Outcome evaluation of outreach screening program compared to facility based screening on early detection, treatment and survival rate of cervical cancer patients at ocean road cancer institute in Tanzania

Abstract

ABSTRACT Background: Cancer screening can improve individual outcome by detecting cancer at early stages. Unfortunately access to screening services is limited due to lack of awareness and knowledge, availability of limited screening facilities and health providers and geographical barriers. Objective: To determine early detection, early treatment and survival rate of cervical cancer patients at Ocean Road Cancer Institute comparing of outreach screening program to facility based screening. Methods: The study employed analytical retrospective cohort study design using secondary data on cervical cancer screening programs and treatment records extracted from ORCI database. The study population included 6,165 cervical cancer patients who were screened by ORCI, 2,803 from outreach program and 3,362 from facility and subsequently showed up for treatment within the period of one year from January 2020 to December 2020 and then followed for three years, from January 2020 to December 2023. Regression statistical used to examine the association between soci-demographic factors and utilization of cervical cancer screening. Results: The study found that facility-based screening detected slightly higher cervical cancers in early stage (62.5%) than outreach programs (62.1%), and women screened at facilities were much more likely to seek treatment (90.4%). The study also indicated that Women aged 30 45(AOR=1.71, 95% CI=1.51, 1.94) and 46-60 (AOR=1.32, 95% CI=1.07, 1.63) had higher odds of utilizing cervical cancer screening services at facility level than those with below 30 years and also women with primary education (AOR=2.44, 95% CI=2.08, 2.86), secondary education (AOR=8.15, 95% CI=6.76, 9.82) and higher education (AOR=17.10, 95% CI=4.99, 58.54) had higher odds of utilizing cervical cancer screening services at facility level compared to those with informal education. A concerning finding was the decline in survival rates, particularly for women detected through outreach, where among 16 women that were enrolled in 2020, 81.25% followed by 69.23% and finally 66.66% in 2021, 2022 and 2023 consecutively, this highlighting the need for further research into these barriers.