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

Abstract

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.

Determinants of Mortality among Cervical Cancer Patients Attending in Tikur Anbessa Specialized Hospital, Ethiopia: Institutional-Based Retrospective Study

“…Patients who presented with advanced stage died more than those with early stage. This result is in line with the studies conducted in New Zealand [ 33 , 34 ]. The increment of mortality could be as the cancer stage getting advanced, its metastasis rate could be increased and these factors might decrease the probability to respond a treatment and lead to death [ 35 ].…”

Incidence, Treatment and Outcomes of Cervical Cancer in Low- and Middle-income Countries

“…With the current treatment capacity limitations, outcomes for early stage disease are generally poorer in Africa, with a reported 2-year overall survival of 50% for stage IeIIA cervical cancer in Nigeria and a median overall survival of 21 and 15 months for stage I and II cervical cancer, respectively, in a cohort of radiationtreated patients in Kenya [29,30]. However, some hospitals report better outcomes, such as 5-year overall survival of 80% for stage I and 69% for stage II cervical cancer in a hospital in Ethiopia [31]. A review of population-based registries from nine African countries revealed a 5-year overall survival of 50.3% for stage IeII cervical cancer [14].…”

Prevalence and determinants of late-stage presentation among cervical cancer patients, a systematic review and meta-analysis

“…Quick scale-up of immunization and double lifetime uterine cervix screening in the world could prevent up to 13.4 million malignancies over the long run half century [ 19 , 20 ]. Additionally, early diagnosis and managing other factors will decrease mortality and also the prevalence among those patients [ 21 ]. So, this systematic review and meta-analysis aimed is to identify pooled prevalence and determinants of late-stage presentation among cervical cancer patients.…”