IntroductionIn Ethiopia, most cervical cancer patients present at advanced cancer stages, long time after they experience first symptoms. We investigated possible predictors of long time spans between symptom onset and pathologic diagnosis (patient intervals). We also aimed to seek out predictors for advanced cancer stage diagnosis.MethodsWe conducted a retrospective cohort study among 1575 cervical cancer patients who were registered at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia between September 2008 and September 2012. Cox proportional hazards regression was used to find predictors of long patient intervals. Cumulative odds ordinal logistic regression was used to identify predictors of cancer stage at diagnosis.ResultsMedian patient interval was 30 weeks, with the interval substantially longer in patients residing in rural than urban areas. Longer patient intervals were associated with more advanced cancer stages at pathologic diagnosis. HIV-positive women had an almost 1.5 times increased risk of diagnosis at a more advanced stage.ConclusionCervical cancer patients are diagnosed after long time periods leading to advanced stages at diagnosis. Measures to raise awareness about cervical cancer, to increase screening and to shorten the time interval from recognition of symptoms to diagnosis are urgently needed.

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埃塞俄比亚的宫颈癌——晚期和延长诊断时间的预测因素

简介在埃塞俄比亚，大多数宫颈癌患者在出现首发症状后很长时间都处于晚期癌症阶段。我们调查了症状发作和病理诊断（患者间隔）之间较长时间跨度的可能预测因素。我们还旨在寻找晚期癌症分期诊断的预测因子。方法我们对 2008 年 9 月至 2012 年 9 月在埃塞俄比亚亚的斯亚贝巴 Tikur Anbessa 专科医院 (TASH) 登记的 1575 名宫颈癌患者进行了一项回顾性队列研究。 Cox 比例风险回归用于寻找长患者间隔的预测因子。累积优势序数逻辑回归用于确定诊断时癌症分期的预测因子。结果中位患者间隔为 30 周，居住在农村地区的患者的间隔时间明显长于城市地区。较长的患者间隔与病理诊断时更晚期的癌症分期相关。HIV 阳性女性在更晚期的诊断风险几乎增加了 1.5 倍。结论宫颈癌患者是在很长一段时间后才被诊断出来的，导致诊断时进入晚期。迫切需要采取措施提高对宫颈癌的认识，增加筛查并缩短从识别症状到诊断的时间间隔。结论宫颈癌患者经过长时间的诊断，导致诊断时已进入晚期。迫切需要采取措施提高对宫颈癌的认识，增加筛查并缩短从识别症状到诊断的时间间隔。结论宫颈癌患者经过长时间的诊断，导致诊断时已进入晚期。迫切需要采取措施提高对宫颈癌的认识，增加筛查并缩短从识别症状到诊断的时间间隔。