Grant Number:	5R01CA244559-04 Interpret this number
Primary Investigator:	Mccormack, Valerie
Organization:	International Agency For Res On Cancer
Project Title:	African Breast Cancer - Disparities in Outcomes - Plus (Abc-Do Plus)
Fiscal Year:	2023

Project Summary Breast cancer is the most common type of cancer diagnosed and the second cause of cancer death in sub-Saharan African women. The few studies on breast cancer survival in this region reported low short-term survival rates, but none were able to comprehensively address reasons for low survival, how to improve survival, nor assess five-year and longer-term survival and survivorship. Further, the impact of more aggressive molecular subtypes, common in women of African-descent, on breast cancer survival in sub-Saharan Africa has not yet been investigated. The African Breast Cancer-Disparities in Outcomes (ABC-DO) study is a five-country sub-Saharan African breast cancer cohort initiated in 2014. During 3 years of recruitment, over 2100 women were recruited in Uganda, Nigeria, Zambia, Namibia, and South Africa. In the proposed project, ABC-DO-Plus, we will build on ABC-DO – namely the established collaborations, research staff, tumor collections, ethical and legal permissions; and novel and successful mobile-Health (mHealth)-implemented follow-up – to actively follow-up women for a further 2 years to 5 years post-diagnosis, examine for the first time 5-year survival overall and by key prognostic factors, molecular subtypes, treatment availability, affordability and compliance, socioeconomic determinants and comorbidities present in this setting, particularly high BMI and HIV. Breast cancer survivorship research, i.e. the health of women with breast cancer post- treatment, has largely been neglected in sub-Saharan Africa. ABC-DO-Plus will examine, for the first time, longitudinal changes in health-related quality of life up to 5 years after a woman’s breast cancer diagnosis. ABC-DO-Plus will inform interventions needed to mitigate the excessive number of deaths of women with the disease, and improve the quality-of-life of survivors. Utilizing a within-African framework of five countries with different cancer care politics, but also representing individual socioeconomic and cultural diversity, will enable comparisons across settings and hereby identification of modifiable factors influencing BC survival. Furthermore, its findings on the proportions of more aggressive tumor molecular subtypes, and how these may affect survival, as well as on the impact on survival of comorbidities such as HIV, will be of relevance to other black women in the US and elsewhere. The success of the proposed ABC-DO-Plus, and its manifold goals, will be ensured through continuity of the experience of the previous 4+ years’ ABC-DO fieldwork, its established research infrastructure, and the efficient mHealth follow-up approach of this unique cohort.




Geospatial disparities in survival of patients with breast cancer in sub-Saharan Africa from the African Breast Cancer-Disparities in Outcomes cohort (ABC-DO): a prospective cohort study.
Authors: Kim J. , Macharia P.M. , McCormack V. , Foerster M. , Galukande M. , Joffe M. , Cubasch H. , Zietsman A. , Anele A. , Offiah S. , et al. .
Source: The Lancet. Global Health, 2024-05-21 00:00:00.0; , .
EPub date: 2024-05-21 00:00:00.0.
PMID: 38788756
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Analysis of the Breast Cancer Journey in Namibia.
Authors: Boucheron P. , Zietsman A. , Pontac J. , Hansen R. , Anderson B.O. , Togawa K. , Macharia P.M. , Foerster M. , Schüz J. , Dos-Santos-Silva I. , et al. .
Source: Jama Network Open, 2023-11-01 00:00:00.0; 6(11), p. e2341402.
EPub date: 2023-11-01 00:00:00.0.
PMID: 37921764
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Regional Variation in the Tumor Microenvironment, Immune Escape and Prognostic Factors in Breast Cancer in Sub-Saharan Africa.
Authors: Bauer M. , Vetter M. , Stückrath K. , Yohannes M. , Desalegn Z. , Yalew T. , Bekuretsion Y. , Kenea T.W. , Joffe M. , van den Berg E.J. , et al. .
Source: Cancer Immunology Research, 2023-06-02 00:00:00.0; 11(6), p. 720-731.
PMID: 37058582
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Drivers of disparities in stage at diagnosis among women with breast cancer: South African breast cancers and HIV outcomes cohort.
