Survival Status and Predictors of Mortality Among Colorectal Cancer Patients in Tikur Anbessa Specialized Hospital: a Retrospective Cohort Study.
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Date
2019-06
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Addis Ababa University
Abstract
Introduction: Colorectal cancer is the commonest cancer type that has a great public health impact both in developed and developing countries. Impacts from the disease have shown decreasing trends in developed counties; whereas, Mortality from the diseases and reduced survival are still the highest and steadily rising in developing countries.
Objective: To determine the survival status and predictors of mortality among colorectal cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2019.
Methods: Institution-based retrospective cohort study was conducted among 621 colorectal cancer patients selected from patients that registered between January 1st ,2013 and December 30th ,2017 and followed up to December 30th, 2018 using Census sampling. Data was collected from patient record review charts. A Kaplan Meier curve and log-rank test were used to estimate the survival curve and presence of difference in survival among explanatory variables. Cox proportional hazard model was used to determine the net effect of each explanatory variable on time to death after diagnosis.
Results: Out of the 621 colorectal cancer patients that were included in the analysis, 202(32.5%) had died. The overall mortality rate was 20.3 per 100 person-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 (AHR: 1.8, CI: 1.3-2.5); stage [II (AHR=3.8, CI: 1.3-11.1), III (AHR=8.0, CI: 2.8-23.3), IV (AHR=17.6, CI: 6.1-50.7)]; smoking (AHR=1.6, CI: 1.1-2.3); alcohol consumption (AHR=1.5, CI:1.07-2.2); age>=70 (AHR=1.7, CI:1.02-2.9); and marital status [married (AHR=2.4, CI:1.5-3.8), widowed (AHR=2.4, CI:1.2-4.6), divorced (AHR=2, CI:1.1-3.7)] were significant predictors of colorectal cancer mortality.
Conclusion and recommendations: the overall survival of colorectal cancer patients was low. It is much lower than the survival rates of colorectal cancer patients in middle- and high-income countries. Hence, the study recommends early detection and screening, and giving priority to comorbid patients and patients that diagnosed at advanced stage.
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Colorectal cancer, predictor, survival status, mortality, time to death