Benchmarking female breast cancer survival in africa, Central and South america, and asia (SURVCAN-3).

Abstract

In limited-resource settings with high cancer mortality, conditional survival which is the probability of surviving given on survival after a certain period of time since diagnosis, can provide a patient-centred and clinically relevant prognosis indicator. We aimed to benchmark breast cancer prognosis using conditional survival estimates in Africa, Central and South America, and Asia. We included data for 197,766 females with breast cancer diagnosed in 2008-2012, from 53 population-based cancer registries with at least 3 years of follow-up across 22 countries. We estimated 3-year age-standardised net survival at diagnosis and 1-year post-diagnosis using period approach. In all countries, 3-year survival estimates improved for females with breast cancer who had survived 1 year as compared to the 3-year survival estimates at diagnosis. Countries with poorer initial survival showed the largest increases in conditional survival at 3 years with the highest improvement seen in Zimbabwe (68% vs. 57%), Mauritius (90% vs. 83%), India (80% vs. 74%), and Malaysia (83% vs. 77%, conditional and at diagnosis survival, respectively). Improvement in survival was mainly found among females ≥70 years. Inequalities in survival across countries persisted, whereas 6 out of 10 countries of the Americas and 4 out of 8 Asian countries had conditional survival >90%, this was observed only in 1 out of 4 African countries. Our results highlight the importance of early care on improving breast cancer survival over time and serve as a resource for physicians and patients who are seeking an updated indicator of breast cancer prognosis.