Low survival of South African urban black women with breast cancer

Walker, Alexander; Walker, B. F.; Tshabalala, E N; Isaacson, C.; Segal, I

doi:10.1038/bjc.1984.37

Cited by 26 publications

(17 citation statements)

References 14 publications

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“…5,37,38,42–47 The remaining 58 studies did not report on race, but their populations were assumed to have the racial composition of their countries’ population and, hence, to consist predominantly (≥80%) of black women. Studies from South Africa included exclusively 39–41 or predominantly (≥80%) black women; 18 or predominantly (≥80%) non-black women (ie, white, Indian, or coloured women 14,36,50–53 ); or provided separate estimates for black women and non-black women 12,28–30 (appendix p 14).…”

Section: Resultsmentioning

confidence: 99%

Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis

Jedy‐Agba

McCormack

Adebamowo

et al. 2016

The Lancet Global Health

273

233

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Summary Background The incidence of breast cancer in sub-Saharan Africa is relatively low, but as survival from the disease in the region is poor, mortality rates are as high as in high-income countries. Stage at diagnosis is a major contributing factor to poor survival from breast cancer. We aimed to do a systematic review and meta-analysis on stage at diagnosis of breast cancer in sub-Saharan Africa to examine trends over time, and investigate sources of variations across the region. Methods We searched MEDLINE, Embase, Web of Knowledge, and Africa-Wide Information to identify studies on breast cancer stage at diagnosis in sub-Saharan African women published before Jan 1, 2014, and in any language. Random-effects meta-analyses were done to investigate between-study heterogeneity in percentage of late-stage breast cancer (stage III/IV), and meta-regression analyses to identify potential sources of variation. Percentages of women with late-stage breast cancer at diagnosis in sub-Saharan Africa were compared with similar estimates for black and white women in the USA from the Surveillance, Epidemiology, and End Results database. Findings 83 studies were included, which consisted of 26788 women from 17 sub-Saharan African countries. There was wide between-study heterogeneity in the percentage of late-stage disease at diagnosis (median 74.7%, range 30.3–100%, I2=93.3%, p<0.0001). The percentage of patients with late-stage disease at diagnosis did not vary by region in black women, but was lower in non-black women from southern Africa than in black women in any region (absolute difference [AD] from black women in western Africa [reference group] −18.1%, 95% CI −28.2 to −8.0), and higher for populations from mixed (urban and rural) settings rather than urban settings (13.2%, 5.7 to 20.7, in analyses restricted to black women). The percentage of patients with late-stage disease at diagnosis in black Africans decreased over time (−10.5%, −19.3 to −1.6; for 2000 or later vs 1980 or before), but it was still higher around 2010 than it was in white and black women in the USA 40 years previously. Interpretation Strategies for early diagnosis of breast cancer should be regarded as a major priority by cancer control programmes in sub-Saharan Africa. Funding None.

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Section: Resultsmentioning

confidence: 99%

Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis

Jedy‐Agba

McCormack

Adebamowo

et al. 2016

The Lancet Global Health

273

233

View full text Add to dashboard Cite

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“…The significantly more favorable overall survival rate seen in White patients follows the pattern of reports emanating from both the United States (10,18,19) and South Africa (11). Published prognoses in Asian women of Indian origin arenot available.…”

Section: Discussionmentioning

confidence: 59%

“…The race of the patient can apparently also influence prognosis. Black Americans and Black South Africans are reported to have a poorer survival (10,11), while Japanese show a more favorable rate of survival (12,13) when compared to Whites. This report examines the prognoses in breast cancer patients of 3 different racial groups taking into account the sharply contrasting patterns of presentation.…”

Section: Introductionmentioning

confidence: 98%

Breast cancer prognosis in three different racial groups in relation to steroid hormone receptor status

Nirmul

Reinach

et al. 1986

Breast Cancer Res Tr

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Follow-up studies on 466 patients over a 5-year period showed Whites to have an overall significantly longer disease-free interval and survival than Blacks and Asians. No racial differences in prognosis were seen in patients with Stage II disease (p greater than 0.2) but in Stage III, White patients had significantly longer disease-free periods than Blacks or Asians; the same was not true of survival. Whites had a 67% incidence of cytoplasmic estrogen receptor (CER) positive tumors compared with only 49% in Blacks and 41% in Asians. When tumors were assayed for CER, nuclear estrogen receptor (NER), and cytoplasmic progesterone receptor (CPR), there were no racial differences in the proportions of tumors containing all 3 receptors, but significant variations were found in neoplasms with no receptors and in those with apparently defective receptors. In White patients receptor status had no influence on prognosis (p greater than 0.3). Black patients whose tumors contained both CER and NER had a significantly better time to recurrence than those whose tumors lacked these receptors, while in Asian women the presence of CER alone, or CER together with NER, or CER, NER, and CPR, was indicative of a significantly longer disease-free period.

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“…In 5 (7.9%) the pain was associated with vomiting and fainting. Fourteen patients (22.2%) went to a private medical practitioner, 24 (38.1%) to a clinic, and 25 (39.7%) directly to hospital. The delay before seeking help ranged from 1 day to 6 months, with a median time of 5 days.…”

Section: Resultsmentioning

confidence: 99%

“…This applies even to developing populations. In 1984In -1986 in African black patients in Benin City, Niger, mortality was 0.3%19; for the same period in Soweto, it was 0.3%. This study describes results obtained from enquiries into the antecedents of a series of consecutive appendicitis patients, resident in Soweto and operated on at Baragwanath Hospital in 1987-1988.…”

Section: Introductionmentioning

confidence: 92%

Appendicitis in Soweto, South Africa: Traditional Healers and Hospitalization

Walker

Manetsi

et al. 1989

Journal of the Royal Society of Health

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Appendicitis is near absent in rural blacks in Africa, and even in urban areas it remains very uncommon. Since the disease is new, and, moreover, potentially dangerous, a study was made of the antecedent history of 97 patients with proven appendicitis. Information was acquired concerning visits, and treatments and history, of (1) 34 patients who went first to traditional healers, and (2) 63 patients who sought orthodox medical attention. Of healers' treatments, none was beneficial; patients were ultimately directed, or decided to go to the hospital. Throughout Africa, traditional healers are held in high esteem and very extensively patronized. Accordingly, in both rural and in urban areas, concerted endeavours must be made by health authorities to promote recognition by healers of those diseases, acute or malignant, for which patients should be told to seek immediate medical attention.

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Low survival of South African urban black women with breast cancer

Cited by 26 publications

References 14 publications

Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis

Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis

Breast cancer prognosis in three different racial groups in relation to steroid hormone receptor status

Appendicitis in Soweto, South Africa: Traditional Healers and Hospitalization

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