Objectives To present the three-year epidemiology of gynecological cancers managed by a Haitian cancer program.
Methods This was a retrospective descriptive observational study. Patients aged 15 years old or more admitted to the cancer clinic of Innovating Health International in Port-au-Prince, Haiti from Jan-2016 to Dec-2018 were included. Data collection included variables such as year of diagnosis, age, cancer type and staging. Primary outcome was overall survival (OS). Secondary outcomes were overall mortality and loss of follow-up rates. Data were analyzed using SPSS 21, with p<0.05 being considered statistically significant.
Results Three hundred and forty (340) cases of gynecological cancers were diagnosed during the study period, respectively 46 in 2016, 94 in 2017 and 200 in 2018 (p<0.001). The mean age was 54.3 years [range 19–90], ranging from 58.8 years in 2016 to 54.2 years in 2018 (p=0.013). Cervical cancer was the most common type (n=238,70%), followed by endometrial cancer (n=45, 13.2%), ovarian cancer (n=43, 12.6%), vulvar cancer (n=3, 0.9%), vaginal cancer (n=2, 0.6%) and gestational trophoblastic cancer (n=2, 0.6%). Seven (2.1%) cases were cancers of unknown primary identified as gynecological cancers. Of the staged patients (n=285), 66% were at stages III or IV of their cancer. The overall mortality rate was 34.7%, with a median overall survival of 3.9 months. Twenty-six (7.6%) of the patients lost follow-up.
Conclusions Gynecological cancers were mostly diagnosed at an advanced stage, which mainly explains the low OS. Vaccination and large-scale screening are mandatory to decrease the burden of cervical cancer in Haiti.
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