{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:23:59Z","timestamp":1791336239489,"version":"4.3.1"},"reference-count":39,"publisher":"Maad Rayan Publishing Company","issue":"4","content-domain":{"domain":["jrhs.umsha.ac.ir"],"crossmark-restriction":false},"short-container-title":["J Res Health Sci"],"published-print":{"date-parts":[[2021,10,12]]},"abstract":"<jats:p>Background: Breast cancer is one of the non-communicable diseases and the main origin of the loss of life in the world. In Ethiopia, breast cancer is the second common cancer health problem for women. The main objective of this study was to identify the potential risk factors affecting the survival time of breast cancer patients in Southwest Ethiopia. Study design: A retrospective study design. Methods: The data were taken from the patients\u2019 medical records that registered from January 1, 2015, to January 31, 2020. A retrospective study design was used in this study. Different shared frailty survival models were employed to analyze the dataset. Results: Out of 642 recorded breast cancer patients, 447(69.6%) cases died during the study period, and 195 (30.4%) patients lost follow-up for unknown reasons. The median time to death for breast cancer patients was 10 months, and hospitals were used as a cluster effect. The result revealed that women with no smoking habit had about 3.35 times higher survival time than patients who had a smoking habit, and as breast cancer patients age increased, the survival time decreased by 0.99. Moreover, breast cancer patients in rural areas had about 0.14 times lower survival time, compared to breast cancer patients who were urban residents. Conclusions: Age, place of residence, treatment taken, stage, histologic grade, tumor size, oral contraceptives, and smoking habits led to a shorter survival time. To reduce the burden of breast cancer, awareness should be given to the community.<\/jats:p>","DOI":"10.34172\/jrhs.2021.65","type":"journal-article","created":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T09:23:03Z","timestamp":1643188983000},"page":"e00532-e00532","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk Factors Affecting Survival Time of Breast Cancer Patients: The Case of Southwest Ethiopia"],"prefix":"10.34172","volume":"21","author":[{"given":"Reta Habtamu","family":"Bacha","sequence":"first","affiliation":[{"name":"Department of Statistics, College of Natural Sciences, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasin Negash","family":"Jabir","sequence":"additional","affiliation":[{"name":"Department of Statistics, College of Natural Sciences, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anberbir Girma","family":"Asebot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Health Sciences, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebe Debu","family":"Liga","sequence":"additional","affiliation":[{"name":"Department of Statistics, College of Natural and Computational Sciences, Wolkite University, Wolkite, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"20123","published-online":{"date-parts":[[2021,10,12]]},"reference":[{"key":"R1","unstructured":"World Health Organization.\u00a0Global Health Estimates 2020: Deaths by cause, age, sex, by country and by region, 2000-2019. WHO;\u00a02020 [cited December 11, 2020]. Available from: who.int\/data\/gho\/data\/themes\/mortality-and-global-health-estimates\/ghe-leading-causes-of-death."},{"key":"R2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12957-018-1345-2","article-title":"Rising global burden of breast cancer: the case of sub-Saharan Africa (with emphasis on Nigeria) and implications for regional development: a review","volume":"16","author":"Azubuike SO","year":"2018","journal-title":"World J Surg Oncol"},{"key":"R3","unstructured":"Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Pi\u00f1eros M, et al. Cancer Today. Lyon: WHO; 2020 [cited December 11, 2020]. Available from: https:\/\/gco.iarc.fr\/today, accessed February 2021."},{"key":"R4","unstructured":"World Health Organization. Latest global cancer data: cancer burden rises to 18.1 million new cases and 9.6 million cancer deaths in 2018.\u00a0WHO;\u00a02020 [cited December 11, 2020]. Available from: https:\/\/www.iarc.who.int\/featured-news\/latest-global-cancer-data-cancer-burden-rises-to-18-1-million-new-cases-and-9-6-million-cancer-deaths-in-2018."},{"key":"R5","unstructured":"American Cancer Society.\u00a0American Cancer Society. Global Cancer Facts & Figures 4th ed. Atlanta; ACS: 2018."