Determinants of healthcare utilisation and predictors of outcome in colorectal cancer patients from Northern Iran

Semnani, Shahryar; Noorafkan, Z.; Aryaie, Mohammad; Sedaghat, Seyed Mehdi; Moghaddami, Abbas; Kazemnejhad, V.; Khorasaninejhad, R.; Ghasemi-Kebria, Fatemeh; Roshandel, Gholamreza

doi:10.1111/ecc.12313

Cited by 10 publications

(5 citation statements)

References 24 publications

(33 reference statements)

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“…This finding is in line with the result of a study which has been conducted in South Iran [16]. However, these values are lower than those from studies conducted in Taiwan [22], Kurdistan [19], North Iran [23], Malaysia [8], and New Zealand [24], Jordan [25], Saudi Arabiya [26] at 5 years. In addition, the values are higher compared to those from the study conducted in Ghana [12].…”

Section: Discussionsupporting

confidence: 89%

Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Follow-up Study

2020

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Colorectal cancer is one of the commonest cancer types that has a great public health impact both in developed and developing countries. However, in Ethiopia, the survival status of colorectal cancer patients was not well understood. Therefore, the aim of this study was to determine the survival status and predictors of mortality among colorectal cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2019. The institution-based retrospective follow-up study was conducted with 621 subjects who were selected from patients registered between January 1, 2013 and December 30, 2017 with follow-up until December 30th, 2018. Data were collected from patient record review charts. A Kaplan-Meier analysis with a log-rank test, and bivariate and multivariable analysis using the Cox proportional hazard model were used. Of the 621 colorectal cancer patients who were included in the analysis, 202 (32.5%) died. The overall mortality rate was 20.3% per year (95% CI: 17.7-23.3). The overall survival was 18.1% with median survival time of 34.8 months (95% CI: 30.4-36.8). Comorbidity (adjusted hazard ratio [AHR] = 1.

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Section: Discussionsupporting

confidence: 89%

Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Follow-up Study

2020

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“…Those coming from rural residences had 1.68 times higher risk of death as compared to those from urban residence. This is in agreement with findings from Iran 44 and China. 41 The possible reasons could be that those from rural residences have poor health care utilization and present late to health care facilities.…”

Section: Discussionsupporting

confidence: 93%

Incidence of Mortality and Associated Factors Among Colorectal Cancer Patients at Oncology Units of Northwest Ethiopia: A Retrospective Cohort Study

Tiruneh

Beshah

Wassie

2022

CMAR

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Background Colorectal cancer is one of the commonest types of malignant neoplasm with an estimated 935,000 deaths in 2020 worldwide. In Ethiopia, colorectal cancer is the third most common cancer with an incidence of 8/100,000 person-years. Despite studies related to the burden of colorectal cancer, data of mortality related to colorectal cancer are limited and unknown in the study areas. Therefore, the aim of this study was to assess the incidence of mortality and associated factors among colorectal cancer patients who were followed-up at oncology units of Northwest Amhara hospitals, Ethiopia. Methods and Materials A retrospective cohort study was conducted among 367 study participants from January 1, 2017, to December 31, 2020 at oncology units of Northwest Amhara hospitals. Data were entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for statistical analysis. The Cox regression model was used to identify factors associated with mortality. All variables with P-value < 0.2 during bi-variable analysis were considered for multivariable Cox regression model and level of statistical significance was declared at P value ≤ 0.05. Results The overall incidence of colorectal cancer mortality was 22.5 per 100 person-years (95% CI: 18.5, 27.38). Being male [AHR =1.60; 95% CI (1.03, 2.48)], having rural residence [AHR=1.68; 95% CI (1.11, 2.55)], carcinoembryonic antigen level ≥5ng/mL [AHR=1.84; 95% CI: (1.02, 3.30)], delay to first health care visit [AHR=1.97; 95% CI (1.19, 3.25)], delay to confirmed diagnosis [AHR=2.45; 95% CI (1.22, 4.90)], and patients who had recurrence after treatment [AHR=1.61;95% CI (1.05, 2.47)] were independently associated with mortality. Conclusion Incidence of colorectal cancer mortality was high. Sex, residency, carcinoembryonic antigen level, time to health care visit, time to confirmed diagnosis, and recurrence significantly increased incidence of mortality. Therefore, creating awareness of colorectal cancer and expanding cancer treatment centers could have paramount importance in reducing the burden of mortality.

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“…The findings demonstrate trends and inequalities in health care utilization across the cancer continuum associated with advancing age, gender, income, education status, rurality, urbanity, migrant status, private health insurance coverage and access to specialist care. Given that even moderate health care utilization has been associated with longer survival times,35,36 inequalities that act as barriers to receiving care may have devastating implications for those individuals with cancer.…”

Section: Discussionmentioning

confidence: 99%

<p>Predictors of health care use in Australian cancer patients</p>

Rana¹,

Alam²,

Gow³

et al. 2019

CMAR

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Objective The purpose of this study is to measure health care utilization in Australian cancer patients based on their demographic, geographic and socioeconomic backgrounds. Method A total of 13,609 participants (aged 15 and over) from 7,230 households were interviewed as part of Wave 13 of the national Household, Income and Labour Dynamics in Australia (HILDA) survey. Five hundred and seventeen participants indicated a current cancer diagnosis with 90% of those receiving active treatment at the time of interview. Independent sample t-tests, Pearson Chi-sq tests, Kruskal‒Wallis H test, binary logistic regression and a zero-inflated Poisson regression were used to examine inequality in health care use. Results Demographic and sociocultural factors such as advancing age, gender, low income, low education status, rurality, no private health insurance, increased psychological distress and less access to specialist care are associated with lower health care utilization among cancer patients. However, models of care such as general practitioner-led cancer care is preferable in younger individuals with cancer, while accessing specialist care is associated with lower rates of hospitalization and higher levels of psychological distress increases hospital length of stay. Conclusions The findings of lower health care utilization by those cancer patients with characteristics of disadvantage have implications for policy development and intervention design. Broadly, policies targeting structural social inequities are likely to increase health care utilization among the most affected/disadvantaged populations. Further investigation is needed to identify potential links between health care utilization and cancer outcomes as a step toward targeted interventions for improving outcomes in the adversely affected groups.

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Determinants of healthcare utilisation and predictors of outcome in colorectal cancer patients from Northern Iran

Cited by 10 publications

References 24 publications

Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Follow-up Study

Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Follow-up Study

Incidence of Mortality and Associated Factors Among Colorectal Cancer Patients at Oncology Units of Northwest Ethiopia: A Retrospective Cohort Study

<p>Predictors of health care use in Australian cancer patients</p>

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