SURVIVORSHIP ANALYSIS AND BREAST CANCER RISK FACTORS AMONG GHANAIAN WOMEN

Abstract

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in female's worldwide. The objective of the study was to identify and describe breast cancer survival pattern in Ghana and factors that explain the disparity in survival rates for breast cancer by the use of Cox proportional hazard. The extent to which selected demographic, hormonal and reproductive factors influence the cause of breast cancer were also examined using the logistic regression technique to determine risk of getting the disease. Two thousand three hundred and ninety seven (2397) women were sampled for the study, of which 1022 (42.64%) were diagnosed with breast cancer between the periods 1st January 2002 to 31st December 2008. The overall mean age of patients was 43.51 years whiles that for breast cancer cases were 47.97 years. The highest number of cases being 351 (34.34%) was aged 40-49 years. Cumulative 5-year survival was 47.91 %. Main mortality risk factors were, tumour size (logrank <0.0001); axillary node involvement (logrank < 0.0064); stage at diagnosis (p = 0.000) and BMI was 0.0015. Survival rate was better for early staged presentation (59.93%); obese women (50.26%); lymph node involvement of less than 25% (63.26%) and tumour size of less than 5cm was 52.30%. The gamma model was found to be the best fitted model for predicting survival following a diagnosis of breast cancer. Breast feeding, late menarche, contraceptive usage, and time interval between age at menarche and age at menopause decreased the risk of breast cancer development. Later age at menopause (OR = 2.306, < 0.0001) on the other hand increased the risk of breast cancer development. There existed some relationships among some of the risk factors using path analysis namely age, parity, breast feeding and age at first child on breast cancer development. It is recommended that governmental/nongovernmental organizations improve on health education/campaigns about breast cancer to create awareness and reduce mortality.