Disparities In Receipt Of Radiotherapy And Outcomes Among Cervical Cancer Patients Seen In Tikur Anbessa Hospital Ethiopia

Introduction: Ethiopia is among countries with the highest burden of cervical cancerrnworldwide. Up to 6,000 new cervical cancer patients are diagnosed each year. The primaryrnobjective of this study was to evaluate the survival of cervical cancer patients in general andrncompare the difference in survival, waiting time and stage migration among patients treatedrnwith radiotherapy in Tikur Anbessa Hospital on private wing and regular sides. rnMethodology: Women with histologically verified cervical cancer, who received radiotherapyrnin 2014, were included. All patient characteristics, tumor characteristics, and informationrnconcerning therapy and outcome were extracted from the patients’ medical record files. Vitalrnstatus was obtained through telephone contact or patient cards. rnResult: Out of 249 patients treated in 2014, the patient file of 242 could be retrieved. 152rn(63%) were treated on the regular service side and 90 (37%) were treated on Private wing side.rnThe median age at diagnosis was 45 years and 48 years for patients with private wing side andrnregular service side. After first oncologist consultation private wing patients waited more (92rndays) than regular side patients (39 days) to receive radiotherapy. During this time, stagernmigration was seen more in private wing (20%) than regular side (8.6%) patients. In general,rnthe estimated of 52 months overall survival probabilities were 21.5% (14.6% in worst-casernscenario). The median overall survival time was 21 months (18 months in worst-case scenario).rnThe median survival was 23 months (19 months in worst-case) and 19 months (17 months inrnworst-case) between private wing and regular side patients, respectively. The FIGO stage,rnintension of radiotherapy, one-year tumor control rate, comorbidity and concurrentrnchemotherapy were the factors, which has found to be significant association with survival. rnConclusion: The survival of cervical cancer patients remains low in Ethiopia, despite the higherrncure rate of the disease. The reason for poor survival were advanced stage at presentation,rnvery long waiting time for treatment and as a result stage migration, the old treatmentrnmachine and technique and absence of brachytherapy are some of the reason. Therefore, thernparallel oriented efforts in all direction such as prevention, early detection and improvingrnaccess to standardized care are required.

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