Determining the Survival Rate of Colorectal Cancer in Iran: A Systematic Review and Meta-Analysis

Tahmasbi, Bahram; Abedi, Ghasem; Moosazadeh, Mahmood; Janbabai, Ghasem; Farshidi, Fereshteh; Mansori, Kamyar; Moradi, Yousef; Shadmani, Fatemeh Khosravi; Parang, Serveh; Khazaei, Zaher

doi:10.31557/apjcp.2018.19.11.3009

Cited by 16 publications

(19 citation statements)

References 49 publications

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“…On the other hand, the discrepancy could also be due to the difference in participants, in which we assessed patients in the cancer registry whereas the study by Atinafu and his colleagues enrolled patients who were being treated in the clinical setting. Overall rate of survival in our study is also worse than the rate reported from Asian LMICs [26,27,28,29], but better than that of Uganda [30] and Ghana [31], which reported 8.3% and 16.0% 5-year survival respectively. The discrepancy in survival might be mainly due to the variation in the availability of screening facilities and initiation of early treatment.…”

Section: Discussioncontrasting

confidence: 85%

Histological characteristics, survival pattern and prognostic determinants among colorectal cancer patients in Ethiopia: A retrospective cohort study

Teka

Yesuf

Hussien

et al. 2021

Heliyon

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Background: The incidence of colorectal cancer (CRC) and associated mortality are rising in low-and middleincome countries. In Ethiopia, colorectal cancer is among the leading causes of cancer morbidity and mortality in both sexes. Although some studies provided estimations on the national burden and regional distribution, the histological characteristics, survival pattern and determinants among colorectal cancer patients are not welldocumented.Aim: This study aimed to describe the histological characteristics, to determine the patterns of survival, and identify factors that determine mortality rate among CRC patients in Ethiopia. Methods: A retrospective cohort study was conducted among CRC patients registered at cancer treatment center of Tikur Anbessa Specialized Hospital, from January 2012 to December 2016. Data were extracted from a total of 161 patient medical records using a pretested abstraction form and supplemented by phone calls with the patients/caregivers. To determine colorectal cancer specific survival overtime, we performed a Kaplan-Meier survival analysis and significance of variation in survival across covariates and treatment categories was tested using log-rank test. A multivariable Cox proportional-hazards model was performed to identify determinants of survival after diagnosis with colorectal cancer. Results: Overall, the median survival time was 21 months [95%CI: 16-35], with two-, three-and five-year CRCspecific survival rates of 46.8%, 39.5% and 28.7% respectively. In the multivariable Cox regression model, the rate of death due to CRC is significantly higher for patients with elevated baseline carcinoembryonic antigen (CEA) level (Adjusted Hazard Ratio (AHR) ¼ 2.31, 95%CI: 1.27-4.19), stage IV at diagnosis (AHR ¼ 2.66, 95%CI: 1.44-4.91), and mucinous or signet-ring cell carcinoma histology type (AHR ¼ 4.92,). Moreover, patients who underwent surgery showed a better survival than those who did not (AHR ¼ 0.35, 95%CI: 0.14-0.88). Conclusion:In Ethiopia, patients diagnosed with CRC showed a low rate of cancer-specific survival. Histology type, stage of cancer and CEA level at diagnosis, and the type of treatment a patient received significantly determine mortality rate. Hence, cancer screening programs could help to detect the disease at an earlier stage and to initiate available treatments timely so as to extend the lifespan of CRC patients.

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Section: Discussioncontrasting

confidence: 85%

Histological characteristics, survival pattern and prognostic determinants among colorectal cancer patients in Ethiopia: A retrospective cohort study

Teka

Yesuf

Hussien

et al. 2021

Heliyon

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“…(29) Also during a systematic review of 28 studies from different parts of Iran, 12 studies revealed an association between age and CRC prognosis, in that about 12% of these patients were younger than 40 years. (11) However in another group of studies age was not reported as an important prognostic factor. (30,31) It has been elucidated that age at diagnosis has no impact on colorectal cancer specific survival rates, but has an impact on deaths due to other causes and on hazard ratio of age at first diagnosis of colorectal cancer.…”

