MORTALITY AND ITS ASSOCIATED FACTORS AMONG COLORECTAL CANCER PATIENTS ON CHEMOTHERAPY FOLLOW UP AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL AND DILCHORA GENERAL HOSPITAL, EASTERN ETHIOPIA

Abstract

Background: Colorectal cancer is the third most commonly diagnosed cancer and the second biggest cause of cancer-related deaths worldwide, impacting both developed and developing nations. The present research aimed to investigate mortality and its associated factors among colorectal cancer patients on chemotherapy follow up at Hiwot Fana Comprehensive Specialized Hospital and Dilchora General Hospital. Methods: A retrospective chart review is performed, and all cases with diagnosis of colorectal cancer from (February 25, 2020–January 1, 2025) 156 at Hiwot Fana Comprehensive Specialized Hospital and (January 1, 2023–January 1, 2025) 29 at Dilchora General Hospital were included for study. For the data collection, the patients’ medical charts were reviewed from March 1 and June 15, 2025. The entry and evaluation of data were conducted with Statistical Package for the Social Sciences software version 27.0. Survival probability over time was estimated using Kaplan Meier curve and factors associated with colorectal cancer mortality were identified through a Cox proportional hazards regression model. Result: Out of 185 participants, 101 (54.6%) were males and 103 (55.7%) were under the age of 49. An average age at admission was 46.65 years (standard deviation 12.74). Of the 185 patients treated for colorectal cancer, 139 (75.1%) died within a period of two years, with a median predicted survival time of 13.8 months. The Cox proportional hazard regression analysis found the presence of underweight (HR=1.72, 95% CI: 1.07-2.78), having carcinoembryonic antigen levels ≥ 5 ng/mL (HR=2.25, 95% CI: 1.19 - 4.26), having low hemoglobin (HR=1.62, 95% CI: 1.10 2.39), and having comorbid diseases (HR=1.65, 95% CI: 1.07 -2.56) were all associated with an increased mortality rate. Conclusion: This study shows that mortality from colorectal cancer was considerably high among patients on chemotherapy follow up at Hiwot Fana Comprehensive Specialized Hospital and Dilchora General Hospital. The mortality was significantly increased among patients with anemia, malnutrition, advanced cancer stage, and comorbid conditions. Early screening, accessible first line chemotherapy, and adherence to treatment protocols are critical for improving colorectal cancer treatment outcomes. Nutritional support and public health education should be integrated into care. These interventions may collectively reduce disease burden and mortality.