Atinafu Bantalem Tilaye, Bulti Fekadu Aga, Demelew Tefera Mulugeta
Department of Nursing, Health Science College, Debre Berhan University, Debre Birhan, Ethiopia.
Department of Nursing, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
J Cancer Prev. 2020 Mar 30;25(1):38-47. doi: 10.15430/JCP.2020.25.1.38.
Colorectal cancer is one of the commonest cancer types that has a great public health impact both in developed and developing countries. However, in Ethiopia, the survival status of colorectal cancer patients was not well understood. Therefore, the aim of this study was to determine the survival status and predictors of mortality among colorectal cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2019. The institution-based retrospective follow-up study was conducted with 621 subjects who were selected from patients registered between January 1, 2013 and December 30, 2017 with follow-up until December 30th, 2018. Data were collected from patient record review charts. A Kaplan-Meier analysis with a log-rank test, and bivariate and multivariable analysis using the Cox proportional hazard model were used. Of the 621 colorectal cancer patients who were included in the analysis, 202 (32.5%) died. The overall mortality rate was 20.3% per 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 (adjusted hazard ratio [AHR] = 1.8, 95% CI: 1.3-2.5); stage (II [AHR = 3.8, 95% CI: 1.3-11.1], III [AHR = 8.0, 95% CI: 2.8-23.3], IV [AHR = 17.6, 95% CI: 6.1-50.7]); smoking (AHR = 1.6, 95% CI: 1.1-2.3); alcohol consumption (AHR = 1.5, 95% CI: 1.07-2.2); age ≥ 70 (AHR = 1.7, 95% CI: 1.02-2.9); and marital status (married [AHR = 2.4, 95% CI: 1.5-3.8], widowed [AHR = 2.4, 95% CI: 1.2-4.6], divorced [AHR = 2.0, 95% CI: 1.1-3.7]) were significant predictors of colorectal cancer mortality. It is crucial to implement early detection and screening, giving priority to rural dweller, comorbid patients and advanced stage diagnosed patients.
结直肠癌是最常见的癌症类型之一，在发达国家和发展中国家都对公众健康产生重大影响。然而，在埃塞俄比亚，结直肠癌患者的生存状况尚不清楚。因此，本研究的目的是确定2019年埃塞俄比亚亚的斯亚贝巴提库尔·安贝萨专科医院结直肠癌患者的生存状况及死亡预测因素。本研究为基于机构的回顾性随访研究，选取了2013年1月1日至2017年12月30日登记的621名患者，并随访至2018年12月30日。数据通过查阅患者病历图表收集。采用Kaplan-Meier分析和对数秩检验，以及使用Cox比例风险模型进行双变量和多变量分析。纳入分析的621名结直肠癌患者中，202例（32.5%）死亡。总死亡率为每年20.3%（95%置信区间：17.7 - 23.3）。总生存率为18.1%，中位生存时间为34.8个月（95%置信区间：30.4 - 36.8）。合并症（调整后风险比[AHR]=1.8，95%置信区间：1.3 - 2.5）；分期（II期[AHR = 3.8，95%置信区间：1.3 - 11.1]，III期[AHR = 8.0，95%置信区间：2.8 - 23.3]，IV期[AHR = 17.6，95%置信区间：6.1 - 50.7]）；吸烟（AHR = 1.6，95%置信区间：1.1 - 2.3）；饮酒（AHR = 1.5，95%置信区间：1.07 - 2.2）；年龄≥70岁（AHR = 1.7，95%置信区间：1.02 - 2.9）；婚姻状况（已婚[AHR = 2.4，95%置信区间：1.5 - 3.8]，丧偶[AHR = 2.4，95%置信区间：1.2 - 4.6]，离婚[AHR = 2.0，95%置信区间：1.1 - 3.7]）是结直肠癌死亡的重要预测因素。实施早期检测和筛查至关重要，应优先关注农村居民、合并症患者和晚期诊断患者。