},{"key":"R6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2010\/595167","article-title":"Breast cancer in developing countries: opportunities for improved survival","volume":"595167","author":"Shulman LN","year":"2010","journal-title":"J Oncol"},{"key":"R7","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung H","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"R8","doi-asserted-by":"crossref","first-page":"010419","DOI":"10.7189\/jogh.08.010419","article-title":"Estimating the incidence of breast cancer in Africa: a systematic review and meta-analysis","volume":"8","author":"Adeloye D","year":"2018","journal-title":"J Glob Health"},{"key":"R9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.canep.2018.01.008","article-title":"First data from a population based cancer registry in Ethiopia","volume":"53","author":"Timotewos G","year":"2018","journal-title":"Cancer Epidemiol"},{"key":"R10","first-page":"1","article-title":"Estimates of Cancer Incidence in Ethiopia in 2015 Using Population-Based Registry Data","volume":"4","author":"Memirie ST","year":"2018","journal-title":"J Glob Oncol"},{"key":"R11","first-page":"2","article-title":"Trends of breast cancer in Ethiopia","volume":"2","author":"Abate SM","year":"2016","journal-title":"International Journal of Cancer Research and Molecular Mechanisms"},{"key":"R12","doi-asserted-by":"crossref","first-page":"e923","DOI":"10.1016\/S2214-109X(16)30259-5","article-title":"Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis","volume":"4","author":"Jedy-Agba E","year":"2016","journal-title":"Lancet Glob Health"},{"key":"R13","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1056\/NEJM199207303270505","article-title":"Breast cancer (1)","volume":"327","author":"Harris JR","year":"1992","journal-title":"N Engl J Med"},{"key":"R14","doi-asserted-by":"crossref","first-page":"343","DOI":"10.3322\/canjclin.46.6.343","article-title":"Hormone replacement therapy in the menopause: a pro opinion","volume":"46","author":"Smith HO","year":"1996","journal-title":"CA Cancer J Clin"},{"key":"R15","doi-asserted-by":"crossref","first-page":"7431","DOI":"10.1002\/cam4.2589","article-title":"Clinical and epidemiologic factors associated with breast cancer and its subtypes among Northeast Chinese women","volume":"8","author":"Ye DM","year":"2019","journal-title":"Cancer Med"},{"key":"R16","doi-asserted-by":"crossref","first-page":"8567","DOI":"10.7314\/APJCP.2015.16.18.8567","article-title":"Survival Analysis of Patients with Breast Cancer using Weibull Parametric Model","volume":"16","author":"Baghestani AR","year":"2015","journal-title":"Asian Pac J Cancer Prev"},{"key":"R17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/9076567","article-title":"Bayesian and Frequentist Analytical Approaches Using Log-Normal and Gamma Frailty Parametric Models for Breast Cancer Mortality","volume":"9076567","author":"Alotaibi RM","year":"2020","journal-title":"Comput Math Methods Med"},{"key":"R18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2147\/IJWH.S292588","article-title":"Risk Factors Associated with Breast Cancer among Women in Addis Ababa, Ethiopia: Unmatched Case\u2013Control Study","volume":"13","author":"Tolessa L","year":"2021","journal-title":"Int J Womens Health"},{"key":"R19","unstructured":"Van der Meulen A. Life tables and survival analysis. Hague: Statistics Netherlands; 2012."},{"key":"R20","doi-asserted-by":"crossref","unstructured":"Kleinbaum DG, Klein M. Kaplan-meier survival curves and the log-rank test. Springer: 2012.","DOI":"10.1007\/978-1-4419-6646-9_2"},{"key":"R21","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1017\/S0021900200042534","article-title":"Modelling heterogeneity in survival data","volume":"28","author":"Hougaard P","year":"1991","journal-title":"J Appl Probab"},{"key":"R22","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/1536867X0200200102","article-title":"Parametric frailty and shared frailty survival models","volume":"2","author":"Gutierrez","year":"2002","journal-title":"Stata J"},{"key":"R23","unstructured":"Duchateau L, Janssen P. The frailty model. Springer; 2007."},{"key":"R24","doi-asserted-by":"crossref","unstructured":"Wienke A. Frailty Models in Survival Analysis. Chapman and Hall\/CRC; 2010.","DOI":"10.1201\/9781420073911"},{"key":"R25","unstructured":"World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.\u00a0WHO;\u00a02020 [cited December 11, 2020]. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/37003."