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1. Correction: Multimorbidity and overall survival among women with breast cancer: results from the South African Breast Cancer and HIV Outcomes Study

Author

Ayeni, Oluwatosin A., Jofe, Maureen, Mapanga, Witness, Chen, Wenlong Carl, O’Neil, Daniel S., Phakathi, Boitumelo, Nietz, Sarah, Buccimazza, Ines, Čačala, Sharon, Stopforth, Laura W., Jacobson, Judith S., Crew, Katherine D., Neugut, Alfred I., Ramiah, Duvern, Ruf, Paul, Cubasch, Herbert, Chirwa, Tobias, McCormack, Valerie, Micklesfeld, Lisa K., and Norris, Shane A.

Published
2023
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2. Multimorbidity and overall survival among women with breast cancer: results from the South African Breast Cancer and HIV Outcomes Study

Author

Ayeni, Oluwatosin A., Joffe, Maureen, Mapanga, Witness, Chen, Wenlong Carl, O’Neil, Daniel S., Phakathi, Boitumelo, Nietz, Sarah, Buccimazza, Ines, Čačala, Sharon, Stopforth, Laura W., Jacobson, Judith S., Crew, Katherine D., Neugut, Alfred I., Ramiah, Duvern, Ruff, Paul, Cubasch, Herbert, Chirwa, Tobias, McCormack, Valerie, Micklesfield, Lisa K., and Norris, Shane A.

Published
2023
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6. The South African breast cancer and HIV outcomes study: Profiling the cancer centres and cohort characteristics, diagnostic pathways, and treatment approaches

Author

Mapanga, Witness, primary, Ayeni, Oluwatosin A., additional, Chen, Wenlong Carl, additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Ruff, Paul, additional, Cubasch, Herbert, additional, O’Neil, Daniel S., additional, Buccimazza, Ines, additional, Čačala, Sharon, additional, Stopforth, Laura W., additional, Farrow, Hayley A., additional, Nietz, Sarah, additional, Phakathi, Boitumelo, additional, Chirwa, Tobias, additional, McCormack, Valerie A., additional, and Joffe, Maureen, additional

Published
2023
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7. Latent class analysis suggests four distinct classes of complementary medicine users among women with breast cancer

Author

Strizich, Garrett, Gammon, Marilie D, Jacobson, Judith S, Wall, Melanie, Abrahamson, Page, Bradshaw, Patrick T, Terry, Mary Beth, Teitelbaum, Susan, Neugut, Alfred I, and Greenlee, Heather

Subjects
Health Sciences, Traditional, Complementary and Integrative Medicine, Cancer, Clinical Trials and Supportive Activities, Mind and Body, Prevention, Nutrition, Breast Cancer, Complementary and Integrative Health, Clinical Research, Adult, Age Factors, Aged, Breast Neoplasms, Complementary Therapies, Dietary Supplements, Educational Status, Female, Humans, Middle Aged, Mind-Body Therapies, New York, Patients, Reproducibility of Results, Treatment Outcome, Alternative medicine, Breast cancer, Latent class analysis, Epidemiology, Complementary and Alternative Medicine, Complementary & Alternative Medicine, Traditional, complementary and integrative medicine
Abstract

BackgroundBreast cancer patients commonly report using >1 form of complementary and alternative medicine (CAM). However, few studies have attempted to analyze predictors and outcomes of multiple CAM modalities. We sought to group breast cancer patients by clusters of type and intensity of complementary and alternative medicine (CAM) use following diagnosis.MethodsDetailed CAM use following breast cancer diagnosis was assessed in 2002-2003 among 764 female residents of Long Island, New York diagnosed with breast cancer in 1996-1997. Latent class analysis (LCA) was applied to CAM modalities while taking into account frequency and intensities.ResultsFour distinct latent classes of CAM use emerged: 1) "Low-dose supplement users" (40%), who used only common nutritional supplements; 2) "Vitamin/mineral supplement users" (39%), using an abundance of supplements in addition to other practices; 3) "Mind-body medicine users" (12%), with near-universal use of supplements, mind-body medicine techniques, and massage; and 4) "Multi-modality high-dose users" (9%), who were highly likely to use nearly all types of CAM. Predictors of membership in classes with substantial CAM use included younger age, more education, higher income, Jewish religion, ideal body mass index, higher fruit and vegetable intake, higher levels of physical activity, receipt of adjuvant chemotherapy, and prior use of oral contraceptives.ConclusionsLCA identified important subgroups of breast cancer patients characterized by varying degrees of complementary therapy use. Further research should explore the reproducibility of these classes and investigate the association between latent class membership and breast cancer outcomes.

