Longitudinal changes in health-related quality of life after a breast cancer diagnosis in sub-Saharan Africa: Evidence from the prospective ABC-DO cohort

Abstract

Breast cancer and its treatments impact on women's health-related quality of life, but few studies have assessed these outcomes among survivors in sub-Saharan Africa (SSA). We investigated longitudinal changes in Global Health Status (GHS) and their correlates within the African Breast Cancer-Disparities in Outcomes cohort. Newly diagnosed women (≥18 years) across five SSA countries were recruited in 2014–2017. In four countries, follow-up interviews were conducted 3-monthly over 7 years using the European Organisation for Research and Treatment of Cancer Quality of Life 30-item core questionnaire version 3. Multilevel mixed-effects models identified correlates of GHS. Overall, 1358 women from Namibia, Nigeria, Uganda and Zambia were included, with a mean age of 50.6 (SD = 13.7) years. Median follow-up time was 3 (IQR = 2–5) years, with a median of 18 GHS assessments per woman (IQR = 10–23). GHS was lowest in the first 6 months post-diagnosis but improved gradually thereafter. GHS increased with increasing education (p-value for linear trend [pt]