Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
BMC Cancer. 2024 Jul 10;24(1):821. doi: 10.1186/s12885-024-12597-9.
The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia.
PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger's regression test, while heterogeneity was evaluated through the Cochran Q test and I statistics.
After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors.
In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.
结直肠癌（CRC）的发病率在撒哈拉以南国家（包括埃塞俄比亚）呈上升趋势。然而，尚未确定埃塞俄比亚 CRC 患者的实际死亡率。因此，本系统评价和荟萃分析旨在确定总体死亡率，并确定埃塞俄比亚 CRC 患者的预测因素。
通过 PubMed、EMBASE、Web of Science、Scopus、Science Direct 和 Google Scholar 搜索相关文章。遵循系统评价和荟萃分析的首选报告项目（PRISMA）。使用纽卡斯尔-渥太华量表关键评估清单评估纳入研究的质量。使用随机效应模型估计总体死亡率和调整后的危险比（AHR）。使用漏斗图和 Egger 回归检验评估发表偏倚，通过 Cochran Q 检验和 I 统计评估异质性。
在回顾了 74 篇文章后，只有 7 项研究符合标准并纳入分析。分析表明，埃塞俄比亚 CRC 患者的总体死亡率为 40.5%（95%置信区间[CI]：32.05，48.87），而 1 年、3 年和 5 年的生存率分别为 82.3%（95% CI：73.33，91.31）、48.8%（95% CI：43.35，54.32）和 26.6%（95% CI：21.26，31.91）。亚组分析表明，与早期研究相比，2017 年后进行的研究死亡率更高（43.0%比 38.2%）。年龄较大（AHR：1.89，95% CI：1.27，2.82）；已婚（AHR：2.53，95% CI：1.79，3.57）；合并症（AHR：1.84，95% CI：1.45，2.35）；CEA 水平较高（AHR：2.06，CI：1.35，3.13）；处于 II 期（AHR：4.13，95% CI：1.85，9.22）、III 期（AHR：8.62，95% CI：3.88，19.15）和 IV 期（AHR：8.06，CI：2.89，22.49）的患者是最重要的预测因素。
在埃塞俄比亚，诊断为 CRC 的患者死亡率较高，五分之二的患者死于该疾病。年龄、婚姻状况、CEA 水平、合并症和癌症分期被确定为 CRC 患者死亡的预测因素。因此，应优先考虑早期发现和筛查，特别是针对年龄较大、已婚、有合并症、CEA 水平升高和癌症晚期的患者。
