Post Radiotherapy utilization Of primary healthcare and associated factors among prostate cancer survivors.

Abstract

ABSTRACT Background: Prostate cancer diagnoses have increased by 3% annually since 2014, with the disease representing 10.4% of reported cancer cases in Tanzania. Advances in treatment have raised the 5-year survival rate for early-stage prostate cancer to nearly 100%, with radiotherapy being essential for most patients. Survivorship care, including disease management and psychosocial support, is provided by specialized cancer centers and primary healthcare facilities, but information on primary care utilization for survivors in Tanzania is limited. Objective: To determine the magnitude and factors associated with primary healthcare utilization (PHU) among prostate cancer survivors (PCS) treated at Besta Super Specialized Polyclinic from January 2021 to December 2023. Methodology: A cross-sectional study was conducted at Besta Super Specialized Polyclinic to evaluate primary healthcare utilization (PHU) post-radiotherapy among prostate cancer survivors. Survivors who completed treatment between January 2021 and December 2023 were recruited through consecutive convenient sampling. Data were collected via questionnaires, medical registry retrieval, and telephone interviews. Analysis was performed using SPSS version 25, with bivariate analysis identifying variables (p<0.25) for inclusion in multivariable logistic regression to determine PHU predictors (p<0.05). Significant associations were found between PHU and various demographic and clinical factors. Result: The study of 213 PCS (median age 70) found most were uneducated peasants, married/cohabiting, living rurally, and in stage III-IV on ADT. Common comorbidities included joint pain and hypertension, with fewer bowel symptoms. The PHU was found to be 147(69.0%). The PHU was found to be 147(69.0%) with the majority, 121(82.3%), reported visiting district hospital. Rural residence (AOR = 3.34, 95% CI [1.48, 7.57], p = 0.004), early-stage disease (AOR = 0.09, 95% CI [0.02, 0.47], p = 0.005), hypertension (AOR = 2.14, 95% CI [1.02, 4.48], p = 0.044), treatment symptoms (AOR = 4.75, 95% CI [2.16, 10.46], p = 0.001), and sexual symptoms (AOR = 5.44, 95% CI [2.44, 12.14], p = 0.001) remain significant. Conclusion: The study has found 69% of the prostate cancer survivors utilize PHC. Factors such as rural residence, advanced disease stage, non-hypertension, and moderate treatment and sexual symptoms are associated with higher utilization of PHC. These insights emphasize the potential of PHU to alleviate the burden on overwhelmed specialized hospital by providing accessible and effective care for cancer survivors.