Presentation, patterns of care, and outcomes of patients with prostate cancer in sub-Saharan Africa: A population-based registry study.

Autor: Seraphin TP; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Joko-Fru WY; African Cancer Registry Network, International Network for Cancer Treatment and Research African Registry Programme, Oxford, United Kingdom.; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom., Hämmerl L; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Griesel M; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Mezger NCS; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Feuchtner JC; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Adoubi I; Department of Immunology, Haematology and Oncology, University of Felix Houphouet-Boigny, Abidjan, Côte d'Ivoire.; Abidjan Cancer Registry, Programme National de Lutte contre le Cancer, Ministry of Health, Abidjan, Côte d'Ivoire., Egué MD; Cotonou Cancer Registry, Ministry of Health, Cotonou, Benin., Okerosi N; National Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya., Wabinga H; Kampala Cancer Registry, Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda., Hansen R; Namibia National Cancer Registry, Cancer Association of Namibia, Windhoek, Namibia., Vuma S; Bulawayo Cancer Registry, Department of Radiotherapy, Mpilo Hospital, Bulawayo, Zimbabwe., Lorenzoni C; National Cancer Control Programme, Ministry of Health, Maputo, Mozambique.; Maputo Cancer Registry, Department of Pathology, Hospital Central de Maputo, Maputo, Mozambique., Coulibaly B; Cancer Registry of Bamako, Hôpital National du Point G, Bamako, Mali., Odzebe SW; Cancer Registry of Brazzaville, University Hospital Brazzaville, Brazzaville, Republic of Congo., Buziba NG; Eldoret Cancer Registry, Moi Teaching Hospital, Eldoret, Kenya.; Department of Haematology and Blood Transfusion, Moi University School of Medicine, Eldoret, Kenya., Aynalem A; Addis Ababa City Cancer Registry, Radiotherapy Center, Addis-Ababa-University, Addis Ababa, Ethiopia., Liu B; African Cancer Registry Network, International Network for Cancer Treatment and Research African Registry Programme, Oxford, United Kingdom., Medenwald D; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Mikolajczyk RT; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany., Efstathiou JA; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.; Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic, Massachusetts General Hospital, Boston, Massachusetts., Parkin DM; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France., Jemal A; Surveillance & Health Equity Science Department, American Cancer Society, Atlanta, Georgia., Kantelhardt EJ; Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.; Department of Gynecology, University Hospital Halle, Martin Luther University Halle-Wittenberg, Halle, Germany.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2021 Nov 15; Vol. 127 (22), pp. 4221-4232. Date of Electronic Publication: 2021 Jul 30.
DOI: 10.1002/cncr.33818
Abstrakt: Background: Although prostate cancer (PCa) is the most commonly diagnosed cancer in men of sub-Saharan Africa (SSA), little is known about its management and survival. The objective of the current study was to describe the presentation, patterns of diagnosis, treatment, and survival of patients with PCa in 10 countries of SSA.
Methods: In this observational registry study with data collection from 2010 to 2018, the authors drew a random sample of 738 patients with PCa who were registered in 11 population-based cancer registries. They described proportions of patients receiving recommended care and presented survival estimates. Multivariable Cox regression was used to calculate hazard ratios comparing the survival of patients with and without cancer-directed therapies (CDTs).
Results: The study included 693 patients, and tumor characteristics and treatment information were available for 365 patients, 37.3% of whom had metastatic disease. Only 11.2% had a complete diagnostic workup for risk stratification. Among the nonmetastatic patients, 17.5% received curative-intent therapy, and 27.5% received no CDT. Among the metastatic patients, 59.6% received androgen deprivation therapy. The 3- and 5-year age-standardized relative survival for 491 patients with survival time information was 58.8% (95% confidence interval [CI], 48.5%-67.7%) and 56.9% (95% CI, 39.8%-70.9%), respectively. In a multivariable analysis, survival was considerably poorer among patients without CDT versus those with therapy.
Conclusions: This study shows that a large proportion of patients with PCa in SSA are not staged or are insufficiently staged and undertreated, and this results in unfavorable survival. These findings reemphasize the need for improving diagnostic workup and access to care in SSA in order to mitigate the heavy burden of the disease in the region.
(© 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
Databáze: MEDLINE
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