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埃塞俄比亚乳腺癌生存率及其决定因素:纵向研究的系统评价与荟萃分析

Breast cancer survival rates and determinants in Ethiopia: a systematic review and meta-analysis of longitudinal studies.

作者信息

Tafese Abenezer Melaku, Fentie Meseker Tesfaye, Seifu Beminate Lemma, Asnake Angwach Abrham, Dirbaba Bikiltu Dugassa, Jara Abdisa Gemedi, Asare Elsabeth Tizazu, George Brandon

机构信息

College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.

Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Cancer. 2025 Aug 4;25(1):1263. doi: 10.1186/s12885-025-14705-9.

DOI:10.1186/s12885-025-14705-9
PMID:40760653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12323059/
Abstract

BACKGROUND

Breast cancer is the most common cancer and the leading cause of cancer mortality among women in Ethiopia, accounting for 32% of new cancer cases and 17.6% of cancer deaths. Despite its growing burden, comprehensive data on survival rates and contributing factors remain limited. This systematic review and meta-analysis aimed to synthesize existing data on breast cancer survival in Ethiopia and identify key determinants influencing outcomes.

METHODS

A comprehensive systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and CINAHL to identify studies on breast cancer survival in Ethiopia published between January 2014 and August 2024. Eligible studies were screened and assessed for quality. A random-effects model was used to estimate pooled 1-, 3-, and 5-year survival rates and examine factors associated with survival.

RESULTS

This review included 15 cohort studies with 6,232 breast cancer patients. The reported median age of patients ranged from 39.0 to 61.0 years, with median survival times varying between 10.0 and 58.7 months. Pooled 1-, 3-, and 5-year survival rates were 92.0% (95% CI: 85.0, 97.0), 66.0% (95% CI: 52.0, 78.0), and 22.0% (95% CI: 8.0, 40.0), respectively. Rural residence (AHR = 1.58, 95% CI: 1.15, 2.17), advanced-stage diagnosis (AHR = 2.56, 95% CI: 1.86, 3.52), and presence of comorbidity (AHR = 1.54, 95%CI: 1.20, 1.98) were associated with higher mortality, while initiation of hormonal therapy (AHR = 0.43, 95% CI: 0.30, 0.61) was associated with improved survival.

CONCLUSION

While short-term survival among breast cancer patients in Ethiopia is favorable, the 5-year survival rate remains significantly lower than regional and global estimates. Strengthening health system capacity and enhancing public awareness are critical to promoting early detection, ensuring timely treatment, and improving long-term outcomes.

PROTOCOL REGISTRATION

PROSPERO (CRD42024574529).

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12885-025-14705-9.

摘要

背景

乳腺癌是埃塞俄比亚女性中最常见的癌症,也是癌症死亡的主要原因,占新癌症病例的32%和癌症死亡人数的17.6%。尽管其负担日益加重,但关于生存率及相关影响因素的全面数据仍然有限。本系统评价和荟萃分析旨在综合埃塞俄比亚乳腺癌生存的现有数据,并确定影响预后的关键决定因素。

方法

在PubMed、Web of Science、Scopus、Embase和CINAHL中进行了全面的系统检索,以识别2014年1月至2024年8月期间发表的关于埃塞俄比亚乳腺癌生存的研究。对符合条件的研究进行筛选和质量评估。采用随机效应模型估计汇总的1年、3年和5年生存率,并检验与生存相关的因素。

结果

本评价纳入了15项队列研究,共6232例乳腺癌患者。报告的患者中位年龄在39.0至61.0岁之间,中位生存时间在10.0至58.7个月之间。汇总的1年、3年和5年生存率分别为92.0%(95%CI:85.0,97.0)、66.0%(95%CI:52.0,78.0)和22.0%(95%CI:8.0,40.0)。农村居住(调整后风险比[AHR]=1.58,95%CI:1.15,2.17)、晚期诊断(AHR=2.56,95%CI:1.86,3.52)和合并症的存在(AHR=1.54,95%CI:1.20,1.98)与较高的死亡率相关,而开始激素治疗(AHR=0.43,95%CI:0.30,0.61)与生存改善相关。

结论

虽然埃塞俄比亚乳腺癌患者的短期生存率较好,但5年生存率仍显著低于区域和全球估计值。加强卫生系统能力和提高公众意识对于促进早期发现、确保及时治疗和改善长期预后至关重要。

方案注册

PROSPERO(CRD42024574529)。

补充信息

在线版本包含可在10.1186/s12885-025-14705-9获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/1f9cc84d38bb/12885_2025_14705_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/1f85b1cf5ff4/12885_2025_14705_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/1f9cc84d38bb/12885_2025_14705_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/1f85b1cf5ff4/12885_2025_14705_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/dbefe3c9aabe/12885_2025_14705_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/618c2bae04cd/12885_2025_14705_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/ae1b23b2af00/12885_2025_14705_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3188/12323059/1f9cc84d38bb/12885_2025_14705_Fig5_HTML.jpg

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Front Oncol. 2025 Apr 3;14:1459613. doi: 10.3389/fonc.2024.1459613. eCollection 2024.
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Timeliness of Breast Cancer Patients' Presentation to Health Care Facilities in Ethiopia: A Systematic Review and Meta-Analysis.《埃塞俄比亚乳腺癌患者及时就诊于医疗机构情况的系统评价和荟萃分析》
JCO Glob Oncol. 2024 Nov;10:e2400263. doi: 10.1200/GO-24-00263. Epub 2024 Nov 21.
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Late-stage diagnosis: The driving force behind high breast cancer mortality in Ethiopia: A systematic review and meta-analysis.
晚期诊断:导致埃塞俄比亚乳腺癌高死亡率的主要原因:系统评价和荟萃分析。
PLoS One. 2024 Jul 19;19(7):e0307283. doi: 10.1371/journal.pone.0307283. eCollection 2024.
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Mortality rate and predictors of colorectal cancer patients in Ethiopia: a systematic review and meta-analysis.埃塞俄比亚结直肠癌患者的死亡率及其预测因素:系统评价和荟萃分析。
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