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

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.