Abstract
Background Globally, about 570,000 cases and 311,000 deaths of cervical cancer occurred in 2018. It was the leading cause of cancer-related deaths among women in Africa. The global mean age at death of cervical cancer was about 59 years. This study aimed to assess the determinants of cervical cancer mortality among cervical cancer patients attending in Tikur Anbessa Specialized Hospital (TASH). Methods Institutional-based retrospective cohort study was conducted in the oncology center of TASH, Ethiopia, from March to April 2019. Data were extracted from patients' chart using structured checklist and analyzed using Stata 14.2. Cox regression was used to identify variables that affect the outcome variable. Result From the total of 2045 reviewed medical records of cervical cancer patients, 1057 medical records were found to be complete and included in this study. The incidence of mortality among cervical cancer patients was 15.6/100/years. Mortality was significantly increased with advanced age (adjusted hazard ratio (AHR) = 1.02, 95% CI (1.01–1.03)), comorbidity (AHR = 1.8, 95% CI (1.39–1.89)), being anemic (AHR = 1.42, 95% CI (1.07–1.89)), advanced stage (AHR = 1.63, 95% CI (1.24–2.13)), and being substance user (AHR = 2.71, 95% CI (2.08–3.53)). Conclusion The study revealed that the incidence of mortality within the cohort was 15.6/100/years. Mortality was significantly increased with advanced age, anemia, advanced stage, comorbidity, and using substances. It is better to give special attention to patients with anemia, advanced age, advanced stage, comorbidity, and substance usage. In addition, expanding cervical cancer early screening will decrease the mortality of patients.
Highlights
About 570,000 cases and 311,000 deaths of cervical cancer occurred in 2018
E incidence and mortality rates of cervical cancer are extremely higher in regions with low and median human development index (HDI) as compared to those with very high and high HDI; death and incidence are more concentrated in low HDI countries [3, 4]
Institutional-based retrospective cohort study was conducted in the oncology center of Tikur Anbessa Specialized Hospital (TASH), Ethiopia, from March to April 2019
Summary
Cancer of uterine cervix was graded in the top three malignancies, affecting females with age less than 45 years. E estimated incidence of the disease was 13.1/100,000 and it varied broadly among countries, with rates ranging from 2 to 75/100,000 [1]. It is the main reason of cancer-related mortality among females in Africa. E incidence and mortality rates of cervical cancer are extremely higher in regions with low and median human development index (HDI) as compared to those with very high and high HDI; death and incidence are more concentrated in low HDI countries [3, 4]. Early diagnosis of cervical cancer and prevention of anemia in cervical cancer patients can reduce the mortality rate of the disease [13, 14]. Since there is limitation of data about determinants of mortality among cervical cancer patients in Ethiopia, this research will fill the gaps and be used as the base line information by health policy makers and administrators in the country
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