Survival pattern of colorectal cancer in Sub-Saharan Africa: A systematic review and meta-analysis

Hamid Y Hassen; Foziya M Hussien; Anissa M Hassen; Reta Dewau; Erkihun T Amsalu; Miteku A Limenih; Neamin M Berhe; Nigussie A Kassaw; Binyam G Sisay; Md Dilshad Manzar

doi:10.1016/j.canep.2022.102276

Survival pattern of colorectal cancer in Sub-Saharan Africa: A systematic review and meta-analysis

Cancer Epidemiol. 2022 Dec:81:102276. doi: 10.1016/j.canep.2022.102276. Epub 2022 Oct 17.

Authors

Affiliations

¹ Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium. Electronic address: Hamid.hassen@uantwerpen.be.
² School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
³ Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium.
⁴ School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁵ Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia.

PMID: 36257176
DOI: 10.1016/j.canep.2022.102276

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.

Keywords: Colorectal cancer; Meta-analysis; Sub-Saharan Africa; Survival; Systematic review.

Publication types

Review