There is little information on breast cancer (BC) survival in Ethiopia and other parts of sub-Saharan Africa. Our study estimated cumulative probabilities of distant metastasis-free survival (MFS) in patients at Addis Ababa (AA) University Radiotherapy Center, the only public oncologic institution in Ethiopia. We analyzed 1,070 females with BC stage 1-3 seen in [2005][2006][2007][2008][2009][2010]. Patients underwent regular follow-up; estrogen receptor-positive and -unknown patients received free endocrine treatment (an independent project funded by AstraZeneca Ltd. and facilitated by the Axios Foundation). The primary endpoint was distant metastasis. Sensitivity analysis (worst-case scenario) assumed that patients with incomplete follow-up had events 3 months after the last appointment. The median age was 43.0 (20-88) years. The median tumor size was 4.96 cm [standard deviation (SD) 2.81 cm; n 5 709 information available]. Stages 1, 2 and 3 represented 4, 25 and 71%, respectively (n 5 644). Ductal carcinoma predominated (79.2%, n 5 1,070) as well as grade 2 tumors (57%, n 5 509). Median follow-up was 23.1 (0-65.6) months, during which 285 women developed metastases. MFS after 2 years was 74% (69-79%), declining to 59% (53-64%) in the worst-case scenario. Patients with early stage (1-2) showed better MFS than patients with stage 3 (85 and 66%, respectively). The 5-year MFS was 72% for stages 1 and 2 and 33% for stage 3. We present a first overview on MFS in a large cohort of female BC patients (1,070 patients) from sub-Saharan Africa. Young age and advanced stage were associated with poor outcome.

Screening rate for cervical cancer among HIV‐infected women and among women overall is low in Ethiopia despite the high burden of the disease and HIV infection, which increases cervical cancer risk. In this paper, we assessed knowledge about cervical cancer symptoms, prevention, early detection, and treatment and barriers to screening among HIV‐positive women attending community health centers for HIV‐infection management in Addis Ababa. A cross‐sectional survey of 581 HIV‐positive women aged 21–64 years old attending 14 randomly selected community health centers without cervical cancer screening service in Addis Ababa. We used univariate analysis to calculate summary statistics for each variable considered in the analysis, binary logistic regression analysis to measure the degree of association between dependent and independent variables, and multiple regressions for covariate adjusted associations. Statistical significance for all tests was set at P < 0.05. We used thematic analysis to describe the qualitative data. Of the 581 women enrolled in the study with mean age 34.9 ± 7.7 years, 57.8% of participants had heard of cervical cancer and 23.4% were knowledgeable about the symptoms, prevention, early detection, and treatment of the disease. In multivariate analysis, higher educational attainment and employment were significantly associated with good knowledge about cervical cancer. In addition, only 10.8% of the participants ever had screening and 17% ever received recommendation for it. However, 86.2% of them were willing to be screened if free of cost. Knowledge about cervical cancer is poor and cervical cancer screening rate and provider recommendation are low among HIV‐positive women attending community health centers for management and follow‐up of their disease in Addis Ababa. These findings underscore the need to scale up health education about cervical cancer prevention and early detection among HIV‐positive women as well as among primary healthcare providers in the city.

Background: Cervical cancer is the second commonest cancer among women living in less developed countries. Women infected with the Human Immunodeficiency Virus (HIV) are at increased risk. However cervical cancer screening for HIV infected women has been started in limited centers in Addis Ababa, data on the uptake of this service are lacking. Therefore, this study aimed to assess the level and predictors of cervical cancer screening uptake among HIV positive women in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted using a structured questionnaire on 411 HIV infected

Breast cancer is the leading cancer diagnosis and second most common cause of cancer deaths in sub‐Saharan Africa (SSA). Yet, there are few population‐level survival data from Africa and none on the survival differences by stage at diagnosis. Here, we estimate breast cancer survival within SSA by area, stage and country‐level human development index (HDI). We obtained data on a random sample of 2,588 breast cancer incident cases, diagnosed in 2008–2015 from 14 population‐based cancer registries in 12 countries (Benin, Cote d'Ivoire, Ethiopia, Kenya, Mali, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Uganda and Zimbabwe) through the African Cancer Registry Network. Of these, 2,311 were included for survival analyses. The 1‐, 3‐ and 5‐year observed and relative survival (RS) were estimated by registry, stage and country‐level HDI. We equally estimated the excess hazards adjusting for potential confounders. Among patients with known stage, 64.9% were diagnosed in late stages, with 18.4% being metastatic at diagnosis. The RS varied by registry, ranging from 21.6%(8.2–39.8) at Year 3 in Bulawayo to 84.5% (70.6–93.5) in Namibia. Patients diagnosed at early stages had a 3‐year RS of 78% (71.6–83.3) in contrast to 40.3% (34.9–45.7) at advanced stages (III and IV). The overall RS at Year 1 was 86.1% (84.4–87.6), 65.8% (63.5–68.1) at Year 3 and 59.0% (56.3–61.6) at Year 5. Age at diagnosis was not independently associated with increased mortality risk after adjusting for the effect of stage and country‐level HDI. In conclusion, downstaging breast cancer at diagnosis and improving access to quality care could be pivotal in improving breast cancer survival outcomes in Africa.

Background. Almost 500,000 women are newly diagnosed with cervical cancer (CC) every year, the majority from developing countries. There is little information on the survival of these patients. Our primary objective was to evaluate consecutive CC patients presenting over 4 years at the only radiotherapy center in Ethiopia. Methods. All patients with CC from September 2008 to September 2012 who received radiotherapy and/or surgery were included (without brachytherapy). Vital status was obtained through telephone contact or patient cards. Results. Of 2,300 CC patients, 1,059 patients with standardized treatment were included. At the end of the study, 249 patients had died; surviving patients had a median follow‐up of 16.5 months; the 10% and 90% percentiles were 3.0 and 32.7 months, respectively. Mean age was 49 years (21–91 years). The majority of patients presented with International Federation of Gynecology and Obstetrics stage IIb–IIIa (46.7%). Because of progression during the waiting time (median 3.8 months), this proportion declined to 19.3% at the beginning of radiotherapy. The 1‐ and 2‐year overall survival probabilities were 90.4% and 73.6%. If assuming a worst‐case scenario (i.e., if all patients not available for follow‐up after 6 months had died), the 2‐year survival probability would be 45.4%. Conclusion. This study gives a thorough 4‐year overview of treated patients with CC in Ethiopia. Given the limited treatment availability, a relatively high proportion of patients survived 2 years. More prevention and early detection at all levels of the health care system are needed. Increasing the capacity for external‐beam radiation as well as options for brachytherapy would facilitate treatment with curative intention.