Late time to treatment initiation and its determinants among patients with colorectal cancer in Amhara region oncology centers a multicentered cohort study a multicentered cohort study, Ethiopia, 2024

Introduction: - Colorectal cancer is a significant cause of mortality globally. Timely initiation of treatment colorectal cancer is crucial, as delays have consistently shown to worsen outcomes and decrease overall survival rates. Despite this, the specific factors affecting late time to treatment initiation among colorectal cancer patients in the Amhara region have not been thoroughly investigated. Objective : - To assess the late time to treatment initiation and its determinants among patients with colorectal cancer in Amhara region oncology centers a multicentered cohort study, Ethiopia, 2024. Method and Material: - A retrospective cohort study was conducted among 484 study participants who started follow-up from July 1, 2018, to June 30, 2023 in Amhara Region Oncology Centers. Data were entered into Epi-data V4.2 and exported to STATA V14 statistical software for analysis. Cox regression model was used to identify factors associated with the incidence of mortality. All variables with P-value < 0.25 and ≤ 0.05 bi-variable and multivariable Cox regression model were considered statistical significance respectively. Results: - The mean age of the participants was 48 years (SD± 7). The median waiting times was 117 days [95% CI: 95, 150]. The result of the multivariable analysis showed that rural residence [AHR= 1.34, 95% CI: 1.00, 1.79], Baseline body surface area £1.78m ² [AHR= 2.48, 95% CI: 1.24, 4.96], Distance of treatment center >80km ([AHR=1.41, 95% CI: 1.06, 1.88] and start non chemotherapy regimens [AHR=1.35, 95% CI: 1.00,1.82] were significantly associated with delays time to treatment initiation. Conclusion and recommendation : - The median waiting times was very high than previous study. Address rural residence, Baseline body surface area £1.78m ² , Distance of treatment center >80km and start non chemotherapy regimens were imperative for optimizing survival outcomes. Government level managers enhancing health care facilities are crucial. Researchers, focus on factors like lifestyle, genetics and treatment quality.