关键词: Colorectal cancer Ethiopia Mortality Predictors

Mesh : Humans Ethiopia / epidemiology Colorectal Neoplasms / mortality epidemiology Survival Rate Male Risk Factors Female Incidence

来  源:   DOI:10.1186/s12885-024-12597-9   PDF(Pubmed)

Abstract:
BACKGROUND: The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia.
METHODS: PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger\'s regression test, while heterogeneity was evaluated through the Cochran Q test and I2 statistics.
RESULTS: After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors.
CONCLUSIONS: In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.
摘要:
背景:在撒哈拉以南国家,结直肠癌(CRC)的发病率一直在增加,包括埃塞俄比亚。然而,埃塞俄比亚CRC患者的实际死亡率尚未确定.因此,本系统综述和荟萃分析旨在确定埃塞俄比亚CRC患者的总死亡率并确定预测因素.
方法:PubMed,EMBASE,WebofScience,Scopus,科学直接,和谷歌学者被搜索以识别相关文章。遵循系统评价和荟萃分析(PRISMA)的首选报告项目。使用纽卡斯尔-渥太华量表关键评估清单评估纳入研究的质量。随机效应模型用于估计合并死亡率和调整风险比(AHR)。使用漏斗图和Egger回归检验评估发表偏倚,异质性通过CochranQ检验和I2统计进行评估。
结果:在回顾了74篇文章之后,只有7项研究符合标准并纳入分析.分析显示,埃塞俄比亚CRC患者的总死亡率为40.5%(95%置信区间[CI]:32.05,48.87),3年,5年为82.3%(95%CI:73.33,91.31),48.8%(95%CI:43.35,54.32),分别为26.6%(95%CI:21.26、31.91)。亚组分析表明,2017年之后进行的研究与之前进行的研究相比,死亡率更高(43.0%vs.38.2%)。年龄较大(AHR:1.89,95%CI:1.27,2.82);已婚(AHR:2.53,95%CI:1.79,3.57);合并症(AHR:1.84,95%CI:1.45,2.35);CEA水平高(AHR:2.06,CI:1.35,3.13);处于第二阶段(AHR:4.13,9.95%,1.85):III(AHR:8.62,95%CI:3.88,19.15),IV(AHR:8.06,CI:2.89,22.49)是最重要的预测因子。
结论:在埃塞俄比亚,诊断为CRC的个体的死亡率很高,五分之二的病人死于这种疾病。年龄,婚姻状况,CEA级别,合并症,和癌症分期被确定为CRC患者死亡率的预测因素。因此,应优先考虑早期发现和筛查,特别是对于老年患者,那些已婚的人,有合并症,CEA水平升高,和晚期癌症阶段。
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