African Breast Cancer - Disparities in Outcomes - Plus (ABC-DO Plus)

项目摘要 乳腺癌是最常见的癌症类型，也是乳腺癌的第二大病因。 撒哈拉以南非洲妇女的癌症死亡率。在这方面，关于乳腺癌生存率的少数研究 该区域报告短期存活率低，但没有一个区域能够全面解决 低生存率的原因，如何提高生存率，也不评估五年和更长期的生存率 生存。此外，在女性中常见的更具攻击性的分子亚型的影响 在撒哈拉以南非洲地区，非洲裔妇女的乳腺癌生存率尚未得到调查。 非洲乳腺癌-结果差异（ABC-DO）研究是一项五国研究， 撒哈拉以南非洲乳腺癌队列于2014年启动。在3年的招聘过程中， 在乌干达、尼日利亚、赞比亚、纳米比亚和南非招募了2100名妇女。在 建议的项目，ABC-DO-Plus，我们将建立在ABC-DO -即建立 合作、研究人员、肿瘤收集、伦理和法律的许可;以及新的和 成功的移动健康（mHealth）-实施后续行动-积极跟进妇女， 诊断后2年至5年，首次检查5年总体生存率， 关键预后因素、分子亚型、治疗可用性、可负担性和依从性， 在这种情况下存在的社会经济决定因素和合并症，特别是高BMI和 艾滋病。 乳腺癌生存率研究，即乳腺癌后妇女的健康， 在撒哈拉以南非洲，治疗在很大程度上被忽视。ABC-DO-Plus将检查，对于 女性乳房植入后5年内健康相关生活质量的首次纵向变化 癌症诊断 ABC-DO-Plus将为减少过多死亡人数所需的干预措施提供信息 并改善幸存者的生活质量。利用非洲内部 五个国家的框架，具有不同的癌症护理政策，但也代表个人 社会经济和文化多样性，将使不同环境的比较， 确定影响BC存活的可改变因素。 此外，它对更具侵袭性的肿瘤分子亚型的比例的发现， 以及这些可能如何影响生存，以及对合并症生存的影响，如 艾滋病毒，将与美国和其他地方的其他黑人妇女有关。 拟议的ABC-DO-Plus及其多方面目标的成功将得到确保 通过延续过去4年多的ABC-DO实地工作经验， 研究基础设施，以及这一独特队列的有效移动健康随访方法。

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.