The South African breast cancer and HIV outcomes study: Profiling the cancer centres and cohort characteristics, diagnostic pathways, and treatment approaches

• DOI: 10.1371/journal.pgph.0002432
• Publication Date: 2023-10-24T17:21:36Z
• Authors: Witness Mapanga; Oluwatosin A. Ayeni; Wenlong Carl Chen; Judith S. Jacobson; Alfred I. Neugut; Paul Ruff; Herbert Cubasch; Daniel S. O’Neil; Ines Buccimazza; Sharon Čačala; Laura W. Stopforth; Hayley A. Farrow; Sarah Nietz; Boitumelo Phakathi; Tobias Chirwa; Valerie A. McCormack; Maureen Joffe
• Keywords: Profiling (computer programming)

The South African Breast Cancer and HIV Outcomes prospective cohort (SABCHO) study was established to investigate survival determinants among HIV-positive HIV-negative SA women with breast cancer. This paper describes common unique characteristics of the cancer centres their participants, examining disparities in pathways diagnosis, treatment resources approaches adopted mitigate resource constraints. Johannesburg (Jhb), Soweto (Sow), Durban (Dbn) sites treat mainly urban, relatively better educated more socioeconomically advantaged patients whereas Pietermaritzburg (Pmb) Empangeni (Emp) predominantly rural, less impoverished communities Sow, Jhb, Emp had younger (mean ages 54 ±14.5, 55±13.7 54±14.3 respectively), at Dbn Pmb sites, greater representation Asian Indian women, were older age 57 ±13.9 58 ±14.6 respectively). prevalence high, ranging from 15%-42%, (Cohort obesity (BMI ≥ 30 kg/m 2 ) 60%, self-reported hypertension (41%) diabetes (13%). Direct referral primary care clinics centre occurred only Sow site which uniquely ran an open clinic where early stage (I II) proportions highest 48.5%. other relied on indirect patient regional hospitals significant delays diagnostics early-stage a low (15%- 37.3%). referred for all treatments located 200km away; provided surgery endocrine services but Jhb Km away chemo- radiation therapy. complete oncology services. All followed international guidelines approaches. Findings may inform policy interventions address national care.