The Outcome of Breast Cancer Is Associated with National Human Development Index and Health System Attainment

Hu, Kaimin; Lou, Lixia; Tian, Wei; Ye, Juan; Zhang, Suzhan

doi:10.1371/journal.pone.0158951

Cited by 22 publications

(24 citation statements)

References 25 publications

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“…This could explain why little difference was observed between countries with medium and low HDI. However, correlations have been shown between national breast cancer mortality‐to‐incidence ratio (MIR) and country HDI with the use of GLOBOCAN 2012 . Finally, we have not adjusted for other important predictors of survival like treatment received and tumor biology.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer survival in sub‐Saharan Africa by age, stage at diagnosis and human development index: A population‐based registry study

Joko‐Fru

Miranda‐Filho

Soerjomataram

et al. 2019

Intl Journal of Cancer

139

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Breast cancer is the leading cancer diagnosis and second most common cause of cancer deaths in sub‐Saharan Africa (SSA). Yet, there are few population‐level survival data from Africa and none on the survival differences by stage at diagnosis. Here, we estimate breast cancer survival within SSA by area, stage and country‐level human development index (HDI). We obtained data on a random sample of 2,588 breast cancer incident cases, diagnosed in 2008–2015 from 14 population‐based cancer registries in 12 countries (Benin, Cote d'Ivoire, Ethiopia, Kenya, Mali, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Uganda and Zimbabwe) through the African Cancer Registry Network. Of these, 2,311 were included for survival analyses. The 1‐, 3‐ and 5‐year observed and relative survival (RS) were estimated by registry, stage and country‐level HDI. We equally estimated the excess hazards adjusting for potential confounders. Among patients with known stage, 64.9% were diagnosed in late stages, with 18.4% being metastatic at diagnosis. The RS varied by registry, ranging from 21.6%(8.2–39.8) at Year 3 in Bulawayo to 84.5% (70.6–93.5) in Namibia. Patients diagnosed at early stages had a 3‐year RS of 78% (71.6–83.3) in contrast to 40.3% (34.9–45.7) at advanced stages (III and IV). The overall RS at Year 1 was 86.1% (84.4–87.6), 65.8% (63.5–68.1) at Year 3 and 59.0% (56.3–61.6) at Year 5. Age at diagnosis was not independently associated with increased mortality risk after adjusting for the effect of stage and country‐level HDI. In conclusion, downstaging breast cancer at diagnosis and improving access to quality care could be pivotal in improving breast cancer survival outcomes in Africa.

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Section: Discussionmentioning

confidence: 99%

Breast cancer survival in sub‐Saharan Africa by age, stage at diagnosis and human development index: A population‐based registry study

Joko‐Fru

Miranda‐Filho

Soerjomataram

et al. 2019

Intl Journal of Cancer

139

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“…Breast cancer survival varies widely across the globe and is strongly associated with a country's gross domestic product as well as its public spending on health 29 . Complex mechanisms underlie the contribution of human development—national income, life expectancy, education, and/or fertility rates—in conjunction with the strength of the health system, to a woman's likelihood of experiencing long‐term survival from breast cancer 30 .…”

Section: Situational Analysismentioning

confidence: 99%

Breast cancer early detection: A phased approach to implementation

Ginsburg

Yip

Brooks

et al. 2020

Cancer

420

208

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When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Breast Health Global Initiative (BHGI) developed resource-stratified guidelines for the early detection and diagnosis of breast cancer. In this consensus article from the sixth BHGI Global Summit held in October 2018, the authors describe phases of early detection program development, beginning with management strategies required for the diagnosis of clinically detectable disease based on awareness education and technical training, history and physical examination, and accurate tissue diagnosis. The core issues address include finance and governance, which pertain to successful planning, implementation, and the iterative process of program improvement and are needed for a breast cancer early detection program to succeed in any resource setting. Examples are presented of implementation, process, and clinical outcome metrics that assist in program implementation monitoring. Country case examples are presented to highlight the challenges and opportunities of implementing successful breast cancer early detection programs, and the complex interplay of barriers and facilitators to achieving early detection for breast cancer in real-world settings are considered. Cancer 2020;126:2379-2393.

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“…Moreover, the HDI may predict changes in the efficacy of interventions that require complex implementation. If this is the case, the HDI would be useful for the study and implementation of pre‐operative optimisation in differing socioeconomic environments .…”

Section: Introductionmentioning

confidence: 99%

The developing world of pre‐operative optimisation: a systematic review of Cochrane reviews

2018

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Pre-operative optimisation is a heterogenous group of interventions aimed at improving peri-operative outcomes. To understand the evidence for pre-operative optimisation in the developing world, we systematically reviewed Cochrane reviews on the topic according to the Human Developmental Index (HDI) of the country where patient recruitment occurred. We used summary statistics and cartograms to describe the HDI, year of publication, timing of pre-operative intervention and risk of bias associated with each included trial. We assessed the impact of multinational trials on the risk of bias introduced by countries of differing HDI. Fourhundred and nine trials representing 51 countries and 89,389 randomly allocated participants were summarised in this review. Four-hundred and nineteen out of 451 (93%) trial populations (i.e. a group of study participants from one country) were from high and very high HDI countries. The median (IQR [range]) HDI of countries were 0.862 (0.806-0.892 [0.445-0.949]). Three of the 409 included trials were multinational, representing 32 countries and 37,736 out of 89,389 (42.2%) included participants. Africa was the least represented continent, with only 4 included trials and 566 participants, of which 62.3% were from one multinational trial. The overall risk of bias was high or unclear in 381 out of 409 (93%) trials. Inclusion of multinational trials decreased the proportion of trial populations introducing high or unclear risk of bias by 9.4% (95%CI 5.1-13.7; p < 0.0001). Half of the world's population live in low-and middle-HDI countries. This population is poorly represented in systematically reviewed evidence on pre-operative optimisation. Multinational trials increase the knowledge contribution from low-and middle-HDI countries and decrease risk of bias in systematic reviews. Anaesthesia 2019, 74, 89-99 du Toit et al. | Developing world of pre-operative optimisation

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The Outcome of Breast Cancer Is Associated with National Human Development Index and Health System Attainment

Cited by 22 publications

References 25 publications

Breast cancer survival in sub‐Saharan Africa by age, stage at diagnosis and human development index: A population‐based registry study

Breast cancer survival in sub‐Saharan Africa by age, stage at diagnosis and human development index: A population‐based registry study

Breast cancer early detection: A phased approach to implementation

The developing world of pre‐operative optimisation: a systematic review of Cochrane reviews

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