Abstract:
Cervical cancer is the fourth most commonly diagnosed and the fourth leading cause of
cancer death among women worldwide. In many low- and middle-income countries
(LMICs) including Kenya cervical cancer remains the leading cause of cancer death
among women. This situation is due to the fact that despite the existence of effective
preventive and early detection programs, lack of implementation in LMICs leads many
women suffering from the disease to premature death. This study was aimed at
estimating the five-year overall survival rates for women with cervical cancer in Kenya.
To achieve this, the study employed a retrospective cohort design where medical records
of all patients who commenced treatment for cervical cancer in 2008 were reviewed
retrospectively over a period of five years from 2008- 2013. Data analysis involved the
use of Stata v14.2 to generate descriptive statistics and conduct survival analysis. The
five-year overall survival estimate for women with cervical cancer at Kenyatta National
Hospital (KNH) in 2008 was found to be 59%. Stage of disease at diagnosis, type of
treatment received and whether or not treatment was initiated and completed are the
three factors revealed to have the strongest influence on patient survival. Occupation
which was used as a proxy for socio-economic status (SES) did not reflect the financial
burden imposed on patients seeking treatment. However, the loss to follow up was
significantly high at a rate of 82.3%; with no deaths observed after the first year, the
overall survival estimate is only accurate over the first year. The results of this study
provided insight on the relationship between various socio-demographic and clinical
factors and patient outcomes of cervical cancer treatments at KNH. Moreover, it
highlighted the ongoing health system challenges surrounding provision of and access to
cancer treatment. The results will inform policy makers and health service providers on
the quality and accessibility of available cervical cancer treatments as delivered within
our healthcare setting.
