Survival pattern of colorectal cancer in Sub-Saharan Africa: A systematic review and meta-analysis |
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| Institution: | 1. Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium;2. School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia;3. School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;4. Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia;1. Research Unit for General Practice, Aarhus, Bartholins Alle 2, 8000 Aarhus C, Denmark;2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus C, Denmark;1. Medical College, Jiaxing University, Jiaxing 314001, China;2. College of Public Health, Xinjiang Medical University, Urumqi 830054, China;3. Affiliated Hospital of Jiaxing University, Jiaxing 314001, China;4. Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China;5. College of Public Health, Zhejiang Chinese Medical University, Hangzhou 310000, China;1. Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, United States;2. Section of Hematology/Oncology, Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, United States;3. Center for Applied Social Research, College of Arts and Sciences, University of Oklahoma, Norman, OK, 73072, United States;1. Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, Ontario, Canada;2. Epidemiology & Biostatistics, Western University, London, Ontario, Canada;3. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;4. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada;5. Division of Medical Oncology & Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;6. Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;7. Division of Thoracic Surgery, Toronto General Hospital, Toronto, Ontario, Canada;1. Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia;2. School of Public Health, University of Queensland, Brisbane, Queensland, Australia;3. Centre for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia;4. School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia;5. Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia;6. Royal Brisbane and Women''s Hospital, Australia;7. Faculty of Medicine, The University of Queensland, Australia;8. Centre for Big Data Research in Health, University of New South Wales UNSW, Sydney, New South Wales, Australia;1. Dept. of Urology, Mount Sinai Medical Center, Miami Beach, FL, United States;2. Florida International University, Herbert Wertheim College of Medicine, Miami, FL, United States |
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| Abstract: | Cancer incidence is relatively low in sub-Saharan Africa (SSA), however, prognosis is expected to be poor in comparison with high-income countries. Comprehensive evidence is limited on the survival pattern of colorectal cancer patients in the region. We conducted a systematic review and meta-analysis to investigate the pattern of colorectal cancer survival in the region and to identify variation across countries and over time. We searched international databases MEDLINE, Scopus, Embase, Web of Science, ProQuest, CINAHL, and Google Scholar to retrieve studies that estimated survival from colorectal cancer in SSA countries from inception to December 31, 2021 without language restriction. Due to between-study heterogeneity, we performed a random-effects meta-analysis to pool survival rates. To identify study-level sources of variation, we performed subgroup analysis and meta-regression. Results are reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guideline and the protocol was registered in PROSPERO database (CRD42021246935). 23 studies involving 10,031 patients were included in the review, of which, 20 were included in the meta-analysis. The meta-analysis results showed that the pooled 1-, 2-, 3-, 4-, and 5-year survival rates in SSA were 0.74 (95% CI, 0.66–0.81), 0.50 (95% CI, 0.41–0.58), 0.36 (95% CI, 0.27–0.47), 0.31 (95% CI, 0.22–0.42), and 0.28 (95% CI, 0.19–0.38) respectively. Subgroup analyses indicated that the survival rate varied according to year of study, in which those conducted in recent decades showed relatively better survival. The 5-year survival was higher in middle-income SSA countries (0.31; 95%CI: 0.17–0.49) than low-income countries (0.20; 95%CI: 0.11–0.35), however, the difference was not statistically significant. In conclusion, survival from colorectal cancer is low in sub-Saharan Africa compared to other regions. Thus, intervention strategies to improve screening, early diagnosis and treatment of colorectal cancer should be developed and implemented to improve survival in the region. |
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| Keywords: | Colorectal cancer Survival Sub-Saharan Africa Systematic review Meta-analysis |
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