Published
2015

12. Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean

Author

Grann, Victor R, Ziv, Elad, Joseph, Cecil K, Neugut, Alfred I, Wei, Ying, Jacobson, Judith S, Horwitz, Marshall S, Bowman, Natalie, Beckmann, Kenneth, and Hershman, Dawn L

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Genetics, Prevention, Adult, Aged, Black People, C-Reactive Protein, Caribbean Region, Cross-Sectional Studies, Duffy Blood-Group System, Europe, Female, Genotype, Humans, Leukocyte Count, Linear Models, Middle Aged, Neutropenia, Polymorphism, Single Nucleotide, Receptors, Cell Surface, United States, White People, Young Adult, ethnic neutropenia, chemokines, DARC, African descent, genotype CC, Cardiorespiratory Medicine and Haematology, Immunology, Cardiovascular medicine and haematology
Abstract

Neutropenia associated with race/ethnicity has essentially been unexplained and, although thought to be benign, may affect therapy for cancer or other illnesses. A recent study linked a single nucleotide polymorphism (SNP) (rs2814778) in the Duffy antigen/receptor chemokine gene (DARC) with white blood cell count. We therefore analysed the association of the rs2814778 CC, TC and TT genotypes with absolute neutrophil count (ANC) among asymptomatic women from the Caribbean, Europe and the United States. Among 261 study participants, 33/47 women from Barbados/Trinidad-Tobago, 34/49 from Haiti, 26/37 from Jamaica, and 29/38 US-born black women, but only 4/50 from the Dominican Republic and 0/40 US- or European-born whites (P = 0.0001) had the CC genotype. In a linear regression model that included percentage African ancestry, national origin, cytokines, socio-economic factors and the ELA2 rs57834246 SNP, only the DARC rs2814778 genotype and C-reactive protein were associated with ANC (P < 0.0001). Women with the CC genotype had lower ANC than other women. Further research is needed on the associations of rs2814778 genotype with neutropenia and treatment delay in the setting of cancer. A better understanding of these associations may help to improve cancer outcomes among individuals of African ancestry.

Published
2008

14. The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer.

Author

O'Neil, Daniel S, Ayeni, Oluwatosin A, Farrow, Hayley A, Chen, Wenlong Carl, Demetriou, Georgia, Buccimazza, Ines, Čačala, Sharon, Stopforth, Laura W, Joffe, Maureen, Antoni, Michael H, Lopes, Gilberto, Pumpalova, Yoanna S, Mapanga, Witness, Jacobson, Judith S, Crew, Katherine D, Neugut, Alfred I, Ruff, Paul, and Cubasch, Herbert

Subjects
ADJUVANT chemotherapy, HIV infections, GRANULOCYTE-colony stimulating factor, REGRESSION analysis, CANCER patients, DESCRIPTIVE statistics, RESEARCH funding, COMBINED modality therapy, BREAST tumors, DOSE-response relationship in biochemistry, COMORBIDITY
Abstract

Introduction In the South African Breast Cancer and HIV Outcomes (SABCHO) study, we previously found that breast cancer patients living with HIV and treated with neoadjuvant chemotherapy achieve lower rates of complete pathologic response than patients without HIV. We now assess the impact of comorbid HIV on receipt of timely and complete neoadjuvant and adjuvant chemotherapy. Materials and Methods Since June 2015, the SABCHO study has collected data on women diagnosed with breast cancer at 6 South African hospitals. We selected a sample of participants with stages I-III cancer who received ≥2 doses of neoadjuvant or adjuvant chemotherapy. Data on chemotherapies prescribed and received, filgrastim receipt, and laboratory values measured during treatment were captured from patients' medical records. We calculated the mean relative dose intensity (RDI) for all prescribed chemotherapies. We tested for association between full regimen RDI and HIV status, using linear regression to control for demographic and clinical covariates, and for association of HIV with laboratory abnormalities. Results The 166 participants living with HIV and 159 without HIV did not differ in median chemotherapy RDI: 0.89 (interquartile range (IQR) 0.77-0.95) among those living with HIV and 0.87 (IQR 0.77-0.94) among women without HIV. Patients living with HIV experienced more grade 3+ anemia and leukopenia than those without HIV (anemia: 10.8% vs. 1.9%, P =.001; leukopenia: 8.4% vs. 1.9%, P =.008) and were more likely to receive filgrastim (24.7% vs. 10.7%, P =.001). Conclusions HIV status did not impact neoadjuvant or adjuvant chemotherapy RDI, although patients with breast cancer living with HIV experienced more myelotoxicity during treatment. [ABSTRACT FROM AUTHOR]

