Colorectal cancer treatment outcome and associated factors among patients treated at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2020-10
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Addis Abeba University
Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second cause of
cancer death worldwide. It is a major public health problem and continues to be a disease of both
the developed and developing nations. The objective of this study was to determine five year’s
survival and associated factors among patients treated for CRC at adult oncology unit of Tikur
Anbessa Specialized Hospital (TASH). A hospital based retrospective cohort study was
conducted and all patient charts with diagnosis of CRC from September 11, 2013 to September
10, 2014 were included for the study and tracked until September 10, 2019. The data was entered
and analyzed using SPSS version 23.0. Survival curves were plotted using Kaplan-Meier method
and prognostic factors for survival were determined using Cox regression model. Out of the 316
CRC patients, 181(57.3%) were male with 1.34 ratio. The mean age in years was 48.66 + 13.58.
Majority 115 (36.4%) of the patients were diagnosed with colon cancer, whereas, 112 (35.4%)
and 89 (28.2%) patients were diagnosed with rectal and colorectal cancer respectively.
Approximately, half (45.60%) of the patients were diagnosed at clinical Tumor Nodes Metastasis
(TNM) stage-IV and 203 (64.2%) of patients were dead in the five years follow-up period with
median survival of 19 months. The result of cox proportional hazard regression analysis showed
that, being underweight (HR=1.72, 95% CI (1.19-2.48)), rectal cancer (HR=1.92, 95% CI (1.382.68))
and late stage of CRC (HR=2.71, 95% CI (1.67-4.41)) were associated with decreased
survival. This study reflects that most patients diagnosed with CRC at TASH were
predominantly presented at advanced stage and treatment outcome was poor compared to many
African studies. Hence, a concerted effort has to be made to improve access to specialized
medical faculties and public health education programs on CRC, which may be necessary for
early detection and thereby improve treatment and CRC survival.
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Keywords
Colorectal cancer, treatment outcome, mortality.