Title : Time to death and predictors among cervical cancer patients admitted to Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia
Abstract:
Background: A sexually transmitted virus called Human Papilloma virus is responsible for more than 99% of cervical cancer cases and its precursors. In 2019, the median survival time of cervical cancer patients at 5 years was 37 months. The survival time and predictors of death from cervical cancer vary in different study settings. This study aimed to assess the time to death and to identify the major predictors of death of cervical cancer patients in Felege Hiwot Comprehensive Specialized Hospital.
Methods: A facility based retrospective follow-up study was conducted among 422 randomly selected cervical cancer patients in Felege Hiwot Comprehensive Specialized Hospital from 25th June 2017 to 31st June 2022. Data was coded and then entered, edited, and cleaned using EPI-data 3.1 and exported to STATA14.2 statistical software for analysis. Kaplan Meier and life table were used to describe the restricted mean survival time and the overall survival rates. Differences in survival among different variables were compared using the log-rank test. Assumption of proportional hazard was checked using Schoenfeld residual test. Variables having P-value > 0.05 were considered as fulfilling the assumption. Variables with a significance level below 0.2 in the bivariable Cox regression model were included in a multivariable Cox regression model analysis, where Variables with a p-value < 0.05 were considered to be statistically at 95% confidence interval. Model fitness was checked by Cox-Snell residual.
Results: The mean follow up time of this cohort was 27.66 (CI: 26.96, 28.36) months, and the restricted mean survival time of cervical cancer patients in this study was 40.21 (95% CI: 38.95, 41.47) months. Being FIGO stage IV [AHR = 6.10, 95% CI: 2.18, 16.90)], having adenocarcinoma [AHR = 3.12, 95% CI: 1.34, 7.28)], having co-morbidity [AHR = 2.57, 95% CI: 1.29, 5.11)], and being initiated with radiotherapy [AHR = 4.57, 95% CI: 1.60, 13.06)] increased the risk of death from cervical cancer.
Conclusion: While the median survival time was undetermined, the restricted mean survival time of cervical cancer patients in this study was 40.21 months. Marital status, type of tumor histology, stage of disease, type of treatment initiated, and presence of co-morbidity were significant predictors of death for cervical cancer in this study. The audience learns from my presentation.
Audience Take Away:
- Key findings, trends in data, progress to date in relation to their job.
- Any difficulties with methods and how I were or will be dealt with.
- Whether my results confirm my hypotheses or how I answer my research question.
- Likely implications or possible applications and what I plan to do next.
