Advanced stage presentation and its determinant factors among colorectal cancer patients in Amhara regional state Referral Hospitals, Northwest Ethiopia

Abstract

Introduction Nowadays, the burden of colorectal cancer (CRC) has been increasing in the world, particularly in developing nations. This could be related to the poor prognosis of the disease due to late presentation at diagnosis and poor treatment outcomes. In Ethiopia, studies related to the stage of colorectal cancer at diagnosis and its determinants are limited. Therefore, the study was intended to assess advanced stage presentation and its associated factors among colorectal cancer patients in northwest Ethiopia. Methods An institution-based retrospective study was conducted among 367 CRC patients at two oncologic centers (the University of Gondar and Felege Hiwot comprehensive specialized hospitals) from January 1, 2017, to December 31, 2020. Data were entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for analysis. Binary logistic regression was used to identify factors associated with the outcome variable. All variables with P-value < 0.2 during bi-variable analysis were considered for multivariable logistic regression. The level of statistical significance was declared at P-value <0.05. Results The magnitude of advanced stage presentation of colorectal cancer was 83.1%. Being rural dwellers (Adjusted odds ratio (AOR) = 3.6; 95% CI: 1.8,7.2), not medically insured (AOR = 3.9; 95% CI: 1.9,7.8), patients delay (AOR = 6.5; 95% CI:3.2, 13.3), recurrence of the disease (AOR = 2.3; 95% CI: 1.1,4.7), and no comorbidity illness (AOR = 4.4; 95% CI: 2.1, 9.1) were predictors of advanced stage presentation of CRC. Conclusion The current study revealed that the advanced-stage presentation of colorectal cancer patients was high. It is recommended that the community shall be aware of the signs and symptoms of the disease using different media, giving more emphasis to the rural community, expanding health insurance, and educating patients about the recurrence chance of the disease. Moreover, expansion of colorectal treatment centers and screening of colorectal cancer should be given emphasis.

Colorectal cancer prognosed to advanced stage and its associated factors in oncologic unit of Dessie Comprehensive Specialized Hospital, Northeast Ethiopia, 2023

“…The study revealed that 83.3% (95% CI: 79.4% -87.3%) of CRC patients were presented at an advanced stage of the disease. This nding is in line with the study conducted in Amhara Region at Felege Hiwot Comprehensive Specialized Hospital and the University of Gondar Hospital, which is 83.1% [10], and with the study conducted in Sokoto, Nigeria, which was 86.8% [18]. However, it is higher than studies conducted in Addis Ababa's Tikur Anbessa specialized hospital, which is 62.7% [19].…”

“…In this study, aged respondents were more likely to be prognosed to advanced stages than those who were not aged. This nding is supported by the study conducted in Amhara region hospitals and in the United States [10,23,24]. This could be due to the fact that as age increases, changes occur in the colon, such as mucosal changes, decreased motility, and reduced blood ow.…”

“…This could be due to probably low awareness of the warning signs of the disease, as most rural communities in Ethiopia are illiterate, inaccessible to health facilities, and have problems with transportation [28] Patients who didn't have medical insurance were presented with advanced stage than those who were insured. This nding is supported by the studies conducted in different countries [10,24,29]. The possible justi cation could be that health insurance coverage might solve the economic constraints of the patients and encourage them to visit health care facilities as early as possible if the signs and symptoms of the disease appear [30,31].…”

“…The sample size for the rst objective was determined using a single population proportion formula by considering the following assumptions: proportion of advanced stage presentation of CRC = 83.1% [10], 95% con dence level, and margin of error = 4%. N = 337= 337+5% (non-retrieval rate) =354 Sample size for the second objective was calculated by using Epi info STAT Calc, but the largest sample size was obtained from the rst objective.…”

Stoma‐related complications and quality‐of‐life assessment: A cross‐sectional study with patients from Ethiopia and Sweden

“…Patients in rural areas in Ethiopia often present with late-stage cancer, increasing the likelihood of needing an ostomy. 35…”