Case Fatality Rate and Review of Literature on Gnaecological Cancers Mortality at a Specialiazed Oncology Unit in Port Harcourt

Abstract

Background: Gynecological cancer is a major public health problem and an important cause of morbidity and mortality in women worldwide. There are only few researches on the overall mortality attributed to gynecological cancers in Nigeria. Objectives: To determine the case fatality rate, prevalence and reason for mortality amongst gynecological oncology patients at the oncology unit of the University of Port Harcourt Teaching Hospital (UPTH). Study Design: This was a retrospective study of mortality from gynecological cancers in UPTH between 1st January, 2014 and 31st December, 2018. Case files of patients with mortality from genital tract malignancies were reviewed and relevant information extracted Results: A total of 2070 gynecological admissions were recorded out of which 399 were gynecological cancer patients, giving a 19.3% prevalence of gynecological cancer. Fifty-six gynecological cancer related deaths were reported within the study period with an overall cancer mortality rate of 14.0%. Ovarian cancer was responsible for the highest number of deaths 48.2% with a case-fatality rate of 18.6% while cervical cancer had a case fatality rate of 13.1%. Majority of the patients 96.6% presented at advanced stage of the disease. Those with financial constraints totaled 62.5% while 89.3% had challenges accessing specialized health care. Conclusion: The study shows that the case-fatality rate of mortalities from gynaecological cancers at UPTH is very high with ovarian malignancy accounting for most deaths. Late presentation, low socioeconomic status and delay in accessing specialized health care were the main factors responsible for these mortalities. Proper screening, early diagnosis. prompt treatment and improvement in the socioeconomic status of gynaecological cancer patients will improve the case fatality rate in UPTH.