Time to Initiation of Adjuvant Chemotherapy and its Predictors among Adult Colorectal Cancer Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia; a Retrospective Cohort Study 2013-2018.
| dc.contributor.advisor | Girma Taye | |
| dc.contributor.author | Sisay Lopiso | |
| dc.date.accessioned | 2025-08-13T08:18:45Z | |
| dc.date.available | 2025-08-13T08:18:45Z | |
| dc.date.issued | 2023-10-10 | |
| dc.description.abstract | Background: Colorectal cancer (CRC) is world’s third most commonly diagnosed cancer type and the second most fatal cancer globally accounting for 10% and 9.4% respectively in 2020. Objectives: to assess the time to initiation of Adjuvant Chemotherapy (ACT) and its predictors among adults with CRC at Tikur Anbesa Specialized Hospital (TASH), Ethiopia, 2013 -2018. Methodology: The study was conducted at TASH, an adult oncology unit. An institution-based retrospective cohort study was done to assess the time to initiation of ACT and its predictors among adults with CRC. Data was collected by kobo toolbox and exported to STATA V17 software for analysis. Kaplan–Meier survival curve was employed to estimate the time to initiation of ACT and the overall survival of patients. The existence of significance differences was as checked by using the Log-rank test. Cox-proportional hazard model was used to identify significant factors associated with initiation of ACT and survival of CRC patients. Result: A total 135 patients were included in this study. Among this, more than half (60%) were males. The median age of the patient was 48. The median time to initiation of ACT among stage Ⅱ and Ⅲ CRC patients after surgery was 11 weeks. Underweighted were 56% less likely to initiate ACT compared to patients with those who had normal BMI Having comorbidities and surgical complications were other significant factors for initiation of ACT with hazard ratio of (AHR = 0.62, 95% CI: 0.22-0.64) and (AHR = 0.45, 95% CI: 0.26, 0.78) respectively. Significant association between initiation of ACT and overall survival was observed; those who initiated ACT late had almost three times higher risk of death compared to those who initiated early. In addition, patients with poorly differentiated cancer cells were four times at higher risk of death (AHR=4.05; 95% CI: 1.58, 10.37). Conclusion; This study revealed that time of initiation ACT was longer than the standard. Comorbidities, post-operative complication, and low BMI were identified factors for late initiation. The overall survival of patients at three- and five-years were low and significant association was found between late initiation of ACT and having poorly differentiated cancer cells. Therefore, actions should be taken targeting those factors delaying timely initiation of ACT and lowering the overall survival of CRC patients both at health facility and policy level. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6751 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa university | |
| dc.subject | Adjuvant chemotherapy | |
| dc.subject | Timely initiation | |
| dc.subject | Colorectal cancer | |
| dc.subject | Overall survival rate | |
| dc.subject | Ethiopia. | |
| dc.title | Time to Initiation of Adjuvant Chemotherapy and its Predictors among Adult Colorectal Cancer Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia; a Retrospective Cohort Study 2013-2018. | |
| dc.type | Thesis |