Short-term Survival Prognosis and Multivariate Analysis of Cervical Cancer in American Women: A NHANES Cohort Study

Abstract Objective To compare the 1-year all-cause and cause-specific short-term survival disparities between female patients diagnosed with cervical cancer and those with other malignant tumors. Methods Female participants enrolled in NHANES 1999–2018 were linked to 1-year mortality follow-up data from the National Death Index (NDI). Subjects were stratified into a cervical cancer group and another malignancy group according to cancer diagnosis. Baseline data including demographic characteristics, lifestyle behaviors and comorbid chronic diseases were collected, with multiple 1-year mortality endpoints designated as study outcomes. Weighted Kaplan-Meier survival curves combined with the Log-rank test were applied to compare intergroup survival profiles. Stepwise adjusted multivariate Cox regression models were constructed to explore mortality-related risk factors. Results A total of 2727 female patients with malignant neoplasms were enrolled in the final analysis, including 339 patients with cervical cancer (12.4%) and 2388 patients with other malignancies (87.6%). Weighted baseline comparisons revealed statistically significant intergroup differences with respect to age, race/ethnicity, socioeconomic status, educational attainment, smoking status and the distribution of chronic comorbidities (all P<0.05). One-year follow-up analyses demonstrated that weighted mortality rates for all predefined endpoints were significantly lower in the cervical cancer group relative to the group with other malignancies (all P<0.05), and the Log-rank test confirmed a statistically significant divergence in survival curves between the two cohorts (P < 0.001). Fully adjusted Cox regression models identified advanced age, non-Hispanic Black ethnicity, widowed marital status, active smoking, type 2 diabetes mellitus, and chronic obstructive pulmonary disease (COPD) as independent risk factors for 1-year mortality among patients with cervical cancer. Elevated household income, higher body mass index (BMI), and medical histories of angina pectoris and hyperlipidemia were found to exert protective effects against mortality, whereas no remaining variables exhibited independent prognostic predictive capacity. Conclusions In this nationally representative female cohort in the United States, women with cervical cancer had superior 1-year overall and cause-specific survival versus those with other malignancies. Age, race, marital status, smoking, metabolic and respiratory comorbidities independently predicted short-term mortality. Standardized cervical cancer screening, smoking cessation, integrated management of glycolipid and cardiopulmonary chronic diseases, and stratified follow-up are warranted for high-risk individuals to reduce short-term mortality.