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Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study
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 multic...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838525/ https://www.ncbi.nlm.nih.gov/pubmed/29197068 http://dx.doi.org/10.1002/ijc.31187 |
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author | McKenzie, Fiona Zietsman, Annelle Galukande, Moses Anele, Angelica Adisa, Charles Parham, Groesbeck Pinder, Leeya Cubasch, Herbert Joffe, Maureen Kidaaga, Frederick Lukande, Robert Offiah, Awa U. Egejuru, Ralph O. Shibemba, Aaron Schuz, Joachim Anderson, Benjamin O. dos Santos Silva, Isabel McCormack, Valerie |
author_facet | McKenzie, Fiona Zietsman, Annelle Galukande, Moses Anele, Angelica Adisa, Charles Parham, Groesbeck Pinder, Leeya Cubasch, Herbert Joffe, Maureen Kidaaga, Frederick Lukande, Robert Offiah, Awa U. Egejuru, Ralph O. Shibemba, Aaron Schuz, Joachim Anderson, Benjamin O. dos Santos Silva, Isabel McCormack, Valerie |
author_sort | McKenzie, Fiona |
collection | PubMed |
description | 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 <secondary education (1.75 (1.42, 2.16)), having never heard of BC (1.64 (1.31, 2.06)), an unskilled job (1.77 (1.43, 2.20)) and pregnancy in the past 3 years (30% of ≤45 year olds) (1.63 (1.15, 2.31)), and were mediated through delays to diagnosis: symptom duration of ≥ 1 year (OR 2.47 (1.93, 3.15)). These findings provide further evidence that late‐stage BC in SSA is largely attributed to modifiable factors and strategies to improve BC education and awareness in women and the health system should be intensified. |
format | Online Article Text |
id | pubmed-5838525 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-58385252018-03-12 Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study McKenzie, Fiona Zietsman, Annelle Galukande, Moses Anele, Angelica Adisa, Charles Parham, Groesbeck Pinder, Leeya Cubasch, Herbert Joffe, Maureen Kidaaga, Frederick Lukande, Robert Offiah, Awa U. Egejuru, Ralph O. Shibemba, Aaron Schuz, Joachim Anderson, Benjamin O. dos Santos Silva, Isabel McCormack, Valerie Int J Cancer Cancer Epidemiology 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 <secondary education (1.75 (1.42, 2.16)), having never heard of BC (1.64 (1.31, 2.06)), an unskilled job (1.77 (1.43, 2.20)) and pregnancy in the past 3 years (30% of ≤45 year olds) (1.63 (1.15, 2.31)), and were mediated through delays to diagnosis: symptom duration of ≥ 1 year (OR 2.47 (1.93, 3.15)). These findings provide further evidence that late‐stage BC in SSA is largely attributed to modifiable factors and strategies to improve BC education and awareness in women and the health system should be intensified. John Wiley and Sons Inc. 2017-12-23 2018-04-15 /pmc/articles/PMC5838525/ /pubmed/29197068 http://dx.doi.org/10.1002/ijc.31187 Text en © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Cancer Epidemiology McKenzie, Fiona Zietsman, Annelle Galukande, Moses Anele, Angelica Adisa, Charles Parham, Groesbeck Pinder, Leeya Cubasch, Herbert Joffe, Maureen Kidaaga, Frederick Lukande, Robert Offiah, Awa U. Egejuru, Ralph O. Shibemba, Aaron Schuz, Joachim Anderson, Benjamin O. dos Santos Silva, Isabel McCormack, Valerie Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
title | Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
title_full | Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
title_fullStr | Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
title_full_unstemmed | Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
title_short | Drivers of advanced stage at breast cancer diagnosis in the multicountry African breast cancer – disparities in outcomes (ABC‐DO) study |
title_sort | drivers of advanced stage at breast cancer diagnosis in the multicountry african breast cancer – disparities in outcomes (abc‐do) study |
topic | Cancer Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838525/ https://www.ncbi.nlm.nih.gov/pubmed/29197068 http://dx.doi.org/10.1002/ijc.31187 |
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