Tsion Afework

Globally, colorectal cancer (CRC) is the third most common type of cancer and the second most deadly. CRC significantly impairs patients’ overall and health-related quality of life, as well as their psychological and physical function. However, in Ethiopia, there is insufficient local evidence about the quality of life of patients with colorectal cancer. Hence, this study aimed to assess the quality of life of adult colorectal cancer patients who have follow-ups at the cancer center in Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. An institutional-based cross-sectional study was conducted among 159 colorectal cancer patients attending the Tikur Anbessa Specialized Hospital Cancer Center from February to April 2019. The validated Amharic version of the European Organisation for Research and Treatment of Cancer Core 30 questionnaire (EORTC QLQ C-30) and the disease-specific colorectal cancer questionnaire (EORTC QLQ CR-29) were used. A binary logistic regression model was used to identify the factors associated with quality of life. The adjusted measure of effect (AOR) with a 95% CI was presented and P < 0.05 was used to declare statistical significance. There were 159 colorectal cancer patients, 89 of whom were male, and the median time from diagnosis was 12.5 months. The patients had a low global health status score with a mean (± SD) of 52.88 ± 21.02. Being employed (AOR = 3.41; 95% CI 1.15, 10.17), early-stage clinical diagnosis (AOR = 4.98; 95% CI 1.51, 16.4), physical functioning (AOR = 1.04, 95% CI 1.01, 1.06), and social functioning (AOR = 1.02; 95% CI 1.01, 1.04) were associated with good quality of life. Whereas, being female (AOR = 0.16; 95% CI 0.05, 0.52), having financial difficulty (AOR = 0.98; 95% CI 0.96, 0.99), and having blood and mucus in the stool (AOR = 0.94; 95% CI 0.91, 0.96) were associated with poor quality of life. In our study, half of our study participants had poor quality of life. The responsible stakeholders should identify and address the patients’ respective symptoms. Female patients, those in severe clinical stages, unemployed patients, those experiencing financial difficulties, and those with blood and mucus in their stool should receive due attention.

Cancer is a global public health issue that continues to increase because of aging and adoption of cancer-causing behaviours. In Ethiopia, cancer belongs to the second most common non-communicable disease. Cancer patients face a range of unmet needs in multiple aspects of their lives. Supportive care is defined as essential care that helps patients to cope with cancer. This study aims to assess the predictors of unmet supportive care needs in adult cancer patients in Ethiopia. Institution-based cross-sectional study was done from February to March 2019 in adult cancer patients. Three hundred seventy-one patients were interviewed using convenience sampling. Supportive care needs were used as outcome variables, dichotomized as 'no need' and 'unmet needs'. Variables with a p-value of <0.2 were candidates for multivariable logistic regression. From 371 patients, 69.8% were females with a mean age of 47 years; the commonest type of cancer was gynaecological cancer. Information about diagnosis, stage of cancer, time since diagnosis, age, wealth index, employment status, gender, type of treatment, history of recurrence, type of cancer and information about diagnosis modified by the source of information were predictors of unmet supportive care needs. The study emphasised the importance of considering sociodemographic, clinical and information-related factors when dealing with cancer patients. Programmes, guidelines and services that focus on supportive care needs should be established and/or implemented.

Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiation intervals of breast cancer patients and quantified the impact of socio-demographic and clinical factors, perceived barriers, and the patients´ perceived social support status on timely systemic treatment initiation (chemotherapy or hormonal therapy). A structured questionnaire was designed based on Pechansky´s “Concept of Access”. Applying simple and multivariate logistic regression we analysed the influence of patients´ characteristics as well as their perceived barriers on timely treatment initiation. We measured social support with the Multidimensional Score of Perceived Social Support (MSPSS) and used the Wilcoxon Rank-Sum Test to assess its relationship with timely treatment initiation. Of 196 patients included into the study, 53% received systemic treatment within 90 days of their pathological diagnosis–the median treatment initiation interval was 85 days (IQR 123.5). Older women and patients diagnosed at late stages had higher odds of timely treatment initiation. Not being able to pay for services and lack of transport were most often perceived as barriers towards timely care. However, none of the perceived barriers showed a substantial influence on timely treatment initiation in the multivariate regression model. The patients´ perceived social support was found to be high, with an average MSPSS score of 73 out of 84 (SD 13,63). No impact of the perceived social support status on timely treatment initiation was found. The percentage of breast cancer patients waiting longer than 90 days from pathological diagnosis to systemic treatment initiation in Ethiopia remains unacceptably high. While women generally feel well supported by their social environment, costs and accessibility of treatment are perceived to be major barriers towards timely treatment initiation.