Factors Associated With Breast Cancer Treatment Adherence in Tanzania.

Abstract

Treatment completion (TC), defined by completing the recommended treatment regimen, and treatment adherence (TA), defined by completing the prescribed treatment in the expected time frame, are critical for improving breast cancer (BC) mortality. Therefore, we conducted this study to measure TC and TA in Tanzania. BC treatment data from 2019 to 2020 at Ocean Road Cancer Institute (ORCI) were collected. Demographic, socioeconomic, and clinical profiles were identified. TC and TA were measured by comparing chemotherapy and radiotherapy prescribed regimens to received treatment. Overall, 813 patients were seen at ORCI between 2019 and 2020. Mean age of patients was 51 ± 12.5 years; 97.9% identified as female; and 67.6% resided outside of Dar es Salaam. Stage III/IV disease was identified in 43.8% patients, with 24.1% showing clinical evidence of metastasis on arrival. TC across treatments ranged between 46.8% and 47.4%, while overall TA was 21.2%. TC was associated with not having metastasis on arrival (<i>P</i> = .01) and residing in proximity to ORCI (<i>P</i> = .04). TA was associated with having insurance (<i>P</i> < .0001) and attending a follow-up appointment after treatment (<i>P</i> < .0001). Poor TC and TA rates in Tanzania pose a significant risk to treatment efficacy. Interventions are needed to specifically target patients with advanced-stage disease and greater geographic distance to treatment to increase treatment compliance.