Abstract:
Colorectal cancer (CRC) is a cancer of the large intestine. Anatomically, it also is known as
colon cancer or rectal cancer but when both present with similar features they are termed
colorectal cancer. It is a common health problem, representing the third most commonly
diagnosed cancer worldwide and causing a significant burden in terms of morbidity and
mortality. In Ethiopia CRC is the third most common cancer next to breast and uterine cancer
for females, but the first most common cancer among the male population. The main objective of
the study was to investigate the associated factors that affect the time to death of CRC patients in
TASH, Addis Ababa, Ethiopia by using survival models. The retrospective cohort study was
conducted on 325 CRC patients who enrolled between January 1, 2017, and December 30, 2020,
in TASH, Addis Ababa, Ethiopia. From 325 patients, 111 (34.15%) died. The overall median
survival time of colorectal cancer patients is 23 months. Kaplan-Meier survival curves and Log Rank test were used to compare the survival experience of different categories of patients. Five
AFT fitted models (Exponential, Weibull, Log-normal, generalized gamma, and Log-logistic)
were compared by using AIC and BIC. The log-logistic AFT model was found to be the best
model to fit the data. Based on the log-logistic model, marital status, stage, family history,
alcohol consumption, physical exercise, tumor grade, and treatment modality were found to be
the most prognostic factors of time to death of CRC patients at 5% levels of significance. The
result showed that non-alcohol user and married patients were prolonged the survival time
whereas, CRC patients who were diagnosed at stage IV (metastatic), patients who did not do
physical activity, patients who had no family history, patients diagnosed with poorly
differentiated tumor grade, patients diagnosed as chemotherapy alone and chemo plus surgery
were shortened the survival time. From our findings, it is better to implement colorectal cancer
early screening and detection programs to improve survival outcomes.
