Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Breast cancer is the leading cancer diagnosis and second most common cause of cancer deaths in sub-Saharan Africa (SSA). Yet, there are few population-level survival data from Africa and none on the survival differences by stage at diagnosis. Here, we estimate breast cancer survival within SSA by area, stage and country-level Human Development Index (HDI). We obtained data on a random sample of 2,588 breast cancer incident cases, diagnosed in 2008-2015 from 14 population-based cancer registries in 12 countries (Benin, Cote d’Ivoire, Ethiopia, Kenya, Mali, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Uganda and Zimbabwe) through the African Cancer Registry Network. Of these, 2311 were included for survival analyses. The 1, 3 and 5-year observed and relative survival were estimated by registry, stage and country-level HDI. We equally estimated the excess hazards adjusting for potential confounders. Among patients with known stage, 64.9% were diagnosed in late stages, with 18.4% being metastatic at diagnosis. The relative survival (RS) varied by registry, ranging from 21.6%(8.2-39.8) at year-3 in Bulawayo to 84.5%(70.6-93.5) in Namibia. Patients diagnosed at early stages had a 3-year RS of 78%(71.6-83.3) in contrast to 40.3%(34.9-45.7) at advanced stages (III and IV). The overall RS at year-1 was 86.1%(84.4-87.6), 65.8%(63.5-68.1) at year-3 and 59.0%(56.3-61.6) at year-5. Age at diagnosis was not independently associated with increased mortality risk after adjusting for the effect of stage and country-level HDI. In conclusion, downstaging breast cancer at diagnosis and improving access to quality care could be pivotal in improving breast cancer survival outcomes in Africa.

Type

Journal article

Journal

International Journal of Cancer

Publisher

Wiley

Keywords

Breast Cancer, Stage, Human Development Index, Survival, Africa