Cervical cancer survival among women referred to cancer centres in Ghana


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Yvonne Nartey1,Brian Cox1,Philip Hill1,Amo-Kwabena Antwi2
1University of Otago,2Komfo Anokye Teaching Hospital

Abstract

Background

Cervical cancer is one of the most common cancers among women worldwide. Despite the fact that it is preventable through HPV vaccination and screening, an estimated 528,000 women were diagnosed with the disease in 2012. Over 85% of the incidence of the disease occurred in low- and middle-income countries. Cervical cancer ranks as the most common cancer among women in Ghana. There have been no data regarding the cervical cancer survival in Ghana.

 

Method

Information on women diagnosed with cervical cancer between 2010 to 2013 was collected from Komfo Anokye and Korle Bu Teaching Hospitals through review of medical, pathology and computer records at the oncology unit and the obstetrics and gynaecology departments. These are the main referral centres and where women with cervical cancer are diagnosed and treated. Telephone interviews were also conducted with patients and relatives to gather further data. Data were recorded using a standardised study questionnaire and analysed using summary statistics. Survival curves were estimated using Kaplan–Meier method and compared by the log-rank test. Using the multivariate proportional hazards model, survival and hazard rates were calculated. 

 

Results

A total of 1,725 women diagnosed with cervical cancer were included in the study. Information for 821 women were available for the survival analysis. Of these women, 497 (60.5%) died during follow-up. At five years after diagnosis, survival was 30%. Compared with women with FIGO stage I disease, survival was lower in women with stage IV disease. The three-year survival for FIGO stage IV was about 20%. Women with SCC had survival advantages compared to those with ADC (p=0.0144). Women who received both radiotherapy and chemotherapy had better survival compared with other forms of treatment (p<0.001).

Conclusion

The study suggests that considerable improvement in patient outcomes in low- and middle-income countries is needed through raising awareness and knowledge of the disease.