Published
2023
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15. The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer

Author

O’Neil, Daniel S, primary, Ayeni, Oluwatosin A, additional, Farrow, Hayley A, additional, Chen, Wenlong Carl, additional, Demetriou, Georgia, additional, Buccimazza, Ines, additional, Čačala, Sharon, additional, Stopforth, Laura W, additional, Joffe, Maureen, additional, Antoni, Michael H, additional, Lopes, Gilberto, additional, Pumpalova, Yoanna S, additional, Mapanga, Witness, additional, Jacobson, Judith S, additional, Crew, Katherine D, additional, Neugut, Alfred I, additional, Ruff, Paul, additional, and Cubasch, Herbert, additional

Published
2023
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16. Abstract P1-01-03: The Impact of Comorbid HIV infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Breast Cancer Patients

Author

O’Neil, Daniel S., primary, Ayeni, Oluwatosin A, additional, Woolridge, Hayley A. Farrow, additional, Chen, Wenlong Carl, additional, Demetriou, Georgia, additional, Buccimazza, Ines, additional, Cacala, Sharon, additional, Joffe, Maureen, additional, Antoni, Michael, additional, Lopes, Gilberto, additional, Pumpalova, Yoanna, additional, Mapanga, Witness, additional, Jacobson, Judith S., additional, Crew, Katherine D., additional, Neugut, Alfred I., additional, Ruff, Paul, additional, and Cubasch, Herbert, additional

Published
2023
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17. Abstract P4-07-03: The impact of HIV on non-adherence for tamoxifen among women with breast cancer in South Africa

Author

Ayeni, Oluwatosin A, primary, Chiwambutsa, Shingirai, additional, Chen, Wenlong Carl, additional, Kapungu, Nyasha N., additional, Kanji, Comfort, additional, Thelingwani, Roslyn, additional, Murugan, Nivashni, additional, Mathiba, Rophiwa, additional, Phakathi, Boitumelo, additional, Nietz, Sarah, additional, Ramiah, Duvern, additional, O’Neil, Daniel S., additional, Jacobson, Judith S., additional, Ruff, Paul, additional, Cubasch, Herbert, additional, Chirwa, Tobias, additional, Joffe, Maureen, additional, Masimirembwa, Collen, additional, and Neugut, Alfred I., additional

Published
2023
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18. Drivers of disparities in stage at diagnosis among women with breast cancer: South African breast cancers and HIV outcomes cohort

Author

Mapanga, Witness, primary, Norris, Shane A., additional, Craig, Ashleigh, additional, Ayeni, Oluwatosin A., additional, Chen, Wenlong C., additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Ruff, Paul, additional, Cubasch, Herbert, additional, O’Neil, Daniel S., additional, Buccimazza, Ines, additional, Čačala, Sharon, additional, Stopforth, Laura W., additional, Farrow, Hayley A., additional, Nietz, Sarah, additional, Phakathi, Boitumelo, additional, Chirwa, Tobias, additional, McCormack, Valerie A., additional, and Joffe, Maureen, additional

Published
2023
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19. Prevalence of multimorbidity in men of African descent with and without prostate cancer in Soweto, South Africa

Author

Mapanga, Witness, primary, Norris, Shane A., additional, Craig, Ashleigh, additional, Pumpalova, Yoanna, additional, Ayeni, Oluwatosin A., additional, Chen, Wenlong Carl, additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Muchengeti, Mazvita, additional, Pentz, Audrey, additional, Doherty, Sean, additional, Minkowitz, Shauli, additional, Haffejee, Mohammed, additional, Rebbeck, Tim, additional, and Joffe, Maureen, additional

Published
2022
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21. The Impact of Breast Cancer Treatment Delays on Survival Among South African Women

Author

Pumpalova, Yoanna S, primary, Ayeni, Oluwatosin A, additional, Chen, Wenlong Carl, additional, Buccimazza, Ines, additional, Cačala, Sharon, additional, Stopforth, Laura W, additional, Farrow, Hayley A, additional, Mapanga, Witness, additional, Nietz, Sarah, additional, Phakathi, Boitumelo, additional, Joffe, Maureen, additional, McCormack, Valerie, additional, Jacobson, Judith S, additional, Crew, Katherine D, additional, Neugut, Alfred I, additional, Ruff, Paul, additional, Cubasch, Herbert, additional, and O’Neil, Daniel S, additional

Published
2022
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31. Cancer outcomes at the Hufeland (Complementary/Alternative Medicine) Klinik: a best-case series review

Author

Jacobson, Judith S., Grann, Victor R., Gnatt, Michael A., Hibshoosh, Hanina, Austin, John H.M., Millar, William S., and Neugut, Alfred I.

