Morbidity and mortality trend analysis of cervical cancer in Zambia for the period 2007 to 2014: a case of Cancer Diseases Hospital

Abstract

In 2014 alone, over 3 million women aged ≥15 years were at risk of being diagnosed with cervical cancer in Zambia. Our study aimed at examining trends and factors associated with cervical cancer morbidity and mortality, among cases presented at the Cancer Diseases Hospital (CDH), in Lusaka, Zambia. A retrospective case-study was conducted to review cervical cancer morbidity and mortality between 2007 and 2014 at Cancer Diseases Hospital (CDH). Eligible cervical cancer cases and deaths recorded from Zambian patients ≥15 years were reviewed using a set criterion. Descriptive statistics were generated for all the variables and further analyses were done using Chi-square, Ordinary least-squares regression and Coxhazard regression in SPSS ver20. Cervical cancer cases were highest in 2012, compared to other years; a unit increase in years, resulted in 8.1 increase in numbers of cases. Conversely, a unit increase in years, resulted in a 3.7 reduction in cervical cancer deaths at CDH. Mean age at diagnosis was 49.9 and 51.5 years at death. High cases were reported among married women of child-bearing age, living in urban areas. Those ≥56 years were 1.1 times more likely to die of cervical cancer than those younger. Risk of death was also influenced by advanced stages of cancer and HIV status. The general overall mean months of survival to death was 58.4 months. Months of survival were statistically affected by factors such as age, staging, radiotherapy as type of treatment, and of HIV positive status. This study established an increasing trend of cervical cancer cases and reducing mortality over 2007-2014. Late diagnosis and HIV positive status increases the case fatality risks among the patients at CDH. We recommend to setting up deliberate cervical cancer screening services especially among HIV positive women.