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埃塞俄比亚乳腺癌患者生存的预测因素:一项系统评价与荟萃分析。

Predictors of survival among breast cancer patients in Ethiopia: a systematic review and meta-analysis.

作者信息

Mulugeta Chalie, Emagneneh Tadele, Kumie Getinet, Ejigu Betelhem, Alamrew Abebaw

机构信息

Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.

Department Of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia.

出版信息

Front Oncol. 2025 Apr 3;14:1459613. doi: 10.3389/fonc.2024.1459613. eCollection 2024.

Abstract

INTRODUCTION

Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa.

METHODS

We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11.

RESULTS

The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% confidence interval, 48.83%-74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (adjusted odds ratio, 3.52; 95% CI, 1.43-5.59), low educational levels (adjusted odds ratio, 3.61; 95% CI, 2.39-4.82), age > 40 years (adjusted odds ratio, 1.87; 1.03, 2.71), absence of breast pain (adjusted odds ratio, 2.42; 1.09, 3.74), distance >5 km away from home to health institution (adjusted odds ratio, 2.89; 1.54, 4.24), and rural residence (adjusted odds ratio, 3.33; 95% CI, 2.16-4.49).

CONCLUSION

This meta-analysis' findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance >5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy.

摘要

引言

乳腺癌仍然是一个重大的公共卫生问题,医疗关注的延迟往往导致疾病进入晚期并降低生存率。在东非,关于乳腺癌延迟就诊的患病率及其影响因素的证据有限。因此,本研究旨在评估东非乳腺癌延迟就诊的合并患病率,并确定相关影响因素。

方法

我们使用PubMed、谷歌学术、Embase、Cochrane图书馆、Hinari和Mednar数据库,对来自东非的观察性研究进行了系统综述。采用2016年纽卡斯尔渥太华批判性评价清单评估方法学质量。使用漏斗图和Egger检验评估发表偏倚,并通过I²检验检查异质性。数据用Microsoft Excel提取,并使用Stata 11进行分析。

结果

东非乳腺癌患者延迟就诊的合并患病率为61.85%(95%置信区间,48.83%-74.88%)。导致延迟就诊的重要因素包括寻求传统治疗师的帮助(调整优势比,3.52;95%置信区间,1.43-5.59)、教育水平低(调整优势比,3.61;95%置信区间,2.39-4.82)、年龄>40岁(调整优势比,1.87;1.03, 2.71)、无乳房疼痛(调整优势比,2.42;1.09, 3.74)、从家到医疗机构的距离>5公里(调整优势比,2.89;1.54, 4.24)以及居住在农村地区(调整优势比,3.33;95%置信区间,2.16-4.49)。

结论

这项荟萃分析的结果表明,东非超过一半的乳腺癌患者延迟了检测。与延迟就诊相关的重要因素包括年龄超过40岁、文盲、农村居住、寻求传统治疗师的帮助、距离医疗机构>5公里以及无乳房疼痛。医疗保健利益相关者和政策制定者必须专注于提高认识并开展教育,以鼓励早期检测和及时治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c9a/12003360/47240f7bcbb3/fonc-14-1459613-g001.jpg

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