title: African Breast Cancer-Disparities in Outcomes (ABC-DO): protocol of a multicountry mobile health prospective study of breast cancer survival in sub-Saharan Africa.
abstract: Sub-Saharan African (SSA) women with breast cancer (BC) have low survival rates from this potentially treatable disease. An understanding of context-specific societal, health-systems and woman-level barriers to BC early detection, diagnosis and treatment are needed.
  
  
  
  The African Breast Cancer-Disparities in Outcomes (ABC-DO) is a prospective hospital-based study of overall survival, impact on quality of life (QOL) and delays along the journey to diagnosis and treatment of BC in SSA. ABC-DO is currently recruiting in Namibia, Nigeria, South Africa, Uganda and Zambia. Women aged 18 years or older who present at participating secondary and tertiary hospitals with a new clinical or histocytological diagnosis of primary BC are invited to participate. For consented women, tumour characteristics, specimen and treatment data are obtained. Over a 2-year enrolment period, we aim to recruit 2000 women who, in the first instance, will be followed for between 1 and 3 years. A face-to-face baseline interview obtains information on socioeconomic, cultural and demographic factors, QOL, health and BC attitudes/knowledge, and timing of all prediagnostic contacts with caregivers in orthodox health, traditional and spiritual systems. Responses are immediately captured on mobile devices that are fed into a tailored mobile health (mHealth) study management system. This system implements the study protocol, by prompting study researchers to phone women on her mobile phone every 3 months and, failing to reach her, prompts contact with her next-of-kin. At follow-up calls, women provide updated information on QOL, care received and disease impacts on family and working life; date of death is asked of her next-of-kin when relevant.
  
  
  
  The study was approved by ethics committees of all involved institutions. All participants provide written informed consent. The findings from the study will be published in peer-reviewed scientific journals, presented to funders and relevant local organisations and at scientific conferences.
authors.affiliation: Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
authors.forename: Fiona
authors.initials: F
authors.lastname: McKenzie
authors.affiliation: Windhoek Central Hospital, Windhoek, Namibia.
authors.forename: Annelle
authors.initials: A
authors.lastname: Zietsman
authors.affiliation: Makerere University, Kampala, Uganda.
authors.forename: Moses
authors.initials: M
authors.lastname: Galukande
authors.affiliation: Federal Medical Centre, Owerri, Nigeria.
authors.forename: Angelica
authors.initials: A
authors.lastname: Anele
authors.affiliation: Abia State University Teaching Hospital, Aba, Nigeria.
authors.forename: Charles
authors.initials: C
authors.lastname: Adisa
authors.affiliation: Department of Surgery, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
authors.forename: Herbert
authors.initials: H
authors.lastname: Cubasch
authors.affiliation: University of North Carolina, Chapel Hill, USA.
authors.forename: Groesbeck
authors.initials: G
authors.lastname: Parham
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.affiliation: Genetics Section, International Agency for Research on Cancer, Lyon, France.
authors.forename: Behnoush
authors.initials: B
authors.lastname: Abedi-Ardekani
authors.affiliation: Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
authors.forename: Joachim
authors.initials: J
authors.lastname: Schuz
authors.affiliation: Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dos Santos Silva
authors.affiliation: Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
authors.forename: Valerie
authors.initials: V
authors.lastname: McCormack
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara; D001943:Breast Neoplasms / Q000401:mortality*; D040421:Cell Phone; D002985:Clinical Protocols; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016387:Women's Health; D055815:Young Adult
keywords: Africa; EPIDEMIOLOGY; Survival