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

项目摘要 乳腺癌是诊断出的最常见的癌症类型，是 撒哈拉以南非洲妇女死于癌症。关于乳腺癌存活率的研究为数不多 该地区报告的短期存活率很低，但没有一个能够全面解决 低存活率的原因，如何提高存活率，也不评估五年和更长期的存活率 和生存能力。此外，女性中常见的更具侵略性的分子亚型的影响 非洲人后裔对撒哈拉以南非洲乳腺癌存活率的影响尚未得到调查。 非洲乳腺癌-预后差异(ABC-DO)研究是一个由五个国家组成的研究 撒哈拉以南非洲乳腺癌队列始于2014年。在招聘的3年时间里，超过 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-即已建立的 合作、研究人员、肿瘤收集、伦理和法律许可；以及新颖和 成功的移动健康(MHealth)-实施跟踪-对妇女进行积极跟踪 在确诊后再进行2年至5年的检查，第一次检查总体和 关键预后因素，分子亚型，治疗可获得性，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共病，特别是高BMI和 爱滋病毒。 乳腺癌生存研究，即乳腺癌患者术后的健康状况 治疗，在撒哈拉以南非洲在很大程度上被忽视。ABC-DO-Plus将检查，对于 第一次，女性乳房后长达5年的健康相关生活质量的纵向变化 癌症诊断。 ABC-Do-Plus将提供必要的干预措施，以减少过多的死亡人数 对患有这种疾病的妇女进行治疗，并提高幸存者的生活质量。利用非洲内部的 框架中的五个国家有不同的癌症关怀政治，但也代表着个人 社会经济和文化多样性，将实现跨环境的比较，因此 确定影响BC存活率的可改变因素。 此外，它对更具侵袭性的肿瘤分子亚型所占比例的发现， 以及这些可能如何影响生存，以及对共病的影响，如 HIV，将与美国和其他地方的其他黑人女性相关。 拟议的ABC-do-Plus及其多重目标的成功将得到确保 通过延续过去4年多来ABC-DO实地考察的经验，它建立了 研究基础设施，以及这一独特队列的高效移动健康后续方法。

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.