Management and survival outcomes of patients with lung cancer at a leading radiotherapy centre in Sub-Saharan Africa: a cross-sectional study.

Abstract

Background: Lung cancer is a major global health challenge that has a substantial impact on the health and well-being of many individuals. Despite the progress that has been made in its treatment globally, there is a paucity of reliable data on management and survival outcomes in sub-Saharan Africa.

Aim: To describe the clinical profiles, management and survival outcomes of patients with lung cancer.

Methods: This research was a cross-sectional study conducted at a leading radiotherapy centre in Ghana. The study involved adult patients with lung cancer who received treatment over a 10-year period. A consecutive random sampling technique was used to select eligible participants for the study. Relevant data were extracted from patients' hospital-based medical records. Data were analysed with STATA (version 17). Kaplan-Meier survival analyses were used to estimate overall survival (OS) outcomes. Cox proportional hazards models were used to identify prognostic factors associated with survival outcomes.

Results: In all, there were 118 patients with a male predominance of 53.4%. The mean age was 59.4 years (± 13), with a significant proportion being geriatric (> 60 years) (48.3%). Also, there were more nonsmokers than smokers (57.6% versus 33.9%), with only 6.8% having a positive family history for cancer. Notably, 4.2% had a history of treatment for pulmonary tuberculosis, while ~75% were diagnosed at advanced stages of lung cancer (stage IVA = 48.3% and IVB = 27.1%). Most patients were diagnosed with non-small cell lung cancer (NSCLC) (94.9%). Management was essentially palliative (65.3%), and with the use of systemic therapy (72.3%). Only 3.4% and 1.7% received targeted and immunotherapy, respectively. Patients <60 years had better OS compared with those ≥ 60 years (p = 0.771). Similarly, patients with NSCLC had better OS than patients with small cell lung cancer (p = 0.001). A good Eastern Cooperative Oncology Group performance status was a predictor of better OS (p = 0.004).

Conclusion: The predominance of advanced-stage disease, reliance on palliative care, systemic chemotherapy and disparities in access to advanced therapies highlight significant challenges faced by healthcare providers. Addressing these barriers through targeted interventions, infrastructure investments and policy changes could significantly improve lung cancer outcomes in the region. A focus on early detection, comprehensive diagnostics and equitable access to advanced treatments is essential for enhancing survival rates and quality of life for lung cancer patients in this region.