Section: Discussionmentioning

confidence: 95%

“…On the other hand, multivariate model analysis revealed a significant improvement in the prognosis of CRC patients during the study period. (9)(10)(11) Since CRC has a high incidence and cancer-related mortality in Iran and East Azerbaijan province, it is necessary to have an epidemiological study of the incidence, sex, age distribution and morphological types of colorectal cancer. The aim of the present study was to determine the most recent epidemiological profile of colorectal cancer along with 1-to 5year colorectal cancer specific survival in East Azerbaijan, Northwest Iran.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological aspects of colorectal cancer in East Azerbaijan, Northwest Iran: five year survival analysis

et al. 2021

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BackgroundColorectal cancer (CRC) is the third most common cancer and the second leading cause of death from cancer in the world. Currently, CRC is the fourth most common cancer in men and the second common cancer in women of all ages in Iran. The aim of this study was to determine the epidemiologic profile of CRC along with CRC specific survival analysis. MethodsThis was an analytical cross-sectional study using the East Azerbaijan Population Based Cancer Registry database (EA-PBCR) as a source for data related to patients with a diagnosis of CRC. Colorectal cancer specific 1- to 5-year survival analysis and mortality rates were calculated. Log-rank test and Cox regression analysis was performed to test the equality of survival function and mortality hazard. ResultsA total of 2,366 newly diagnosed CRCs were registered during 3 years, with a male: female ratio of 1.31. Overall survival rate was 49.8%. One- to 5-year survival rates were 96.21%, 56.94%, 48.62%, 47.88% and 46.76% respectively. At multivariate level, after adjusting for all variables, regression analysis showed that the hazard of mortality in stage IV cancers was 46.44 times higher than that in stage I cancers (HR=46.44, 95% CI: 14.86-145.14, p=0.000). However, differences in patients’ age group and sex and the subsite of cancer did not create any statistically significant variation between groups in regards to mortality hazards (p>0.05). ConclusionThis study demonstrated that the stage and grade of CRC were important prognostic factors and that early screening and diagnosis of CRC were essential.

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“… 81 , 82 Among other effective factors that can influence the survival rate in patients is smoking and consuming alcohol. 83 Phips and Newcomb in 2011 stated that smoking significantly reduced the survival rate of patients with CRC. 84 To add, the cohort study done by Kangwha cohort study in South Korea stated that the chances of death in CRC patients were about 5 times more than non-alcoholic patients.…”

Section: Discussionmentioning

confidence: 99%

Survival Rate of Colorectal Cancer in Eastern Mediterranean Region Countries: A Systematic Review and Meta-Analysis

et al. 2020

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Colorectal cancer (CRC) is the second most common cause of cancer-related deaths worldwide. Survival rates are among the most important factors in quality control and assessment of treatment protocols. This study was aimed to assess the survival rate of colorectal cancer in Eastern Mediterranean Region Countries. In the present study we comprehensively searched 6 international databases including PubMed/Medline, ProQuest, Scopus, Embase, Web of Knowledge and Google Scholar for published articles until November 2018. The Newcastle-Ottawa Quality Assessment Form for Cohort Studies was applied to evaluate the quality of included studies. The heterogeneity of papers was assessed with the Cochran Test and I-Square statistics. Meta-regression test was performed based on publication year, sample size and Human Development Index (HDI) of each study. Among the total of 1023 titles found in the systematic search, 43 studies were eligible to be included in the present meta-analysis. According to the results, the 1-year, 3-year and 5-year survival rate of patients with Colorectal Cancer was 88.07% (95% CI, 83.22-92.92), 70.67% (95% CI, 66.40-74.93) and, 57.26% (95% CI, 50.43-64.10); respectively. Furthermore, Meta-regressions did not show significant correlations between survival rate and year, sample size or Human Development Index. Survival rates, especially the 5-year survival rate in the EMRO were less than European countries and the USA. Documented and comprehensive evidence-based findings of the present meta-analysis can be used to enhance policies and outcomes of different medical areas including prophylaxis, treatment and health related objectives in colorectal cancer.

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Determining the Survival Rate of Colorectal Cancer in Iran: A Systematic Review and Meta-Analysis

Cited by 16 publications

References 49 publications

Histological characteristics, survival pattern and prognostic determinants among colorectal cancer patients in Ethiopia: A retrospective cohort study

Histological characteristics, survival pattern and prognostic determinants among colorectal cancer patients in Ethiopia: A retrospective cohort study

Epidemiological aspects of colorectal cancer in East Azerbaijan, Northwest Iran: five year survival analysis

Survival Rate of Colorectal Cancer in Eastern Mediterranean Region Countries: A Systematic Review and Meta-Analysis

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