SURVIVAL ANALYSIS OF PROGNOSTIC FACTORS ASSOCIATED WITH CERVICAL CANCER

Abstract

The paper aimed to present a survival analysis of prognostic factors associated with cervical cancer. This is a major public health menace to women of reproductive age.  This study aimed to investigate the survival time and prognostic factors of patients diagnosed with cervical cancer from January 2010 to December 2020 at the National Hospital, Abuja (NHA), Nigeria. Survival function and median time were estimated using the Kaplan-Meier estimator. Results showed that out of 388 cervical cancer patients, 234 deaths (60%) were recorded. Each patient has a 50% chance of surviving at least 13 months and a minimum of 10 months, but not more than 17 months. The Log-rank test was used to test the differences in the survival curves. Result showed a significant difference in survival times for International Federation of Gynaecology and Obstetrics (FIGO) stages and recurrence, with a p-value of 5e-08 and 0.007, respectively.  Accelerated failure time (AFT) was used to determine the prognostic factors associated with cervical cancer. AFT models considered were Exponential, Weibull, Log-normal, and Log-logistic. Based on the Akaike Information criterion (AIC), Log normal model with the minimum AIC value of 1821.70 was the best model for the data and was subsequently used for further analysis.  Recurrence, histological type (adenosquamous (ADQ)) significantly prolonged the survival time of patients (Time ratio (TR) = 2.467; p: =0.00, TR= 2.78; p: = 0.05, respectively) compared to patients without recurrence and those with other histological types. Parity (TR=0.92; p: = 0.08), occupation (TR=0.49; p=0.00), tribe (TR=0.54; p=0.08), tumour grade (Well differentiated (WD)) (TR=0.65; p=0.05), treatment received (chemotherapy) (TR= 0.69; p=0.09) shortened the survival time of patients.