Estimating the survival of patients with cancer of the cervix at Kenyatta National Hospital in Nairobi, Kenya

Cervical cancer ranks as the second most frequent cancer among women globally. The majority of patients present in advanced disease stages, leading to high mortality rates. Information on the survival of cervical cancer patients in Kenya which is necessary in estimating the burden of the disease and informing policy shifts in management of the disease is lacking. The objective of this study was to estimate the cure fraction, the survival time and rate and, identify covariates that significantly affect the survival of patients with cervical cancer in Nairobi, Kenya. A retrospective, descriptive nonintervention study of selected patients with cancer of the cervix was carried out in Nairobi at Kenyatta National Hospital. A total of 211 patients with an initial diagnosis of cancer of the cervix between January 2005 and June 2007 were followed up for five years respectively. Of the 211 patients, 108 (51.18%) of them were confirmed dead within that period, 15 (7.11%) were still alive and 88 (41.70%) were lost to follow up. Most of the patients were from low income areas (60.19%) within Nairobi, followed by those from middle income areas (37.91%) with the smallest proportion coming from high income areas (1.90%). The patients’ ages ranged from 14 to 76 years; the median age was 46 years while the mean 46.45 years. The probability of surviving beyond the maximum amount of time (60 months) was estimated at 0.198. The cumulative proportion surviving at the end of the study interval was 0.67 at stage I, 0.36 at stage II, 0.15 at stage III and 0 at stage IV. The median survival time at stage I was 60 months, 23.02 months at stage II, 10.14 months at stage III and 9.73 months at stage IV. Patients with an initial diagnosis at stage II, stage III and stage IV had an increased risk of death 6.29, 13.71 and 15.47 times respectively those diagnosed at stage I. The age of patients, stage at diagnosis and level of education significantly affected the survival. Early detection of cervical cancer and, prompt and comprehensive treatment should be taken up to improve the overall survival of the patients.