Factors Influencing Receipt of Radiation Treatment in Women with Carcinoma of the Cervix in Ghana

Abstract

Objective: We evaluated the influence of demographic and clinical features on access to radiotherapy among women with cervical cancer.Methodology: A cross-sectional analytical study design was used to review hospital records of women diagnosed with cervical cancer from 1st January 2010 and 31st December 2013 at Ghana’s two largest public cancer treatment centres. Basic demographic andclinical data were captured from the records. Multivariate logistic regression was used to determine the odds of receiving radiotherapy in women with carcinoma of the cervix.Results: One thousand seven hundred twenty-five (1725) women with cervical cancer were studied, of which 955 (57.7%) women received radiotherapy. The likelihood of receiving radiotherapy increased with increasing age (OR: 2.2; 95% confidence interval, CI,1.5-3.1, 70-79, versus ≤39 years. The indigenous semiurban dwellers (unadjusted OR: 2.4; 95% CI: 1.6-3.5), and foreign nationals (unadjusted OR: 4.1; 95% CI: 2.5- 6.9), were more likely to receive radiation treatment relative to those who resided in the metropolis. Women with three or more comorbidities (unadjusted OR: 0.2; 95% CI: 0.1-0.5), those recruited at the gynaecology unit (unadjusted OR: 0.01; 95% CI: 0.002- 0.01) and subjects with no histological diagnosis (unadjusted OR: 0.004; 95% CI: 0.002-0.01) were likely not to receive radiation treatment. After controlling for other variables, recruitment from the gynaecologic units was significantly associated with a probability of receiving radiation treatment (Adjusted OR: 0.1; 95% CI: 0.01- 0.3).Conclusion: Women diagnosed with cervical cancer at the gynaecologic departments were less likely to access radiation treatment.