Abstract:
Background: There are marked disparities in cancer survival between low-income and high-income countries, yet population-based survival data from low-income settings remain scarce. Understanding cancer survival patterns is crucial for guiding cancer control strategies and improving outcomes.
Methods: This study analyzed data from the national cancer registry of Rwanda for 542 patients diagnosed with eight of the most common adult cancers—stomach (C16), colorectum (C18-20), liver (C22), breast (female) (C50), cervix (C53), ovary (C56), prostate (C61), and non-Hodgkin lymphomas (C82-85)— between 2014 and 2017. Patients were randomly selected for active follow-up to calculate 1-, 3-, and 5-year observed and relative survival (RS) by cancer type and stage.
Results: Overall, 53.7% of cases had died within five years of diagnosis. Five-year RS varied by malignancy, ranging from 17.6% (95% Cl: 6.7%-32.6%) for liver cancer to 68% (Cl: 51.6%-79.8%) for prostate cancer. Stage was assigned to 71.6% of patients (388 out of 542), with over half (58%) diagnosed at an advanced stage (III/IV). For most cancers, stage at diagnosis was a strong predictor of survival, except for liver and ovarian cancers. For example, three-year observed survival was 90.9% for early-stage breast cancer and 44.8% for advanced-stage breast cancer (p = 0.002).
Conclusions: This study demonstrates that stage-specific survival can be obtained from population-based cancer registries in sub-Saharan Africa, providing essential data for international benchmarking and local cancer control planning and evaluation. These findings highlight the need for early detection efforts to improve cancer outcomes in low-resource settings.
