TIME TO DEATH AND ASSOCIATED FACTORS OF COLORECTAL CANCER PATIENTS IN TIKUR ANBESSA SPECIALIZED HOSPITAL, ADDIS ABABA, ETHIOPIA

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.