Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
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| Authors: | Fiona McKenzie Annelle Zietsman Moses Galukande Angelica Anele Charles Adisa Groesbeck Parham Leeya Pinder Herbert Cubasch Maureen Joffe Frederick Kidaaga Robert Lukande Awa U. Offiah Ralph O. Egejuru Aaron Shibemba Joachim Schuz Benjamin O. Anderson Isabel dos Santos Silva Valerie McCormack |
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| Affiliation: | 1. Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France;2. Windhoek Central Hospital, Windhoek, Namibia;3. Makerere University, Kampala, Uganda;4. Federal Medical Centre, Owerri, Nigeria;5. Abia State University Teaching Hospital, Aba, Nigeria;6. University of North Carolina, Chapel Hill, USA;7. University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa;8. Namibian Institute of Pathology, Windhoek, Namibia;9. University Teaching Hospital, Lusaka, Zambia;10. Fred Hutchinson Cancer Research Center, Seattle, Washington, USA;11. Department of Non‐Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK |
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| Abstract: | Breast cancer (BC) survival rates in sub‐Saharan Africa (SSA) are low in part due to advanced stage at diagnosis. As one component of a study of the entire journey of SSA women with BC, we aimed to identify shared and setting‐specific drivers of advanced stage BC. Women newly diagnosed in the multicountry African Breast Cancer–Disparities in Outcomes (ABC‐DO) study completed a baseline interview and their stage information was extracted from medical records. Ordinal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for advanced stage (I, II, III, IV) in relation to individual woman‐level, referral and biological factors. A total of 1795 women were included from Nigeria, Uganda, Zambia, and the multiracial populations of Namibia and South Africa, 1091 of whom (61%) were stage III/IV. Stage was lower in women with greater BC knowledge (OR 0.77 (95% CI: 0.70, 0.85) per point on a 6 point scale). More advanced stage was associated with being black (4.00 (2.79, 5.74)), having attended
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| Keywords: | breast cancer stage at diagnosis survival sub‐Saharan Africa |
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