Clinical and non-clinical determinants of cervical cancer mortality: A retrospective cohort study in Lagos, Nigeria

INTRODUCTION: Cervical cancer (CCa) is the fourth most frequent and a common cause of cancer mortality in women, the majority of whom live in low- and middle-income countries. Data on CCa mortality and its determinants have been poorly studied in Nigeria, resulting in a paucity of information that can assist patient management and cancer control policy. AIM: The purpose of this study was to assess the mortality rate among CCa patients in Nigeria as well as the major factors influencing CCa mortality. STUDY DESIGN: Data from the medical records of 343 CCa patients seen at the Lagos University Teaching Hospital and NSIA-LUTH Cancer Center from 2015 to 2021 were used in a retrospective cohort analysis. The hazard ratios (HR) and confidence intervals (CI) associated with the exposure variables and CCa mortality were calculated using Cox proportional hazard regression. RESULTS: The CCa mortality rate was 30.5 per 100 women-years after 2.2 years of median follow-up. Clinical factors such as HIV/AIDS (adjusted HR [aHR]: 11.9; 95% CI: 4.6, 30.4), advanced clinical stage (aHR: 2.7; 95% CI: 1.5, 4.7), and anemia at presentation (aHR: 1.8; 95% CI: 1.1, 3.0) were associated with a higher mortality risk, as were non-clinical factors such as age at diagnosis >50 years (aHR: 1.4; 95% CI: 1.0, 1.9) and family history of CCa (aHR: 3.5; 95%CI: 1.1, 11.1) CONCLUSION: CCa has a high mortality rate in Nigeria. Incorporating these clinical and non-clinical factors into CCa management and control policies may improve women’s outcomes.