Treatment guideline concordance, initiation, and abandonment in patients with non-metastatic breast cancer from the African Breast Cancer–Disparities in Outcomes (ABC-DO) cohort in sub-Saharan Africa: a prospective cohort study

Researchers from the International Agency for Research on Cancer (IARC) and partner institutions found that only two thirds of women in sub-Saharan Africa who required chemotherapy to treat breast cancer received treatment in line with guidelines, and that only 1 in 3 of these women adequately completed their treatment. At least 1 in 5 women abandoned their treatment. These results are reported in a new analysis of breast cancer management, guideline concordance, and treatment abandonment in sub-Saharan Africa, from the African Breast Cancer – Disparities in Outcomes (ABC-DO) study. The article was published in The Lancet Oncology.

This study is based on more than 1700 patients with breast cancer from seven population groups, diagnosed with non-metastatic invasive breast cancer. During a median follow-up of 5.2 years, multimodality treatment consisting of surgery and systemic therapy with or without radiotherapy was initiated in 74% of women with localized tumours compared with 47% of women with locally advanced tumours. Of the 66% of patients who initiated a guideline-concordant chemotherapy regimen, only 35% adequately completed the treatment course, whereas 24% only marginally completed the course and 20% abandoned treatment. Completion was unknown in 15% of women. There were pronounced differences between populations. The highest treatment initiation rates were recorded in Namibia and South Africa, and the lowest rates were recorded in Nigeria.

This study provides a detailed description of current breast cancer management in sub-Saharan Africa, which is the region with the lowest survival rates for patients with breast cancer in the world. The authors identified population-specific treatment gaps and needs, which will help in shaping strategic interventions to provide timely high-quality breast cancer treatment in the region, as called for by the World Health Organization’s Global Breast Cancer Initiative.

Foerster M, McCormack V, Anderson BO, Boucheron P, Zietsman A, Cubasch H, et al.
Treatment guideline concordance, initiation, and abandonment in patients with non-metastatic breast cancer from the African Breast Cancer–Disparities in Outcomes (ABC-DO) cohort in sub-Saharan Africa: a prospective cohort study
Lancet Oncol, Published online 9 May 2022;
https://doi.org/10.1016/S1470-2045(22)00198-X

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