Alem Addis, Abdu Hussen, Temam Ahmed Juhar, Geto Zeleke, Assefa Ebrahim Msaya, Bihonegn Mohammed Derso, Belete Mekonin, Abebe Gashaw, Abdu Seid Mohammed, Kassaw Altaseb Beyene, Mankelkl Gosa, Abebe Melese Shenkut, Tareke Amare Abera
Department of Biomedical Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Cancer Causes Control. 2025 Jul;36(7):653-662. doi: 10.1007/s10552-025-01982-9. Epub 2025 Mar 2.
Evidence on breast cancer survival and factors affecting survival is crucial for evaluating treatment effectiveness and formulating breast cancer control strategies. Although original research has been conducted on the survival rate of breast cancer patients and their determinants in Ethiopia, there is a shortage of comprehensive scientific evidence. The present study systematically reviewed literature on the survival rate of breast cancer patients and the predictors of survival in Ethiopia.
A comprehensive search was conducted in the PubMed, HINARI, Global Index Medicus, and Google Scholar databases up to August 26, 2024. Without any design restrictions, studies on breast cancer patients that measured survival at different time points in Ethiopia were included. The results are summarized in a table, the survival rates are pooled, and risk factors are narratively synthesized. To assess the risk of bias, the Newcastle Ottawa Scale was utilized. Heterogeneity between studies was assessed using the I statistic. Potential publication bias was assessed using a funnel plot. To examine robustness, a leave-one-out sensitivity analysis was performed.
The pooled survival rates in the first, second, third, fifth, and sixth years were 90%, 70%, 68%, 46%, and 44%, respectively. Advanced age, lower socioeconomic status, late clinical stage, delayed diagnosis, higher histological grade, metastasis, lymph node involvement, presence of comorbidity, tumor size, and estrogen receptor positive were factors that increased the risk of mortality in the included studies.
Survival rate of breast cancer patients in later time including fifth and sixth years was comparably lower than other countries. It is crucial to raise awareness about breast cancer screening, early diagnosis, and therapy initiation to increase the survival rate of breast cancer patients in Ethiopia. In addition, it is important to emphasize the risky population groups, which includes those with lower socioeconomic status and advanced clinical parameters.
乳腺癌生存情况及影响生存的因素的证据对于评估治疗效果和制定乳腺癌控制策略至关重要。尽管在埃塞俄比亚已针对乳腺癌患者的生存率及其决定因素开展了原创性研究，但仍缺乏全面的科学证据。本研究系统回顾了埃塞俄比亚乳腺癌患者生存率及生存预测因素的文献。
截至2024年8月26日，在PubMed、HINARI、全球医学索引和谷歌学术数据库中进行了全面检索。纳入了埃塞俄比亚在不同时间点测量乳腺癌患者生存情况且无任何设计限制的研究。结果汇总成表格，合并生存率，并对风险因素进行叙述性综合分析。使用纽卡斯尔渥太华量表评估偏倚风险。使用I统计量评估研究间的异质性。使用漏斗图评估潜在的发表偏倚。为检验稳健性，进行了逐一剔除的敏感性分析。
第一年、第二年、第三年、第五年和第六年的合并生存率分别为90%、70%、68%、46%和44%。高龄、社会经济地位较低、临床分期较晚、诊断延迟、组织学分级较高、转移、淋巴结受累、合并症存在、肿瘤大小以及雌激素受体阳性是纳入研究中增加死亡风险的因素。
包括第五年和第六年在内的晚期乳腺癌患者生存率低于其他国家。提高对乳腺癌筛查、早期诊断和治疗启动的认识对于提高埃塞俄比亚乳腺癌患者的生存率至关重要。此外，强调包括社会经济地位较低和临床参数较晚的高危人群也很重要。
