Few Losses to Follow-up in a Sub-Saharan African Cancer Cohort via Active Mobile Health Follow-up The African Breast Cancer-Disparities in Outcomes Study
Few Losses to Follow-up in a Sub-Saharan African Cancer Cohort via Active Mobile Health Follow-up The African Breast Cancer-Disparities in Outcomes Study
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DOI：
10.1093/aje/kwaa070
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发表时间：
2020-10-01
影响因子：
5
通讯作者：
McCormack, Valerie
中科院分区：
文献类型：
--
作者：
Foerster, Milena;Anele, Angelica;McCormack, Valerie
在撒哈拉以南非洲地区，需要准确的生存率估计来指导癌症控制工作，但由于过度失访（LTFU），以前的研究受到未知偏倚的阻碍。在非洲乳腺癌-结局差异研究（一项前瞻性乳腺癌队列研究）中，我们实施了主动的移动的健康随访，每三个月用她的移动的电话给每位女性或她的近亲（NOK）打电话，以更新她的生命状态信息。分析了从2014-2017年诊断到最早的2018年9月1日，死亡或诊断后3年与女性/NOK的每次接触日期。将死亡作为竞争事件，计算LTFU的累积发生率。总共对1，490名女性进行了中位数为24.2（四分位距（IQR），14.2-34.5）个月的随访，对应于与女性/NOK的8，529次成功联系（占总联系的77%）。成功联系之间的中位时间为3.0（IQR，3.0-3.7）个月。总共有71名女性（5.3%）在3年时为LTFU：尼日利亚为0.8%，纳米比亚为2.2%，乌干达为5.6%。由于主动随访的暂时中断，赞比亚20.3%的妇女在2年后出现长期随访。至研究通知死亡的中位时间为9.1（IQR，3.9-14.0）周。虽然本研究不是一项随机对照试验，但在该积极移动的健康随访的癌症队列中，LTFU远低于先前的研究，并能够估计最新和可靠的癌症生存率。
Accurate survival estimates are needed for guiding cancer control efforts in sub-Saharan Africa, but previous studies have been hampered by unknown biases due to excessive loss to follow-up (LTFU). In the African Breast Cancer-Disparities in Outcomes Study, a prospective breast cancer cohort study, we implemented active mobile health follow-up, telephoning each woman or her next-of-kin (NOK) trimonthly on her mobile phone to update information on her vital status. Dates of every contact with women/NOK were analyzed from diagnosis in 2014-2017 to the earliest of September 1, 2018, death, or 3 years postdiagnosis. The cumulative incidence of being LTFU was calculated considering deaths as competing events. In all, 1,490 women were followed for a median of 24.2 (interquartile range (IQR), 14.2-34.5) months, corresponding to 8,529 successful contacts (77% of total contacts) with the women/NOK. Median time between successful contacts was 3.0 (IQR, 3.0-3.7) months. In all, 71 women (5.3%) were LTFU at 3 years: 0.8% in Nigeria, 2.2% in Namibia, and 5.6% in Uganda. Because of temporary discontinuity of active follow-up, 20.3% of women were LTFU after 2 years in Zambia. The median time to study notification of a death was 9.1 (IQR, 3.9-14.0) weeks. Although the present study was not a randomized controlled trial, in this cancer cohort with active mobile health follow-up, LTFU was much lower than in previous studies and enabled estimation of up-to-date and reliable cancer survival.