Authors: Mapanga W. , Norris S.A. , Craig A. , Ayeni O.A. , Chen W.C. , Jacobson J.S. , Neugut A.I. , Ruff P. , Cubasch H. , O'Neil D.S. , et al. .
Source: Plos One, 2023; 18(2), p. e0281916.
EPub date: 2023-02-16 00:00:00.0.
PMID: 36795733
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Reproductive history and breast cancer survival: Findings from the African breast cancer-Disparities in outcomes cohort and implications of Africa's fertility transition on breast cancer prognosis.
Authors: Boucheron P. , Anele A. , Offiah A.U. , Zietsman A. , Galukande M. , Parham G. , Pinder L.F. , Anderson B.O. , Foerster M. , Schüz J. , et al. .
Source: International Journal Of Cancer, 2022-12-22 00:00:00.0; , .
EPub date: 2022-12-22 00:00:00.0.
PMID: 36545890
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Global and regional estimates of orphans attributed to maternal cancer mortality in 2020.
Authors: Guida F. , Kidman R. , Ferlay J. , Schüz J. , Soerjomataram I. , Kithaka B. , Ginsburg O. , Mailhot Vega R.B. , Galukande M. , Parham G. , et al. .
Source: Nature Medicine, 2022-11-20 00:00:00.0; , .
EPub date: 2022-11-20 00:00:00.0.
PMID: 36404355
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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.
Authors: Foerster M. , McCormack V. , Anderson B.O. , Boucheron P. , Zietsman A. , Cubasch H. , Joffe M. , Anele A. , Offiah S. , Galukande M. , et al. .
Source: The Lancet. Oncology, 2022-05-09 00:00:00.0; , .
EPub date: 2022-05-09 00:00:00.0.
PMID: 35550274
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Disparities in breast cancer survival between women with and without HIV across sub-Saharan Africa (ABC-DO): a prospective, cohort study.
Authors: Chasimpha S. , McCormack V. , Cubasch H. , Joffe M. , Zietsman A. , Galukande M. , Parham G. , Pinder L.F. , Anele A. , Adisa C.A. , et al. .
Source: The Lancet. Hiv, 2022 03; 9(3), p. e160-e171.
PMID: 35245508
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Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study.
Authors: Boucheron P. , Anele A. , Zietsman A. , Galukande M. , Parham G. , Pinder L.F. , Andersson T.M. , Anderson B.O. , Foerster M. , Schüz J. , et al. .
Source: Breast Cancer Research : Bcr, 2021-11-24 00:00:00.0; 23(1), p. 109.
EPub date: 2021-11-24 00:00:00.0.
PMID: 34819118
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Geospatial barriers to healthcare access for breast cancer diagnosis in sub-Saharan African settings: The African Breast Cancer-Disparities in Outcomes Cohort Study.
Authors: Togawa K. , Anderson B.O. , Foerster M. , Galukande M. , Zietsman A. , Pontac J. , Anele A. , Adisa C. , Parham G. , Pinder L.F. , et al. .
Source: International Journal Of Cancer, 2021-05-01 00:00:00.0; 148(9), p. 2212-2226.
EPub date: 2020-12-08 00:00:00.0.
PMID: 33197280
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Dissecting the journey to breast cancer diagnosis in sub-Saharan Africa: Findings from the multicountry ABC-DO cohort study.
Authors: Foerster M. , McKenzie F. , Zietsman A. , Galukande M. , Anele A. , Adisa C. , Parham G. , Pinder L. , Schüz J. , McCormack V. , et al. .
Source: International Journal Of Cancer, 2021-01-15 00:00:00.0; 148(2), p. 340-351.
EPub date: 2020-08-04 00:00:00.0.
PMID: 32663320
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Maternally Orphaned Children and Intergenerational Concerns Associated With Breast Cancer Deaths Among Women in Sub-Saharan Africa.
Authors: Galukande M. , Schüz J. , Anderson B.O. , Zietsman A. , Adisa C. , Anele A. , Parham G. , Pinder L.F. , Mutumba S. , Lombe D. , et al. .
Source: Jama Oncology, 2020-12-23 00:00:00.0; , .
EPub date: 2020-12-23 00:00:00.0.
PMID: 33355599
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