Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya

PURPOSEAlthough lung cancer is a major cause of cancer incidence and mortality worldwide, lung cancer studies in sub-Saharan Africa are scarce. Here, we present outputs from a designated lung cancer program in western Kenya, part of the Multi-National Lung Cancer Control Program, which focused on ca...

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Main Authors: Naftali Busakhala, Lawrence Atundo, Hillary Kiprono, Kibet Keitany, Elias Melly, Ruth Ruto, Madrine Wanja, Daniel Chepsiror, Hussain Rangoonwala, Cornelius Kipchirchir, Erick Chesori, John Oguda, Jesse Opakas, Patrick J. Loehrer, Lameck Diero, Jennifer Morgan
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-04-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO.24.00212
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author Naftali Busakhala
Lawrence Atundo
Hillary Kiprono
Kibet Keitany
Elias Melly
Ruth Ruto
Madrine Wanja
Daniel Chepsiror
Hussain Rangoonwala
Cornelius Kipchirchir
Erick Chesori
John Oguda
Jesse Opakas
Patrick J. Loehrer
Lameck Diero
Jennifer Morgan
author_facet Naftali Busakhala
Lawrence Atundo
Hillary Kiprono
Kibet Keitany
Elias Melly
Ruth Ruto
Madrine Wanja
Daniel Chepsiror
Hussain Rangoonwala
Cornelius Kipchirchir
Erick Chesori
John Oguda
Jesse Opakas
Patrick J. Loehrer
Lameck Diero
Jennifer Morgan
author_sort Naftali Busakhala
collection DOAJ
description PURPOSEAlthough lung cancer is a major cause of cancer incidence and mortality worldwide, lung cancer studies in sub-Saharan Africa are scarce. Here, we present outputs from a designated lung cancer program in western Kenya, part of the Multi-National Lung Cancer Control Program, which focused on case finding, diagnosis, and treatment.METHODSWe retrospectively reviewed patients with pathologically confirmed non–small cell lung cancer (NSCLC) enrolled in this program at Moi Teaching and Referral Hospital from January 2018 to December 2022. Clinical data were analyzed using descriptive statistics, Kaplan-Meier methods, and proportional hazards regression model.RESULTSTwo hundred forty-nine patients diagnosed with NSCLC were included with a median age at diagnosis of 61 (IQR, 52-70) years. Most patients were married (n = 177; 71%) and nonsmokers (n = 177; 71%) with 58 (23%) having received tuberculosis treatment and 93 (37%) having Eastern Cooperative Oncology Group (ECOG) performance status (PS) of [Formula: see text]2. At diagnosis, adenocarcinoma was the prominent histology (n = 187; 75%) along with clinical stage IV (n = 195; 78% stage IV) or unstaged (n = 40; 16%) disease. Most patients received chemotherapy and radiotherapy (n = 176; 71%) with few palliative care referrals (n = 2; 0.8%). The median overall survival (OS) was only 3.7 months (IQR, 2.7-5.4). ECOG PS (3 or 4) and being unstaged were predictors of poor 1-year OS.CONCLUSIONPatients with NSCLC enrolled in this program presented with advanced disease and poor survival. Despite a designated case finding effort, late diagnosis remained common and highlights a need for locally relevant interventions targeting community and provider education as well as innovative diagnostics that can improve early recognition of lung cancer. These interventions must also be paired with access to proven treatments including molecular therapies and palliative care which can extend lung cancer survival.
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spelling doaj-art-dae8e283a8a84a068eb7a8161f842d252025-08-20T03:17:58ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-04-011110.1200/GO.24.00212Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western KenyaNaftali Busakhala0Lawrence Atundo1Hillary Kiprono2Kibet Keitany3Elias Melly4Ruth Ruto5Madrine Wanja6Daniel Chepsiror7Hussain Rangoonwala8Cornelius Kipchirchir9Erick Chesori10John Oguda11Jesse Opakas12Patrick J. Loehrer13Lameck Diero14Jennifer Morgan15Academic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaAcademic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaKEMRI Wellcome Trust, Kilifi, KenyaMoi University Teaching and Referral Hospital, Eldoret, KenyaKenya National Cancer Institute, Nairobi, KenyaAcademic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaAcademic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaMoi University Teaching and Referral Hospital, Eldoret, KenyaIndiana University School of Medicine, Indianapolis, INMoi University Teaching and Referral Hospital, Eldoret, KenyaMoi University Teaching and Referral Hospital, Eldoret, KenyaIndiana University School of Medicine, Indianapolis, INMoi University Teaching and Referral Hospital, Eldoret, KenyaAcademic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaAcademic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaAcademic Model for Providing Access to Healthcare (AMPATH), Eldoret, KenyaPURPOSEAlthough lung cancer is a major cause of cancer incidence and mortality worldwide, lung cancer studies in sub-Saharan Africa are scarce. Here, we present outputs from a designated lung cancer program in western Kenya, part of the Multi-National Lung Cancer Control Program, which focused on case finding, diagnosis, and treatment.METHODSWe retrospectively reviewed patients with pathologically confirmed non–small cell lung cancer (NSCLC) enrolled in this program at Moi Teaching and Referral Hospital from January 2018 to December 2022. Clinical data were analyzed using descriptive statistics, Kaplan-Meier methods, and proportional hazards regression model.RESULTSTwo hundred forty-nine patients diagnosed with NSCLC were included with a median age at diagnosis of 61 (IQR, 52-70) years. Most patients were married (n = 177; 71%) and nonsmokers (n = 177; 71%) with 58 (23%) having received tuberculosis treatment and 93 (37%) having Eastern Cooperative Oncology Group (ECOG) performance status (PS) of [Formula: see text]2. At diagnosis, adenocarcinoma was the prominent histology (n = 187; 75%) along with clinical stage IV (n = 195; 78% stage IV) or unstaged (n = 40; 16%) disease. Most patients received chemotherapy and radiotherapy (n = 176; 71%) with few palliative care referrals (n = 2; 0.8%). The median overall survival (OS) was only 3.7 months (IQR, 2.7-5.4). ECOG PS (3 or 4) and being unstaged were predictors of poor 1-year OS.CONCLUSIONPatients with NSCLC enrolled in this program presented with advanced disease and poor survival. Despite a designated case finding effort, late diagnosis remained common and highlights a need for locally relevant interventions targeting community and provider education as well as innovative diagnostics that can improve early recognition of lung cancer. These interventions must also be paired with access to proven treatments including molecular therapies and palliative care which can extend lung cancer survival.https://ascopubs.org/doi/10.1200/GO.24.00212
spellingShingle Naftali Busakhala
Lawrence Atundo
Hillary Kiprono
Kibet Keitany
Elias Melly
Ruth Ruto
Madrine Wanja
Daniel Chepsiror
Hussain Rangoonwala
Cornelius Kipchirchir
Erick Chesori
John Oguda
Jesse Opakas
Patrick J. Loehrer
Lameck Diero
Jennifer Morgan
Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya
JCO Global Oncology
title Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya
title_full Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya
title_fullStr Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya
title_full_unstemmed Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya
title_short Characteristics and Associated Survival of Patients Diagnosed With Non–Small Cell Lung Cancer in a Designated Lung Cancer Program in Western Kenya
title_sort characteristics and associated survival of patients diagnosed with non small cell lung cancer in a designated lung cancer program in western kenya
url https://ascopubs.org/doi/10.1200/GO.24.00212
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