Abstract
BackgroundGlobally, the incidence of prostate cancer is increasing, particularly in low- and middle-income countries. It is the most common cancer among men worldwide, with higher mortality in low and middle-income countries. In Ethiopia, it is the second most common cause of cancer morbidity and mortality among men. Despite a few studies done regarding the disease burden, the evidence is scarce about the survival and prognostic determinants of prostate cancer patients in Ethiopia. Thus, this study assessed the survival and prognostic determinants of patients with prostate cancer.MethodsWe retrospectively followed patients who were newly diagnosed from 2012 to 2016 at the Oncology Department of Tikur Anbessa Specialized Hospital. We extracted the data from patient charts that were available in the cancer registry using a checklist with the help of oncology nurses. Kaplan-Meier survival analyses with the log-rank test were used to estimate and compare the probability of survival among covariate categories. After checking for assumptions, a multivariable Cox regression analysis was performed to identify prognostic determinants of survival.ResultsThe median survival time was 28 months with an overall 2-, 3- and 5-year survival of 57%, 38.9% and 22%, respectively. The overall survival differs according to the clinical stage (P-value<0.01), presence or absence of distant metastasis (P<0.01) and androgen deprivation therapy (ADT) (P<0.05). Cancer stage at diagnosis (adjusted hazard ratio (AHR) = 0.309, 95%CI = 0.151–0.633) and ADT (AHR = 3.884, 95%CI = 1.677–8.997) remained significant in the final Cox proportional hazards model.ConclusionsThe overall 2-, 3- and 5-year survival of prostate cancer patients in Ethiopia is very low. The cancer stage at diagnosis and treatment modalities are significant prognostic determinants of survival. Therefore, early detection through screening and timely initiation of treatment are essential to improve the survival of prostate cancer patients.
Highlights
Cancer is among the leading causes of premature death worldwide, and the prevalence is still increasing
The overall survival differs according to the clinical stage (Pvalue
Early detection through screening and timely initiation of treatment are essential to improve the survival of prostate cancer patients
Summary
Cancer is among the leading causes of premature death worldwide, and the prevalence is still increasing. Cancer was described as a disease of the riches, but it has become evident that it is a public health problem in low- and middle-income countries (LMICs). This could be due to the lifestyle changes, rapid urbanization, cultural transition, and an increase in life expectancy in LMICs. From 2005 to 2015, the highest (10–20%) increase in the incidence of cancer observed in the World Health Organization (WHO) African region [1, 2]. The incidence of prostate cancer is increasing, in low- and middleincome countries It is the most common cancer among men worldwide, with higher mortality in low and middle-income countries. This study assessed the survival and prognostic determinants of patients with prostate cancer
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