Dataset Information

Survival Status of Esophageal Cancer Patients and its Determinants in Ethiopia: A Facility Based Retrospective Cohort Study.

ABSTRACT:

Background

Globally, the incidence and mortality due to esophageal cancer are increasing, particularly in low- and middle-income countries. Cancer of the esophagus is the eighth in incidence and seventh in cancer mortality in Ethiopia. A few studies have shown an increasing burden, however, little is known about the survival pattern and its determinants among esophageal cancer patients in Ethiopia. Therefore, we assessed the survival pattern and its determinants among esophageal cancer patients.

Methods

We conducted a retrospective cohort study among 349 esophageal cancer patients who were diagnosed at or referred to Tikur Anbessa Specialized Hospital, Ethiopia from January 2010 to May 2017. Using an abstraction form, nurses who were working at the oncology department extracted the data from patient charts. To estimate and compare the probability of survival among covariate categories, we performed a Kaplan-Meier survival analysis with the log-rank test. To identify the prognostic determinants of survival, we performed a multivariable Cox proportional regression analysis.

Results

The median follow-up time was 32 months with interquartile range of 15 to 42. Overall, the median survival time after diagnosis with esophageal cancer was 4 months with one-, two- and three-year survival of 14.4, 6.3, and 2.4% respectively. In the multivariable Cox proportional hazards model, receiving chemotherapy [Adjusted Hazard Ratio (AHR)=0.36, 95%CI: 0.27-0.49], radiotherapy [AHR=0.38, 95%CI: 0.23-0.63] and surgery [AHR=0.70, 95%CI: 0.54-0.89] were statistically significant.

Conclusions

In Ethiopia, esophageal cancer patients have a very low one-, two- and three-year survival. Despite a very low overall survival, patients who received either chemotherapy, radiotherapy or surgery showed a better survival compared with those who did not receive any treatment. Hence, it is essential to improve the survival of patients with esophageal cancer through early detection and timely initiation of the available treatment options.

SUBMITTER: Hassen HY

PROVIDER: S-EPMC7917207 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Survival Status of Esophageal Cancer Patients and its Determinants in Ethiopia: A Facility Based Retrospective Cohort Study.

Hassen Hamid Yimam HY Teka Mohammed Ahmed MA Addisse Adamu A

Frontiers in oncology 20210215

<h4>Background</h4>Globally, the incidence and mortality due to esophageal cancer are increasing, particularly in low- and middle-income countries. Cancer of the esophagus is the eighth in incidence and seventh in cancer mortality in Ethiopia. A few studies have shown an increasing burden, however, little is known about the survival pattern and its determinants among esophageal cancer patients in Ethiopia. Therefore, we assessed the survival pattern and its determinants among esophageal cancer p ...[more]

PMID: 33659206

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Project description:BACKGROUND:Globally, the incidence of prostate cancer is increasing, particularly in low- and middle-income countries. It is the most common cancer among men worldwide, with higher mortality in low and middle-income countries. In Ethiopia, it is the second most common cause of cancer morbidity and mortality among men. Despite a few studies done regarding the disease burden, the evidence is scarce about the survival and prognostic determinants of prostate cancer patients in Ethiopia. Thus, this study assessed the survival and prognostic determinants of patients with prostate cancer. METHODS:We retrospectively followed patients who were newly diagnosed from 2012 to 2016 at the Oncology Department of Tikur Anbessa Specialized Hospital. We extracted the data from patient charts that were available in the cancer registry using a checklist with the help of oncology nurses. Kaplan-Meier survival analyses with the log-rank test were used to estimate and compare the probability of survival among covariate categories. After checking for assumptions, a multivariable Cox regression analysis was performed to identify prognostic determinants of survival. RESULTS:The median survival time was 28 months with an overall 2-, 3- and 5-year survival of 57%, 38.9% and 22%, respectively. The overall survival differs according to the clinical stage (P-value<0.01), presence or absence of distant metastasis (P<0.01) and androgen deprivation therapy (ADT) (P<0.05). Cancer stage at diagnosis (adjusted hazard ratio (AHR) = 0.309, 95%CI = 0.151-0.633) and ADT (AHR = 3.884, 95%CI = 1.677-8.997) remained significant in the final Cox proportional hazards model. CONCLUSIONS:The overall 2-, 3- and 5-year survival of prostate cancer patients in Ethiopia is very low. The cancer stage at diagnosis and treatment modalities are significant prognostic determinants of survival. Therefore, early detection through screening and timely initiation of treatment are essential to improve the survival of prostate cancer patients.

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Project description:Background:Worldwide, 10-20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15-57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia. Objective:To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia. Patients and Methods:A case-control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P<0.05. Results:Married mothers were 67% (AOR=0.33, 95%CI: 0.15-0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01-0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04-0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05-0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04-0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51-10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04-0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy. Conclusion and Recommendation:Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.

Project description:The incidence of esophageal adenocarcinoma (EAC) is increasing worldwide and has overtaken squamous histology in occurrence. We studied the impact of socioeconomic status (SES) on EAC stage at diagnosis, receipt of treatment, and survival. A population-based retrospective cohort study was conducted using Ontario Cancer Registry-linked administrative health data. Multinomial logistic regression was used to examine the association between SES (income quintile) and stage at EAC diagnosis and EAC treatment. Survival times following EAC diagnosis were estimated using Kaplan-Meier method. Cox proportional-hazards regression analysis was used to examine the association between SES and EAC survival. Between 2003-2012, 2,125 EAC cases were diagnosed. Median survival for the lowest-SES group was 10.9 months compared to 11.6 months for the highest-SES group; the 5-year survival was 9.8% vs. 15.0%. Compared to individuals in the highest-SES group, individuals in the lowest-SES category experienced no significant difference in EAC treatment (91.6% vs. 93.3%, P = 0.314) and deaths (78.9% vs. 75.6%, P = 0.727). After controlling for covariates, no significant associations were found between SES and cancer stage at diagnosis and EAC treatment. Additionally, after controlling for age, gender, urban/rural residence, birth country, health region, aggregated diagnosis groups, cancer stage, treatment, and year of diagnosis, no significant association was found between SES and EAC survival. Moreover, increased mortality risk was observed among those with older age (P = 0.001), advanced-stage of EAC at diagnosis (P < 0.001), and those receiving chemotherapy alone, radiotherapy alone, or surgery plus chemotherapy (P < 0.001). Adjusted proportional-hazards model findings suggest that there is no association between SES and EAC survival. While the unadjusted model suggests reduced survival among individuals in lower income quintiles, this is no longer significant after adjusting for any covariate. Additionally, there is an apparent association between SES and survival when considering only those individuals diagnosed with stage 0-III EAC. These analyses suggest that the observed direct relationship between SES and survival is explained by patient-level factors including receipt of treatment, something that is potentially modifiable.

Dataset Information

Survival Status of Esophageal Cancer Patients and its Determinants in Ethiopia: A Facility Based Retrospective Cohort Study.

Background

Methods

Results

Conclusions

Publications

Survival Status of Esophageal Cancer Patients and its Determinants in Ethiopia: A Facility Based Retrospective Cohort Study.

Similar Datasets

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