Disparities in Receipt of Radiotherapy and Outcomes Among Cervical Cancer Patients Seen in Tikur Anbessa Hospital, Ethiopia
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Date
2018-05
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Addis Ababa University
Abstract
Introduction: Ethiopia is among countries with the highest burden of cervical cancer worldwide. Up to 6,000 new cervical cancer patients are diagnosed each year. The primary
objective of this study was to evaluate the survival of cervical cancer patients in general and compare the difference in survival, waiting time and stage migration among patients treated with radiotherapy in Tikur Anbessa Hospital on private wing and regular sides.
Methodology: Women with histologically verified cervical cancer, who received radiotherapy in 2014, were included. All patient characteristics, tumor characteristics, and information concerning therapy and outcome were extracted from the patients’ medical record files. Vital status was obtained through telephone contact or patient cards.
Result: Out of 249 patients treated in 2014, the patient file of 242 could be retrieved. 152 (63%) were treated on the regular service side and 90 (37%) were treated on Private wing side. The median age at diagnosis was 45 years and 48 years for patients with private wing side and regular service side. After first oncologist consultation private wing patients waited more (92 days) than regular side patients (39 days) to receive radiotherapy. During this time, stage
migration was seen more in private wing (20%) than regular side (8.6%) patients. In general, the estimated of 52 months overall survival probabilities were 21.5% (14.6% in worst-case scenario). The median overall survival time was 21 months (18 months in worst-case scenario). The median survival was 23 months (19 months in worst-case) and 19 months (17 months in worst-case) between private wing and regular side patients, respectively. The FIGO stage, intension of radiotherapy, one-year tumor control rate, comorbidity and concurrent chemotherapy were the factors, which has found to be significant association with survival.
Conclusion: The survival of cervical cancer patients remains low in Ethiopia, despite the higher cure rate of the disease. The reason for poor survival were advanced stage at presentation, very long waiting time for treatment and as a result stage migration, the old treatment machine and technique and absence of brachytherapy are some of the reason. Therefore, the parallel oriented efforts in all direction such as prevention, early detection and improving
access to standardized care are required.
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Keywords
Cervical cancer,Radiotherapy