Stage at diagnosis and survival among adult patients with cancer in Rwanda: A population‐based study

• Published in: International journal of cancer Vol. 155; no. 6; pp. 988 - 995
• Main Authors: Hagenimana, Marc, Motlhale, Melitah, Parkin, Donald Maxwell, Businge, Lydia, Bardot, Aude, Liu, Biying, Anastos, Kathryn, Castle, Philip E., Murenzi, Gad, Claire, Kimilu, Sabushimike, Daniel, Cyuzuzo, Callixte, Kubwiana, Gallican, Maniragaba, Theoneste, Uwinkindi, Francois, Paczkowski, Maggie, Soerjomataram, Isabelle
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 15.09.2024; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Breast cancer; Cancer; Control programs; Female; Health disparities; Humans; Liver cancer; Lymphoma; Male; Malignancy; Medical diagnosis; Middle Aged; Neoplasm Staging; Neoplasms - diagnosis; Neoplasms - epidemiology; Neoplasms - mortality; Older people; Ovaries; Population studies; Population-based studies; Prostate; Registries; Rwanda - epidemiology; Survival; Survival Rate; Young Adult; Rwanda
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.34969

There are marked disparities in cancer survival in low‐income countries compared to high‐income countries, yet population‐based data in the first is largely lacking. In this study, data from the national cancer registry of Rwanda were examined for 542 patients diagnosed with eight of the most common cancers of adults stomach (C16), colorectum (C18‐20), liver (C22), breast (female) (C50), cervix (C53), ovary (C56), prostate (C61), and non‐Hodgkin lymphomas (C82‐85) between 2014 and 2017. Subjects were randomly selected for active followed‐up to calculate 1‐, 3‐, and 5‐year observed and relative survival (RS) by cancer type and stage. Overall, 53.7% of cases had died within 5 years of diagnosis. Five‐year RS varied by malignancy and ranged from 17.6% (95% confidence interval [CI]: 6.7%–32.6%) for liver cancer to 68% (CI: 51.6%–79.8%) for cancers of the prostate. Stage was assigned for 71.6% of patients (n = 388 of 542), with over half (58%) having advanced stage (III/IV) at diagnosis. For all except liver and ovary, stage was a strong predictor of survival; for example, three‐year observed survival was 90.9% and 44.8% (p‐value: .002) for early and advanced breast cancer, respectively. This study demonstrates that stage specific survival can be obtained from population based cancer registries in sub Saharan Africa, data that are invaluable for international benchmarking, and for local planning and evaluation of cancer control programs. What's new? In general, cancer survival proportions are low in low‐income countries, relative to high income countries. This disparity is likely due to the tendency in low‐income countries for patients to be diagnosed at advanced stages of disease. Specifically in sub‐Saharan Africa, however, data on the cancer patients distribution of cancer stage is lacking. Here, the authors examined data on cancer survival from Rwanda and carried out analyses of population‐based cancer survival by stage at diagnosis and sex. Analyses reveal marked survival differences by cancer type. Impacts on survival were greatest for advanced stage cancer, highlighting the need for improved early diagnosis and detection.