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PLoS One. 2013 Oct 30;8(10):e78411. doi: 10.1371/journal.pone.0078411. eCollection 2013.

Analysis of factors contributing to the low survival of cervical cancer patients undergoing radiotherapy in Kenya.

Author information

1
University of Manchester, Viral Oncology, Research Floor, St Mary's Hospital, Manchester, United Kingdom ; Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.

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.

PMID:
24205226
PMCID:
PMC3813592
DOI:
10.1371/journal.pone.0078411
[Indexed for MEDLINE]
Free PMC Article

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