Subjects
Cancer -- Care and treatment, Alternative medicine -- Usage -- Case studies, Health, Usage, Case studies
Abstract

Purpose: A best-case series review is an efficient tool with which to screen complex complementary and alternative treatments for cancer as candidates for further study. Study Design: The National Cancer [...]

Published
2005

32. Impact of Breast Cancer Treatment Delays on Survival Among South African Women.

Author

Pumpalova, Yoanna S, Ayeni, Oluwatosin A, Chen, Wenlong Carl, Buccimazza, Ines, Cačala, Sharon, Stopforth, Laura W, Farrow, Hayley A, Mapanga, Witness, Nietz, Sarah, Phakathi, Boitumelo, Joffe, Maureen, McCormack, Valerie, Jacobson, Judith S, Crew, Katherine D, Neugut, Alfred I, Ruff, Paul, Cubasch, Herbert, and O'Neil, Daniel S

Subjects
BREAST tumor treatment, BREAST cancer prognosis, CONFIDENCE intervals, REGRESSION analysis, TREATMENT delay (Medicine), COMPARATIVE studies, CANCER patients, DESCRIPTIVE statistics, SOCIODEMOGRAPHIC factors, COMBINED modality therapy, WOMEN'S health, PROPORTIONAL hazards models
Abstract

Background In 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). Methods We 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. Results Of 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. Conclusions Delays in BC treatment initiation are common in SA public hospitals and are associated with worse survival among women treated with upfront surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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33. Evaluation of a Breast Cancer Early Detection Curriculum Among Nurses Working in 5 Antiretroviral Clinics in Eswatini

Author

O’Neil, Daniel S., primary, Nxumalo, Sifiso, additional, Ngcamphalala, Cebisile, additional, Jacobson, Judith S., additional, Nuwagaba-Biribonwoha, Harriet, additional, Harripersaud, Katherine, additional, Dlamini, Xolisile, additional, Pace, Lydia E., additional, Neugut, Alfred I., additional, and Harris, Tiffany G., additional

Published
2020
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34. Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures

Author

O’Neil, Daniel S., primary, Chen, Wenlong Carl, additional, Ayeni, Oluwatosin, additional, Nietz, Sarah, additional, Buccimazza, Ines, additional, Singh, Urishka, additional, Čačala, Sharon, additional, Stopforth, Laura, additional, Joffe, Maureen, additional, Crew, Katherine D., additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Ruff, Paul, additional, and Cubasch, Herbert, additional

Published
2019
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38. Middle East studies

Author

Stanislawski, Michael, Weiss, Bari, Beery, Ariel, Kahane, Daniella, Horwitz, Aharon, Jacobson, Judith S., Federgruen, Awi, Raphaeli-Slivko, Ruth, Shachter, Neil S., Arkovitz, Marc S., Stern, Sarah N., Luttwak, Edward N., and Karsh, Efraim

Subjects
Ethnic, cultural, racial issues/studies, Literature/writing, Philosophy and religion
Abstract

TO THE EDITOR: I am writing to correct an egregious error in Efraim Karsh's article about the controversy at Columbia University over allegations of classroom bias against pro-Israel students ['Columbia [...]

Published
2005

40. Informal Caregiver Challenges for Advanced Cancer Patients During End-of-Life Care in Johannesburg, South Africa and Distinctions Based on Place of Death

Author

O'Neil, Daniel S., Prigerson, Holly G., Mmoledi, Keletso, Sobekwa, Mfanelo, Ratshikana-Moloko, Mpho, Tsitsi, Jacob M., Cubasch, Herbert, Wong, Michelle L., Omoshoro-Jones, Jones A.O., Sackstein, Paul E., Blinderman, Craig D., Jacobson, Judith S., Joffe, Maureen, Ruff, Paul, Neugut, Alfred I., and Blanchard, Charmaine L.

