Idris O Ola, Adeyemi A Okunowo, Muhammad Y Habeebu
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引用次数: 0
摘要
背景:在尼日利亚,共病使癌症患者的死亡风险增加了约6倍,影响了约26%的宫颈癌(CC)患者。然而,其对CC结果的影响尚未得到充分探讨。方法:我们分析了2015年1月至2021年12月期间尼日利亚拉各斯大学教学医院和NSIA-LUTH癌症中心的数据。基于高血压增强型Charlson合并症指数(hCCI),采用Cox比例风险模型估计与CC死亡率相关的风险比(hr)。结果:我们的研究结果显示死亡率为30.1/100妇女年,平均死亡年龄为59.8岁。与hCCI为0的女性相比,hCCI为2-6的女性在未调整模型(HR 1.68[95%可信区间{CI} 1.10至2.57])和年龄调整模型(HR 1.57[95%可信区间{CI} 1.02至2.42])中死亡风险显著增加。当考虑CC分期时,与hCCI 0相比,hCCI 2-6的晚期转移性CC的死亡率风险梯度明显(HR 2.32 [95% CI 1.23至4.39],在调整模型中增加到4.15 (95% CI 1.69至10.18)。结论:宫颈癌死亡风险随着合并症评分的增加而增加。在CC患者的临床评估中常规纳入合并症评分以及多学科癌症护理团队的使用可能会对他们的临床和心理社会管理产生积极影响。
Mortality risk stratification based on comorbidity status among cervical cancer patients in Lagos, Nigeria.
Background: Comorbidity amplifies mortality risk by approximately sixfold in cancer patients and affects about 26% of cervical cancer (CC) patients in Nigeria. However, its impact on CC outcomes has yet to be fully explored.
Methods: We analysed data from the Lagos University Teaching Hospital and the NSIA-LUTH Cancer Center in Lagos, Nigeria, between January 2015 and December 2021. Based on the hypertension-augmented Charlson comorbidity index (hCCI), the hazard ratios (HRs) associated with CC mortality were estimated using Cox proportional hazards model.
Results: Our results showed a mortality rate of 30.1/100 women-years with a mean age at death of 59.8 years. Women with hCCI 2-6 had a significant increase in mortality risk in unadjusted (HR 1.68 [95% confidence interval {CI} 1.10 to 2.57]) and age-adjusted models (adjusted HR 1.57 [95% CI 1.02 to 2.42]) compared with those with hCCI 0. When CC stage was considered, the mortality risk gradient by hCCI was pronounced for late-metastatic CC with hCCI 2-6 (HR 2.32 [95% CI 1.23 to 4.39], increasing to 4.15 (95% CI 1.69 to 10.18) in the adjusted model compared with hCCI 0.
Conclusions: Cervical cancer mortality risk increases with an increasing comorbidity score. Routine incorporation of comorbidity scoring in the clinical assessment of CC patients as well as the use of multidisciplinary cancer care teams may positively impact their clinical and psychosocial management.
期刊介绍:
International Health is an official journal of the Royal Society of Tropical Medicine and Hygiene. It publishes original, peer-reviewed articles and reviews on all aspects of global health including the social and economic aspects of communicable and non-communicable diseases, health systems research, policy and implementation, and the evaluation of disease control programmes and healthcare delivery solutions.
It aims to stimulate scientific and policy debate and provide a forum for analysis and opinion sharing for individuals and organisations engaged in all areas of global health.