ArticleThe oncologist2022
The Impact of Breast Cancer Treatment Delays on Survival Among South African Women.
Article in The oncologist, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Stage at Diagnosis and Molecular Subtype Distribution of Breast Cancer in Sub-Saharan Africa: A Systematic Review.Cancer reports (Hoboken, N.J.) · 2026Pooled it
- Impact of and recovery after Covid-19 on breast cancer diagnosis and care in Johannesburg, South Africa.BMC cancer · 2026Article
- Associations Between HIV Infection Status, Psychosocial Factors, and Adjuvant Endocrine Therapy Adherence Among South African Women with Stage I-III Breast Cancer.International journal of behavioral medicine · 2026Article
- Review
- Access and time to chemotherapy among Ethiopian cancer patients: a population-based registry study.The oncologist · 2026Article
- Breast cancer overall survival, annual risks of death, and survival gap apportionment in sub-Saharan Africa (ABC-DO): 7-year follow-up of a prospective cohort study.The Lancet. Global health · 2025Article
- Article
- Associations between HIV infection status, psychosocial factors, and adjuvant endocrine therapy adherence among South African women with early-stage breast cancer.Research square · 2024Article
- From Incidence to Intervention: A Comprehensive Look at Breast Cancer in South Africa.Oncology and therapy · 2024Article
- Treatment delays for cancer patients in Sub-Saharan Africa: South Africa as a microcosm.Ecancermedicalscience · 2024Article
- Review
- The South African breast cancer and HIV outcomes study: Profiling the cancer centres and cohort characteristics, diagnostic pathways, and treatment approaches.PLOS global public health · 2023Article
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundIn high-income settings, delays from breast cancer (BC) diagnosis to initial treatment worsen overall survival (OS). We examined how time to BC treatment initiation (TTI) impacts OS in South Africa (SA).
methodsWe evaluated women enrolled in the South African BC and HIV Outcomes study between July 1, 2015 and June 30, 2019, selecting women with stages I-III BC who received surgery and chemotherapy. We constructed a linear regression model estimating the impact of sociodemographic and clinical factors on TTI and separate multivariable Cox proportional hazard models by first treatment (surgery and neoadjuvant chemotherapy (NAC)) assessing the effect of TTI (in 30-day increments) on OS.
resultsOf 1260 women, 45.6% had upfront surgery, 54.4% had NAC, and 19.5% initiated treatment >90 days after BC diagnosis. Compared to the surgery group, more women in the NAC group had stage III BC (34.8% vs 81.5%). Living further away from a hospital and having hormone receptor positive (vs negative) BC was associated with longer TTI (8 additional days per 100 km, P = .003 and 8 additional days, P = .01, respectively), while Ki67 proliferation index >20 and upfront surgery (vs NAC) was associated with shorter TTI (12 and 9 days earlier; P = .0001 and.007, respectively). Treatment initiation also differed among treating hospitals (P < .0001). Additional 30-day treatment delays were associated with worse survival in the surgery group (HR 1.11 [95%CI 1.003-1.22]), but not in the NAC group.
conclusionsDelays in BC treatment initiation are common in SA public hospitals and are associated with worse survival among women treated with upfront surgery.
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