Departments of Statistics

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    MODELING TIME TO LOSS FOLLOW-UP AMONG WOMEN UNDER BREAST CANCER PATIENTS AT HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL: APPLICATION OF COMPETING RISK MODEL
    (HAWASSA UNIVERSITY, 2025-03) TSEGISHET TEMESGEN
    Incomplete breast cancer treatment poses a significant challenge for breast cancer programs. This study aims to assess risk factors for treatment discontinuation and loss to follow-up among breast cancer patients at Hawassa University Comprehensive Specialized Hospital, considering death as a competing risk event. This study used all four year data of 463 breast cancer patients under follow up between January 2020 and December 2023. Descriptive analysis and cumulative incidence survival curve evaluations were conducted in the presence of competing risks. Univariate and Multivariate cause-specific and sub-distribution hazard analyses examined the factors associated with loss to follow-up, with death as a competing event. Out of 463 breast cancer patients recorded, 96 (20.73%) were loss to follow up, 121(26.13%) were died and 246 (53.13%) censored during the follow up. The cause-specific hazard and sub-distribution hazard models revealed that age, place of residence, types of Treatment, Stage of cancer, has non communicable disease, performance status, marital status, distance, experienced chemotherapy, experienced radiotherapy, expected adverse effect, histologic grade were the significant risk factor associated with time to loss follow up treatment. Patients with non-communicable disease had 1.846 and 2.8589 times higher risk of losing follow up compared to patients without non communicable disease comorbidities (CSHR : 1.846(0.56,2.27859))and (SDHR2.8589(0.567,4.3006)) respectively. Distance patients greater than 100km have 1.954 and 201times high risk of lost follow up compare to distance less than 100km (CSHR:2.011(0.67,2.52991) and SDHR: 1.954(0.623,6.122)). The findings showed that the estimates of the covariates effects were different for the two hazard models. This study conclude that breast cancer patients with non-communicable diseases, those residing far from the treatment center, experiencing adverse effects during follow-up, having advanced cancer stages, and being aged 60 years and older are at a higher risk of loss to follow-up. These findings highlight the critical need for Targeted interventions are essential to enhance patient retention and prevent treatment discontinuation. Finally this study recommended that the hospital authorities to give attention to patients those who are distant from Hospital, had Has NCD Comorbidities, Experienced Advert Effect at follow up and older patients.