| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Ayeni, Oluwatosin A. Joffe, Maureen Mapanga, Witness Chen, Wenlong Carl O’Neil, Daniel S. Phakathi, Boitumelo Nietz, Sarah Buccimazza, Ines Čačala, Sharon Stopforth, Laura W. Jacobson, Judith S. Crew, Katherine D. Neugut, Alfred I. Ramiah, Duvern Ruff, Paul Cubasch, Herbert Chirwa, Tobias McCormack, Valerie Micklesfield, Lisa K. Norris, Shane A. |
| Abstract | Background Breast cancer survival in South Africa is low, but when diagnosed with breast cancer, many women in South Africa also have other chronic conditions. We investigated the impact of multimorbidity (≥ 2 other chronic conditions) on overall survival among women with breast cancer in South Africa. Methods Between 1 July 2015 and 31 December 2019, we enrolled women newly diagnosed with breast cancer at six public hospitals participating in the South African Breast Cancer and HIV Outcomes (SABCHO) Study. We examined seven chronic conditions (obesity, hypertension, diabetes, HIV, cerebrovascular diseases (CVD), asthma/chronic obstructive pulmonary disease, and tuberculosis), and we compared socio-demographic, clinical, and treatment factors between patients with and without each condition, and with and without multimorbidity. We investigated the association of multimorbidity with overall survival using multivariable Cox proportional hazard models. Results Of 3,261 women included in the analysis, 45% had multimorbidity; obesity (53%), hypertension (41%), HIV (22%), and diabetes (13%) were the most common individual conditions. Women with multimorbidity had poorer overall survival at 3 years than women without multimorbidity in both the full cohort (60.8% vs. 64.3%, p = 0.036) and stage groups: stages I–II, 80.7% vs. 86.3% (p = 0.005), and stage III, 53.0% vs. 59.4% (p = 0.024). In an adjusted model, women with diabetes (hazard ratio (HR) = 1.20, 95% confidence interval (CI) = 1.03–1.41), CVD (HR = 1.43, 95% CI = 1.17–1.76), HIV (HR = 1.21, 95% CI = 1.06–1.38), obesity + HIV (HR = 1.24 95% CI = 1.04–1.48), and multimorbidity (HR = 1.26, 95% CI = 1.13–1.40) had poorer overall survival than women without these conditions. Conclusions Irrespective of the stage, multimorbidity at breast cancer diagnosis was an important prognostic factor for survival in our SABCHO cohort. The high prevalence of multimorbidity in our cohort calls for more comprehensive care to improve outcomes for South African women with breast cancer. |
| Related Links | https://breast-cancer-research.biomedcentral.com/counter/pdf/10.1186/s13058-023-01603-w.pdf |
| Ending Page | 13 |
| Page Count | 13 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| DOI | 10.1186/s13058-023-01603-w |
| Journal | Breast Cancer Research |
| Issue Number | 1 |
| Volume Number | 25 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-01-23 |
| Access Restriction | Open |
| Subject Keyword | Cancer Research Oncology Surgical Oncology Breast cancer Multimorbidity Chronic conditions Survival South Africa |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cancer Research Oncology |
| Journal Impact Factor | 6.1/2023 |
| 5-Year Journal Impact Factor | 7.1/2023 |
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