Analysis of factors contributing to the low survival of cervical cancer patients undergoing radiotherapy in Kenya
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Authors
Maranga, Innocent O.
Hampson, Lynne
Oliver, Anthony W.
Gamal, Anas
Gichangi, Peter
Opiyo, Anselmy
Holland, Catharine M.
Hampson, Ian N.
Issue Date
2013-10-30
Type
Article
Language
en_US
Keywords
Low Survival , Cervical Cancer Patients , Radiotherapy , Kenya
Alternative Title
Abstract
Background:
In contrast to the developed nations, invasive cervical cancer (ICC) is the most common womens malignancy in Kenya and many other locations in sub-Saharan Africa. However, studies on survival from this disease in this area of the world are severely restricted by lack of patient follow-up. We now report a prospective cohort study of ICC in Kenyan women analysing factors affecting tumour response and overall survival in patients undergoing radiotherapy.
Methods and Findings:
Between 2008 and 2010, 355 patients with histologically confirmed ICC were recruited at the Departments of Gynaecology and Radiotherapy at Kenyatta National Hospital (KNH). Structured questionnaires were completed recording socio-demographics, tumour response and overall survival following treatment with combinations of external beam radiation (EBRT), brachytherapy and adjuvant chemotherapy. Of the 355 patients, 42% (146) were lost to follow-up while 18% (64) died during the two year period. 80.5% of patients presented with advanced stage IIB disease or above, with only 6.7% of patients receiving optimal combined EBRT, brachytherapy and adjuvant chemotherapy. Kaplan Meier survival curves projected two year survival at <20%.
Conclusion:
Cervical cancer is preventable yet poverty, poor education, lack of cancer awareness coupled with an absence of regular screening programs, late patient presentation, sub-optimal diagnosis and treatments are major factors contributing to the alarmingly low survival rate of cervical cancer patients in Kenya. It is concluded that simple cost-effective changes in clinical practice could be introduced which would have a marked impact on patient survival in this setting.
Description
Citation
Maranga, I. O., Hampson, L., Oliver, A. W., Gamal, A., Gichangi, P., Opiyo, A., Holland, C. M., & Hampson, I. N. (2013). Analysis of factors contributing to the low survival of cervical cancer patients undergoing radiotherapy in Kenya. PloS one, 8(10), e78411. https://doi.org/10.1371/journal.pone.0078411
Publisher
PloS One