Factors Influencing the Completion of Head and Neck Cancer Treatment: A Case Study of Tikur Anbessa Referral Hospital, Addis Ababa, Ethiopia

Abstract

Cancer is a class of disease in which group of cells display uncontrolled growth, invasion that intrude upon and destroy adjacent tissues, and sometimes metastasis or spreading to other locations in the body via lymph nodes or blood. The objective of this study was to identify the risk factors that determine the completion of treatments for head and neck cancer patients at Tikur Anbessa Referral Hospital, Addis Ababa, Ethiopia. It was a retrospective study and the data from patients who were registered at the Tikur Anbessa Referral Hospital between December 2007 to January 2010. The simple random sampling method, descriptive statistics and the Kaplan-Meier survival estimator were used to estimate and compare the survival times of the patients. The Cox proportional hazard regression model was applied to model treatment follow up time and examines the association between this time with different demographic and medical variables. Result showed that among 344 head and neck cancer (HNC) patients 38.4% discontinued treatment. The survival distribution of time until treatment discontinuation was found to be significantly related to sex, age interval, region, tumor size, lymph node size, initial stage of the cancer, type of treatment, and duration for radiotherapy that the patient took as well as the aim of the prescription radiotherapy. The log rank test showed that the survival probability of patients was not statistically different among groups classified by HNC site. The study hence identifies these factors as the main reason that affects the completion of HNC treatments. It is therefore suggested that patients should be well informed about the disease so that they follow up the treatment until completion to minimize the dropout rate.