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

Abstract

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.