Colorectal cancer survival in sub‐Saharan Africa by age, stage at diagnosis and Human Development Index: A population‐based registry study. Issue 8 (21st July 2021)

• Record Type: Journal Article
• Authors: Gullickson, Cricket; Goodman, Michael; Joko‐Fru, Yvonne W.; Gnangnon, Freddy Houéhanou Rodrigue; N'Da, Guy; Woldegeorgis, Mathewos Assefa; Buziba, Nathan Gyabi; Karugu, Caroline; Manraj, Shyam S.; Lorenzoni, Cesaltina Ferreira; Hansen, Rolf; Finesse, Anne; Somdyala, Nontuthuzelo I. M.; Bukirwa, Phiona; Chingonzoh, Tatenda; Chokunonga, Eric; Liu, Biying; Kantelhardt, Eva; Parkin, Donald M.; Jemal, Ahmedin
• Is Part Of: International journal of cancer. Volume 149:Issue 8(2021)
• Page Start: 1553
• Page End: 1563
• Publication Date: 2021-07-21
• Subjects: Africa -- colorectal cancer -- Human Development Index -- registry -- survival; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.33715
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: There are limited population‐based survival data for colorectal cancer (CRC) in sub‐Saharan Africa. Here, 1707 persons diagnosed with CRC from 2005 to 2015 were randomly selected from 13 population‐based cancer registries operating in 11 countries in sub‐Saharan Africa. Vital status was ascertained from medical charts or through next of kin. 1‐, 3‐ and 5‐year overall and relative survival rates for all registries and for each registry were calculated using the Kaplan‐Meier estimator. Multivariable analysis was used to examine the associations of 5‐year relative survival with age at diagnosis, stage and country‐level Human Development Index (HDI). Observed survival for 1448 patients with CRC across all registries combined was 72.0% (95% CI 69.5‐74.4%) at 1 year, 50.4% (95% CI 47.6‐53.2%) at 3 years and 43.5% (95% CI 40.6‐46.3%) at 5 years. We estimate that relative survival at 5 years in these registry populations is 48.2%. Factors associated with poorer survival included living in a country with lower HDI, late stage at diagnosis and younger or older age at diagnosis (<50 or ≥70 years). For example, the risk of death was 1.6 (95% CI 1.2‐2.1) times higher for patients residing in medium‐HDI and 2.7 (95% CI 2.2‐3.4) times higher for patients residing in low‐HDI compared to those residing in high‐HDI countries. Survival for CRC remains low in sub‐Saharan African countries, though estimates vary considerably by HDI. Strengthening health systems to ensure access to prevention, early diagnosis and appropriate treatment is critical in improving outcomes of CRC in the region. Abstract : What's new? Colorectal cancer is on the rise in sub‐Saharan Africa. Here, the authors conducted a population‐based study to evaluate survival by age, stage, and country‐level Human Development Index (HDI). HDI is determined by the average life expectancy at birth, years of education, and per capita income. The authors found that poorer survival correlated with later stage at diagnosis, lower HDI, and age at diagnosis of under 50 or over 70. Improving access to prevention, screening and early treatments will all help improve outcomes.