},{"key":"R26","unstructured":"Wintrebert CMA. Statistical modelling of repeated and multivariate survival data. Leiden University; 2007 [cited 10 March 2021]. Available from; https:\/\/scholarlypublications.universiteitleiden.nl\/handle\/1887\/11456."},{"key":"R27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v051.i11","article-title":"Parfm: Parametric Frailty Models in R","volume":"51","author":"Munda M","year":"2012","journal-title":"J Stat Softw"},{"key":"R28","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1109\/TAC.1974.1100705","article-title":"A new look at the statistical model identification","volume":"19","author":"Akaike H","year":"1974","journal-title":"IEEE Trans Automat Contr"},{"key":"R29","doi-asserted-by":"crossref","first-page":"795","DOI":"10.2307\/2532345","article-title":"Semiparametric estimation of random effects using the Cox model based on the EM algorithm","volume":"48","author":"Klein JP","year":"1992","journal-title":"Biometrics"},{"key":"R30","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1177\/1536867X1501500116","article-title":"Tools for checking calibration of a cox model in external validation: prediction of population-averaged survival curves based on risk groups","volume":"15","author":"Royston P","year":"2015","journal-title":"Stata J"},{"key":"R31","first-page":"3","article-title":"Survival Analysis \u2013 Breast Cancer, Undergraduate","volume":"6","author":"Hoang P","year":"2014","journal-title":"Journal of Mathematical Modeling"},{"key":"R32","first-page":"e2145","article-title":"Survival outcomes of breast cancer in Ghana: an analysis of clinicopathological features","volume":"3","author":"Mensah A","year":"2016","journal-title":"Open Access Library Journal"},{"key":"R33","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0140-6736(14)62038-9","article-title":"Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)","volume":"385","author":"Allemani C","year":"2015","journal-title":"Lancet"},{"key":"R34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12905-017-0368-0","article-title":"Reproductive risk factors associated with breast cancer in women in Bangui: a case-control study","volume":"17","author":"Balekouzou A","year":"2017","journal-title":"BMC Women\u2019s Health"},{"key":"R35","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1093\/ije\/11.4.316","article-title":"Oral contraceptives and breast cancer","volume":"11","author":"Brinton LA","year":"1982","journal-title":"Int J Epidemiol"},{"key":"R36","doi-asserted-by":"crossref","first-page":"378","DOI":"10.3322\/caac.21405","article-title":"Obesity and adverse breast cancer risk and outcome: mechanistic insights and strategies for intervention","volume":"67","author":"Picon-Ruiz M","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"R37","first-page":"2429","article-title":"The obesity and the risk of breast cancer among pre and postmenopausal women","volume":"19","author":"Gravena AAF","year":"2018","journal-title":"Asian Pacific J Cancer Prev"},{"key":"R38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13058-019-1129-9","article-title":"Body mass index, mammographic density, and breast cancer risk by estrogen receptor subtype","volume":"21","author":"Shieh Y","year":"2019","journal-title":"Breast Cancer Res"},{"key":"R39","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1002\/ijc.29266","article-title":"Active cigarette smoking and risk of breast cancer","volume":"136","author":"Catsburg C","year":"2015","journal-title":"Int J Cancer"}],"container-title":["Journal of Research in Health Sciences"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/jrhs.umsha.ac.ir\/index.php\/JRHS\/article\/download\/7120\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jrhs.umsha.ac.ir\/index.php\/JRHS\/article\/download\/7120\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T09:23:26Z","timestamp":1643189006000},"score":1,"resource":{"primary":{"URL":"http:\/\/jrhs.umsha.ac.ir\/index.php\/JRHS\/article\/view\/7120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,12]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,10]]}},"URL":"https:\/\/doi.org\/10.34172\/jrhs.2021.65","relation":{},"ISSN":["2228-7795","2228-7809"],"issn-type":[{"value":"2228-7795","type":"print"},{"value":"2228-7809","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,12]]},"assertion":[{"value":"Hamadan University of Medical Sciences","name":"journal_owner","label":"Journal Owner"},{"value":"Hamadan University of Medical Sciences","name":"journal_publisher","label":"Journal Publisher"},{"value":"2021-08-06","order":1,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}