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

Atinafu, Bantalem Tilaye; Aga, Fekadu; Demelew, Tefera Mulugeta

doi:10.15430/jcp.2020.25.1.38

Cited by 15 publications

(28 citation statements)

References 30 publications

(34 reference statements)

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“…Patients diagnosed at stage IV showed a higher rate of death than those diagnosed at stage I or II. This finding is supported by studies from Ethiopia, Taiwan and Ghana, which showed advanced stage at diagnosis is associated with poor survival [17,27,31]. Similarly, a study done in Iran also indicated cancer grade significantly associated with mortality from CRC [39].…”

Section: Discussionsupporting

confidence: 55%

“…In our study, the two-and three-year survival for all stages combined was below 50% and the five-year survival was 28.7%. A study by Atinafu et al reported 21.7% of five-year survival among patients treated in TASH [17]. However, the study has methodological limitations in the event ascertainment and missing data management that could lead to discrepancy in survival estimate.…”

Section: Discussionmentioning

confidence: 98%

“…However, little is known on the survival of patients with CRC in Ethiopia. Recently, Atinafu et al investigated the predictors of mortality from CRC among patients treated in Tikur Anbessa Specialized Hospital (TASH) [17]. Nevertheless, the study has some methodological limitations in the event ascertainment and missing data management.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 98%

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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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“…The three-year survival rates in Ghana were found to be 21% (10), those in Kenya 40% 17 and those in Ethiopia were 47%. 18 These three-year survival rates in Sub-Saharan Africa are lower than those from studies conducted in England (3-year survival for colon carcinoma: 69.5%; 3-year survival for rectal carcinoma: 69.7%), 19 Taiwan (79.4%), 20 Malaysia (55.04%), 21 Kurdistan (57%), 22 Jordan (66%) 23 and Northern Iran (52%). 24 The survival rates of CRC in high-income developed countries such as the United States, parts of Europe, Canada, Australia and New Zealand are better than ours, 1 even though these countries report higher CRC…”

Section: Discussionmentioning

confidence: 80%

Prognostic Factors for Survival of Colorectal Adenocarcinoma Patients in Uganda

Wismayer¹,

Kiwanuka²,

Wabinga³

et al. 2022

CMAR

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Background:In Uganda, similar to other countries in East Africa, the incidence of colorectal cancer (CRC) has been steadily increasing. This increase in incidence is accompanied by a poor prognosis. There is limited knowledge on factors responsible for the poor outcome of patients with CRC in Uganda. Cancer survival analysis is one way of determining some of these prognostic factors. The aim of this study was to determine prognostic factors associated with CRC survival in Ugandan patients. Methods: This was a retroprospective cohort study involving patients with linked data in the Kampala cancer registry and medical records from hospitals in Uganda. Participants with a diagnosis of colorectal adenocarcinoma between 1st January 2008 and 31st December 2018 were included. Variables included patients' demographic data, grade, stage and location of CRC, data on whether a patient was operated on, type of operation, treatment modalities and date of diagnosis. Our outcome variable was time to death after diagnosis. We computed and compared survival using the Log rank test and used Cox proportional hazards regression to determine factors associated with survival. Results: A total of 247 patients were included in the study with a mean (SD) age of 53.3 (15.7) years and a female:

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“…Recent studies on screening for and following up CRC have mainly adopted insurance database analysis, case review, and questionnaire survey methods [9,19,[21][22][23][24]. Few health authorities have purposefully established a database for people participating in CRC screening containing relevant data from across the whole country.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the follow-up time after a positive result in the fecal occult blood test

Cheng

2021

PLoS ONE

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In 2010, Taiwan included the fecal occult blood test (FOBT) under preventive health insurance services. For patients whose test positive, receiving follow-ups is paramount. This study investigated factors affecting the follow-up time of these patients. This retrospective study used data from the colorectal cancer screening archives. The study period was from 2010 to 2013, and the subjects were 50–75-year-old persons who tested positive for FOBT. The t test, one-way ANOVA, and multiple regression were performed to address the differences in the mean tracking period between variables such as the population’s demographic characteristics. The mean follow-up time for the 98,482 participants whose screening results were positive exhibited significant differences (p < 0.001) according to medical unit region and classification, age, screening location, family history, examination method, and diagnosis. The model predicting the mean follow-up time predicted a period of 10.079 days longer for those whose hospital was on an offshore island than that of those whose hospital was in the eastern regions. The follow-up time was 1.257 days shorter for people who were inpatients than those who were outpatients and was 8.902 days longer for people who underwent double contrast barium enema plus flexible sigmoidoscopy than those who underwent other examination methods. Patients with a family history of colorectal cancer and those whose examination results indicated cancer had a follow-up time of 2.562 and 2.476 days shorter than those who did not know their family history and those with other results, respectively. Factors affecting the follow-up time of people whose FOBT results were positive consisted of the location and classification of the follow-up institution, age, screening location, family history, examination method, and diagnosis. This provides valuable references for improving the cancer screening program.

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

Cited by 15 publications

References 30 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

Prognostic Factors for Survival of Colorectal Adenocarcinoma Patients in Uganda

Factors affecting the follow-up time after a positive result in the fecal occult blood test

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