
Methodology
Study Design
ABC-DO is a multi-country observational study to prospectively estimate breast cancer survival and investigate its proximal and distal determinants in sub-Saharan Africa. The primary outcome will be vital status, i.e. survival after breast cancer diagnosis, and secondary outcomes will include patient-reported assessment of health and well-being, treatment compliance, and time to treatment. Over a 2-year period of enrolment, about 1800 women newly diagnosed with breast cancer at four public hospital settings in sub-Saharan Africa (see Settings) will be invited to participate in the study. At the first visit where breast cancer is suspected, the woman will be interviewed by a study nurse to obtain information on breast cancer risk factors, social, cultural, and economic factors, access to health care, health knowledge and beliefs, and health-seeking behaviour. The study nurse will also obtain the clinical and treatment data during the woman's period of treatment. At 3-monthly intervals for up to 3 years, the study nurse will telephone the woman or her next of kin to obtain data on vital status, treatment side-effects, treatment compliance, and health status and possible barriers to health-care utilization and treatment adherence. A specific effort is being made to reduce losses to follow-up as this has been a major drawback of previous studies. To achieve this, an integral methodological component is the use of mobile technologies for data capture at diagnosis, during clinical care and for follow-up.Settings

- Batho Pele Breast Clinic, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
- Windhoek Central Hospital, Namibia
- Maratha Clinic, Abia State University Hospital, Abia State, Nigeria
- Mulago Hospital, Kampala, Uganda
Timeline
Early 2014 – Pre-fieldwork preparationsApril 2014 – Kick-off meeting at IARC
Mid-2014 – First patient enrolment
Mid-2016 – Last patient enrolment
End 2017 – First 3-year survival analysis to be completed
The study has been approved by the IARC Ethics committee (IEC). Local ethics approvals are currently being sought.