Predictors of Time to Death among Cervical Cancer Patients at Hawassa University Comprehensive Specialized Hospital: A Facility-Based Retrospective Follow-Up Study

Abstract

Background: Cervical cancer is a major cause of mortality among women worldwide, particularly in low and middle-income countries. Remarkably, in developing countries, less than 50% of women with cervical cancer survive longer than 5 years. Moreover, the survival time and predictors of death from cervical cancer vary in different study settings. Hence understanding the predictors of time to death among cervical cancer patients is crucial for improving prognosis and developing targeted interventions. The study aimed to determine the time to death from cervical cancer and predictors among cervical cancer patients at Hawassa University specialized and comprehensive hospital, Ethiopia, 2023.

Methods: This facility-based retrospective follow-up study utilized 212 medical records of cervical cancer patients treated at HUSCH between January 1, 2018 and December 31, 2022. A simple random sampling Method was employed to select the study participants. Data were extracted by using a structured checklist. Epidata version 4.6.0 and STAT version 14 were used for data entry and analysis respectively. The Kaplan Meier survival curve and log rank test were used to estimate survival time and a statistical comparison of two groups respectively. Bivariable and multivariable Cox proportional hazard model was fitted to identify predictors of time to death.  Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CIs) and a p-value< 0.05 were considered to be statistically significant.

Results: The overall incidence density of death was 12.4 per 1000 person-years of Follow-up.  The median (IQR) time to death was 23(2-36) months. The Cox proportional hazards regression analysis revealed that advanced stage of cancer (AHR = 2.1; 95% CI: 1.068-4.068) and presence of co-morbidities (AHR=1.2; 95% CI: 1.065-1.335) were a significant predictors of time to death from cervical cancer.

Conclusion: The overall death rate was found to be low as compared to other studies conducted both nationally and globally. However, stages of cancer and co-morbidity status are identified as critical predictors of time to death among cervical cancer patients. Therefore, these findings highlight the importance of early detection and treatment, as well as comprehensive care, for improving survival outcomes in cervical cancer patients.