Cervical Cancer in Ethiopia: The Effect of Adherence to Radiotherapy on Survival

Moelle, Ulrike; Assefa, Mathewos; Abreha, Aynalem; Wondemagegnehu, Tigeneh; Bekuretsion, Yonas; Begoihn, Matthias; Addissie, Adamu; Unverzagt, Susanne; Jemal, Ahmedin; Thomssen, Christoph; Vordermark, Dirk; Kantelhardt, Eva Johanna

doi:10.1634/theoncologist.2017-0271

Cited by 32 publications

(37 citation statements)

References 38 publications

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“…The current result is in agreement with study conducted on the effect of adherence of radiation therapy for one-year survival in Ethiopia which was 96% for radical therapy and 87% for those who took none radical radiation therapy [21]. This may be due to the similarity of study setting, treatment modalities and roughly the same sample sizes of study participants.…”

Section: Discussionsupporting

confidence: 91%

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

et al. 2019

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BackgroundCervical cancer is a cancer of uterine cervix caused mostly by sexually-acquired infection called Human papillomavirus (HPV. In developing region of the globe, fewer than 50% of women with cervical malignancy survive more than 5 years. Therefore, the objective of this study was to assess survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Ethiopia.MethodsFacility based retrospective cohort study was conducted from March to April 2019 at Tikur Anbesa Specialized Hospital oncology center. Data was collected from patient’s chart using pre-tested and structured checklist prepared in English and analyzed using STATA14.2. Cox regression model was used to identify Variables that affected survival.ResultThe overall survival rate was 38.62% at 5 years. There were a significance differences in survival experience between categories of stage of cervical cancer, age of patients, comorbidity, substance use, base line anemia and treatment modalities. Being stage IV [AHR = 11.76; 95% CI (4.02–34.4)],being advanced age [AHR = 5.99; 95% CI (2.1–17.08)], being comorbid [AHR = 1.58; 95%CI(1.14–2.19)], using substance [AHR = 1.56;95% CI(1.09–2.22)] and being anemic [AHR = 1.6;95% CI(1.11–2.36)] increased the risk of death.ConclusionThe overall survival rate was lower than high- and middle-income countries and Significant factors of death after diagnosis of cervical cancer were; advanced FIGO stage, base line anemia, comorbidity, substance use, advanced age and treatment modality. Authors recommend that it is better to expand cervical cancer early screening programs and treatment facilities, strengthen awareness in collaboration with public medias about cervical cancer prevention, screening and treatment options.

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Section: Discussionsupporting

confidence: 91%

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

et al. 2019

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“…27 To our knowledge, there are no other published reported rates of acute RT toxicity in head and neck cancer in sub-Saharan Africa. Moelle et al 28 reported grade 3 early toxicity in 5% of patients with cervical cancer who received curative RT in the same center in Ethiopia, which was a considerably higher rate than in this study. This is at least partially a result of the addition of brachytherapy during our study period, which alleviates the need for an external-beam boost, causing higher toxicity to the surrounding tissue.…”

Section: Discussioncontrasting

confidence: 66%

Patterns of Care of Cancers and Radiotherapy in Ethiopia

Rick

Habtamu

Tigeneh

et al. 2019

JGO

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PURPOSE Radiotherapy (RT) is an essential component of cancer treatment. There is a lack of RT services in sub-Saharan Africa as well as limited knowledge regarding clinical practices. The purpose of this study was to identify and describe the patterns for RT treatment in Ethiopia. METHODS AND MATERIALS We performed a retrospective analysis of 1,823 patients treated with cobalt RT at a large referral hospital in Addis Ababa, Ethiopia, from May 2015 through January 2018. Paper charts were reviewed for patient and treatment characteristics. Descriptive statistics were computed using SPSS (IBM, Armonk, NY). RESULTS Among patients treated for cancer, 98% (n = 1,784) were adults, 78% (n = 1,426) were female, 5% (n = 85) were HIV positive, 30% (n = 555) were from Addis Ababa, and the median age was 48 years (interquartile range [IQR], 38-58 years). Cervical cancer was the most frequent cancer treated (47%, n = 851), followed by breast cancer (15%, n = 274) and head and neck cancer (10%, n = 184). Seventy-three percent of patients (n = 1,339) presented at a late stage, and 62% (n = 1,138) received palliative RT. The wait times were the shortest for patients receiving palliative treatment (median, 0 days; IQR, 0-15 days; n = 1,138), whereas wait times were longer for patients receiving curative treatment (median, 150 days; IQR, 60-210 days; n = 685). Three percent of patients (n = 56) had documented grade 3 or 4 acute toxicity; of these, 59% (n = 33) were patients with head and neck cancer. CONCLUSION Cervical cancer accounted for half of patients treated; thus, a majority of patients were adult females. Most patients had advanced-stage cancer, and goals of care were palliative. Wait times were long for patients with curative-intent cancer as a result of low capacity for RT services.

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“…We conducted a retrospective cohort study among cervical cancer patients who registered at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia between September 2008 and September 2012 as described earlier [6, 14, 15]. TASH is the largest hospital in Ethiopia and the only hospital in the country currently offering radiotherapy – thus, people from all parts of the country were referred there for therapy.…”

Section: Methodsmentioning

confidence: 99%

Cervical cancer in Ethiopia – predictors of advanced stage and prolonged time to diagnosis

Begoihn

Assefa

Abreha

et al. 2019

Infect Agents Cancer

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IntroductionIn Ethiopia, most cervical cancer patients present at advanced cancer stages, long time after they experience first symptoms. We investigated possible predictors of long time spans between symptom onset and pathologic diagnosis (patient intervals). We also aimed to seek out predictors for advanced cancer stage diagnosis.MethodsWe conducted a retrospective cohort study among 1575 cervical cancer patients who were registered at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia between September 2008 and September 2012. Cox proportional hazards regression was used to find predictors of long patient intervals. Cumulative odds ordinal logistic regression was used to identify predictors of cancer stage at diagnosis.ResultsMedian patient interval was 30 weeks, with the interval substantially longer in patients residing in rural than urban areas. Longer patient intervals were associated with more advanced cancer stages at pathologic diagnosis. HIV-positive women had an almost 1.5 times increased risk of diagnosis at a more advanced stage.ConclusionCervical cancer patients are diagnosed after long time periods leading to advanced stages at diagnosis. Measures to raise awareness about cervical cancer, to increase screening and to shorten the time interval from recognition of symptoms to diagnosis are urgently needed.

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Cervical Cancer in Ethiopia: The Effect of Adherence to Radiotherapy on Survival

Cited by 32 publications

References 38 publications

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

Patterns of Care of Cancers and Radiotherapy in Ethiopia

Cervical cancer in Ethiopia – predictors of advanced stage and prolonged time to diagnosis

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