Colorectal cancer survival in sub-Saharan Africa by age, stage at diagnosis and Human Development Index: A population-based registry study.

Autor: Gullickson C; Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.; Emory University School of Medicine, Atlanta, Georgia, USA., Goodman M; Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Joko-Fru YW; The African Cancer Registry Network, INCTR African Registry Programme, Oxford, UK.; Nuffield Department of Population Health, University of Oxford, Oxford, UK., Gnangnon FHR; Cotonou Cancer Registry, Cotonou, Benin.; Department of Visceral Surgery, School of Medicine, University of Abomey-Calavi, Benin., N'Da G; Abidjan Cancer Registry, Abidjan, Côte d'Ivoire., Woldegeorgis MA; Addis Ababa City Cancer Registry, Addis Ababa, Ethiopia., Buziba NG; Eldoret Cancer Registry, Eldoret, Kenya., Karugu C; Nairobi Cancer Registry, Nairobi, Kenya., Manraj SS; Mauritius National Cancer Registry, Port Louis, Mauritius., Lorenzoni CF; Maputo Cancer Registry, Maputo, Mozambique., Hansen R; Namibian Cancer Registry, Windhoek, Namibia., Finesse A; Seychelles National Cancer Registry, Victoria, Seychelles., Somdyala NIM; Eastern Cape Cancer Registry, South African Medical Research Council, Tygerberg, South Africa., Bukirwa P; Kampala Cancer Registry, Kampala, Uganda., Chingonzoh T; Bulawayo Cancer Registry, Bulawayo, Zimbabwe., Chokunonga E; Zimbabwe National Cancer Registry, Harare, Zimbabwe., Liu B; The African Cancer Registry Network, INCTR African Registry Programme, Oxford, UK., Kantelhardt E; Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle, Germany.; Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Germany., Parkin DM; The African Cancer Registry Network, INCTR African Registry Programme, Oxford, UK.; Nuffield Department of Population Health, University of Oxford, Oxford, UK.; Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France., Jemal A; American Cancer Society, Atlanta, Georgia, USA.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2021 Oct 15; Vol. 149 (8), pp. 1553-1563. Date of Electronic Publication: 2021 Jul 21.
DOI: 10.1002/ijc.33715
Abstrakt: There are limited population-based survival data for colorectal cancer (CRC) in sub-Saharan Africa. Here, 1707 persons diagnosed with CRC from 2005 to 2015 were randomly selected from 13 population-based cancer registries operating in 11 countries in sub-Saharan Africa. Vital status was ascertained from medical charts or through next of kin. 1-, 3- and 5-year overall and relative survival rates for all registries and for each registry were calculated using the Kaplan-Meier estimator. Multivariable analysis was used to examine the associations of 5-year relative survival with age at diagnosis, stage and country-level Human Development Index (HDI). Observed survival for 1448 patients with CRC across all registries combined was 72.0% (95% CI 69.5-74.4%) at 1 year, 50.4% (95% CI 47.6-53.2%) at 3 years and 43.5% (95% CI 40.6-46.3%) at 5 years. We estimate that relative survival at 5 years in these registry populations is 48.2%. Factors associated with poorer survival included living in a country with lower HDI, late stage at diagnosis and younger or older age at diagnosis (<50 or ≥70 years). For example, the risk of death was 1.6 (95% CI 1.2-2.1) times higher for patients residing in medium-HDI and 2.7 (95% CI 2.2-3.4) times higher for patients residing in low-HDI compared to those residing in high-HDI countries. Survival for CRC remains low in sub-Saharan African countries, though estimates vary considerably by HDI. Strengthening health systems to ensure access to prevention, early diagnosis and appropriate treatment is critical in improving outcomes of CRC in the region.
(© 2021 UICC.)
Databáze: MEDLINE
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