosis and stage. These findings may be attributed to the low performance rate of Pap screening tests in both groups.

Background: Uterine sarcoma constitutes a highly malignant group of uterine tumors. It accounts for 2–6% of uterine malignancies and its incidence is 1.7 in 100,000 women. The three most common variants of uterine sarcoma are endometrial stromal sarcoma, leiomyosarcoma and carcinosarcoma. Based on relatively small case series, the literature provides little information on the risk factors, the natural course of the disease and the preferred treatment.

Objectives: To evaluate uterine sarcoma patients treated in a tertiary referral center in Israel over a 20 year period (1980–2005).

Methods: We conducted a retrospective review of the charts of 40 uterine sarcoma patients, including their tumor characteristics, stage at diagnosis, treatment modalities, follow-up and survival.

Results: The patients’ mean age was 53 years (range 32–76); 30% of the patients had carcinosarcoma, 55% had leiomyosarcoma and 15% had ESS[1]. Half of the patients presented with stage I disease, 23% stage II, 10% stage III and 15% stage IV. Thirty-nine patients were treated by surgery. Adjuvant radiotherapy was administered to 39% of the patients, adjuvant chemotherapy to 21% and combined radiotherapy and chemotherapy to 9%. The mean follow-up period was 44 months, at which time disease had recurred in 44% of the patients. The disease stage was correlated with the 5-year survival rate, which was 73.1% for stages I-II and 22.2% for stages III- IV.

Conclusions: In accordance with other larger studies our data show that the only prognostic factor that was significantly correlated with prognosis was the stage of the disease at diagnosis. Despite advances in diagnosis and treatment, survival has not improved over the last 25 years.