Survival analysis of women breast cancer patients in Northwest Amhara, Ethiopia

Feleke, Bereket; Tesfaw, Lijalem Melie; Mitku, Aweke A.

doi:10.3389/fonc.2022.1041245

Cited by 4 publications

(1 citation statement)

References 43 publications

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“…Previous, studies also stated that when cancer has metastasized, the patient's chance of survival is reduced [21]. This investigation will serve as for policymakers to convey better management of Breast Cancer patients.…”

Section: Model Comparisonmentioning

confidence: 78%

Time-to-death predictors on breast cancer patients in northern Ethiopia: a retrospective cross-sectional study

Hagos

Gebrerufael

2023

Preprint

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Background Breast cancer (BC) remains still is a community public health problem of world widely in both developed and under-developed countries. It is the greatest frequently happening cancer among women in sub-Saharan African countries, especially in Ethiopia. In spite of the overburden of difficulty, the predictors associated with mortality are not yet determined in Ethiopia. Besides, studies related to this area are sparse. Therefore, the main objective of this investigation was to determine the major significant predictors which influenced to shortened survival time of BC patients in Northern Ethiopia. Methods An institutional-based retrospective cross-sectional study design was conducted from September 12, 2015, to March 9, 2019, among 146 women who had BC in Northern Ethiopia. The statistical analysis was done by using STATA version 14 software. Kaplan-Meier curve for survival experience and a Log-normal regression model for predictor identification were applied. Results The overall prevalence of experiencing death rate was 18.5% in Northern Ethiopia. The selected patients were followed retrospectively for an overall estimated mean follow-up time of 28.12 months. The age range of patients was 23–78 years with a median of 48 years. The multivariable Log-normal model analysis revealed, being distant metastatic [ATR = 0.52, CI= (0.341, 0.787)], regional metastatic [ATR = 0.63, (0.423, 0.924)], Age [(ATR = 0.98, 95% CI: (0.968–0.997)], Baseline tumor size [(ATR = 0.98, 95% CI: (0.968, 0.996)], Clinical Stage IV [ATR = 0.48, 95% CI: (0.297–0.789)], illiterate [ATR = 0.52, 95% CI: (0.325–0.823)], and urban residence [ATR = 0.68, 95% CI: (0.516–0.904 )] were found to be critical risk factors of time to death breast cancer patients. Conclusion In conclusion, the findings showed that the prevalence death rate among BC patients in Northern Ethiopia still remains a critical public health problem. Being clinical stage IV, distant and regional metastasis, illiteracy education level, baseline tumor cell level, residence, and old Age were found to be the most important risk predictors for the time to death of patients. Therefore, the government and other stakeholders need to address educational opportunities; creating awareness about the diagnosis of late-stage disease and valuable counseling of screening programs on time would reduce the death rate and lengthen the survival time of patients.

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Section: Model Comparisonmentioning

confidence: 78%

Time-to-death predictors on breast cancer patients in northern Ethiopia: a retrospective cross-sectional study

Hagos

Gebrerufael

2023

Preprint

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Modelling of the time to death of breast cancer patients at Hiwot Fana Specialized University Hospital

Tasfa,

Takele,

Wesenu

2024

Sci Rep

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Breast cancer is the most common cause of cancer death and is a frequently diagnosed cancer among women worldwide. It is becoming a challenging health condition in Ethiopia with a high rate of morbidity and mortality. The main aim of this study was to model the time to death in breast cancer patients at Hiwot Fana Specialized University Hospital. A retrospective cohort study was carried out from April 1st, 2020, to April 1st, 2023, and 296 women were included in the study. We used nonparametric methods and Bayesian accelerated failure time models (with Laplace approximation) to identify risk factors and choose a model fitting breast cancer patient data. Model comparison was performed using the marginal likelihood, deviance information criterion and Watanabe Akaike information criterion. From the total of 296 patients in the study, 56 (18.9%) died. The estimated median survival time was 33 months. The log-rank test showed that age group, stage, alcohol consumption, smoking habit, and comorbidity were potential risk factors associated with the time to death in breast cancer patients at the 5% level of significance. The Bayesian Weibull accelerated failure time model was found to be the best fitted model for predicting the survival time of patients with minimum DIC (520.39) and WAIC (521.59) values. The final Bayesian Weibull AFT model with the integrated nested Laplace approximation estimation technique revealed that age group, stage, alcohol consumption, smoking habit, and comorbidity were significantly associated with the time to death in breast cancer patients. Individuals older than 65 years, with stage IV disease, drinking alcohol, smoking cigarettes and having comorbidities had shortened survival times in patients with breast cancer. Hence, Hiwot Fana Specialized University Hospital and related bodies should work on awareness creation to reduce smoking habits and alcohol use as well as give due attention to elderly and stage IV breast cancer patients during intervention.

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Late-stage diagnosis: The driving force behind high breast cancer mortality in Ethiopia: A systematic review and meta-analysis

Geremew,

Golla,

Simegn

et al. 2024

PLoS ONE

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Introduction Breast cancer continues to be the most common malignancy and the leading cause of cancer-related deaths in Ethiopia. The poor prognosis and high mortality rate of breast cancer patients in the country are largely caused by late-stage diagnosis. Hence, understanding the epidemiology of late-stage diagnosis is essential to address this important problem. However, previous reports in Ethiopia indicated inconsistent findings. Therefore, this literature review was conducted to generate dependable evidence by summarizing the prevalence and determinants of late-stage diagnosis among breast cancer patients in Ethiopia. Methods Pertinent articles were retrieved by systematically searching on major electronic databases and gray literature. Data were extracted into an Excel spreadsheet and analyzed using the STATA 17 statistical software. The pooled estimates were summarized using the random effect meta-analysis model. Heterogeneity and small study effect were evaluated using the I2 statistics and Egger’s regression test in conjunction with the funnel plot, respectively. Meta-regression, sub-group analysis, and sensitivity analysis were also employed. Protocol registration number: CRD42024496237. Results The pooled prevalence of late-stage diagnosis after combining reports of 24 studies with 8,677 participants was 65.85 (95% CI: 58.38, 73.32). Residence (adjusted OR: 1.92; 95% CI: 1.45, 2.53), patient delay at their first presentation (adjusted OR: 2.65; 95% CI: 1.56, 4.49), traditional medicine use (adjusted OR: 2.54; 95% CI: 1.89, 3.41), and breast self-examination practice (adjusted OR: 0.28; 95% CI: 0.09, 0.88) were significant determinants of late-stage diagnosis. Conclusion Two-thirds of breast cancer patients in Ethiopia were diagnosed at an advanced stage. Residence, delay in the first presentation, traditional medicine use, and breast self-examination practice were significantly associated with late-stage diagnosis. Public education about breast cancer and its early detection techniques is crucial to reduce mortality and improve the survival of patients. Besides, improving access to cancer screening services is useful to tackle the disease at its curable stages.

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Survival analysis of women breast cancer patients in Northwest Amhara, Ethiopia

Cited by 4 publications

References 43 publications

Time-to-death predictors on breast cancer patients in northern Ethiopia: a retrospective cross-sectional study

Time-to-death predictors on breast cancer patients in northern Ethiopia: a retrospective cross-sectional study

Modelling of the time to death of breast cancer patients at Hiwot Fana Specialized University Hospital

Late-stage diagnosis: The driving force behind high breast cancer mortality in Ethiopia: A systematic review and meta-analysis

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