Published
2018
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42. Neoadjuvant Chemotherapy Use for Nonmetastatic Breast Cancer at Five Public South African Hospitals and Impact on Time to Initial Cancer Therapy

Author

O'Neil, Daniel S., primary, Nietz, Sarah, additional, Buccimazza, Ines, additional, Singh, Urishka, additional, Čačala, Sharon, additional, Stopforth, Laura W., additional, Joffe, Maureen, additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Crew, Katherine D., additional, Ruff, Paul, additional, and Cubasch, Herbert, additional

Published
2018
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43. Illness Understanding and End-of-Life Care Communication and Preferences for Patients With Advanced Cancer in South Africa

Author

Shen, Megan Johnson, primary, Prigerson, Holly G., additional, Ratshikana-Moloko, Mpho, additional, Mmoledi, Keletso, additional, Ruff, Paul, additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Amanfu, Jamila, additional, Cubasch, Herbert, additional, Wong, Michelle, additional, Joffe, Maureen, additional, and Blanchard, Charmaine, additional

Published
2018
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44. Development, Evaluation, and Implementation of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate

Author

Andrews, Caroline, primary, Fortier, Brian, additional, Hayward, Amy, additional, Lederman, Ruth, additional, Petersen, Lindsay, additional, McBride, Jo, additional, Petersen, Desiree C., additional, Ajayi, Olabode, additional, Kachambwa, Paidamoyo, additional, Seutloali, Moleboheng, additional, Shoko, Aubrey, additional, Mokhosi, Mamokhosana, additional, Hiller, Reinhard, additional, Adams, Marcia, additional, Ongaco, Chrissie, additional, Pugh, Elizabeth, additional, Romm, Jane, additional, Shelford, Tameka, additional, Chinegwundoh, Frank, additional, Adusei, Ben, additional, Mante, Sunny, additional, Snyper, Nana Yaa, additional, Agalliu, Ilir, additional, Lounsbury, David W., additional, Rohan, Thomas, additional, Orfanos, Alex, additional, Quintana, Yuri, additional, Jacobson, Judith S., additional, Neugut, Alfred I., additional, Gelmann, Edward, additional, Lachance, Joseph, additional, Dial, Cherif, additional, Diallo, Thierno Amadou, additional, Jalloh, Mohamed, additional, Gueye, Serigne Magueye, additional, Kane, Papa Moussa Sène, additional, Diop, Halimatou, additional, Ndiaye, Anna Julienne, additional, Sall, Amina Sow, additional, Toure-Kane, Ndeye Coumba, additional, Onyemata, Ezenwa, additional, Abimiku, Alash’le, additional, Adjei, Andrew A., additional, Biritwum, Richard, additional, Gyasi, Richard, additional, Kyei, Mathew, additional, Mensah, James E., additional, Okine, Julian, additional, Okyne, Vicky, additional, Rockson, Isabella, additional, Tay, Evelyn, additional, Tettey, Yao, additional, Yeboah, Edward, additional, Chen, Wenlong C., additional, Singh, Elvira, additional, Cook, Michael B., additional, Duffy, Christine N., additional, Hsing, Ann, additional, Soo, Cassandra Claire, additional, Fernandez, Pedro, additional, Irusen, Hayley, additional, Aisuodionoe-Shadrach, Oseremen, additional, Jamda, Abubakar Mustapha, additional, Olabode, Peter Oluwole, additional, Nwegbu, Maxwell Madueke, additional, Ajibola, Olalekan Hafees, additional, Ajamu, Olushola Jeremiah, additional, Ambuwa, Yakubu Garba, additional, Adebiyi, Akindele Olupelumi, additional, Asuzu, Michael, additional, Ogunbiyi, Olufemi, additional, Popoola, Olufemi, additional, Shittu, Olayiwola, additional, Amodu, Olukemi, additional, Odiaka, Emeka, additional, Makinde, Ifeoluwa, additional, Joffe, Maureen, additional, Pentz, Audrey, additional, and Rebbeck, Timothy R., additional

Published
2018
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49. Breast Cancer Care Quality in South Africa's Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures.

Author

O'Neil, Daniel S., Chen, Wenlong Carl, Ayeni, Oluwatosin, Nietz, Sarah, Buccimazza, Ines, Singh, Urishka, Čačala, Sharon, Stopforth, Laura, Joffe, Maureen, Crew, Katherine D., Jacobson, Judith S., Neugut, Alfred I., Ruff, Paul, and Cubasch, Herbert

Subjects
BREAST cancer, HORMONE therapy, LUMPECTOMY, ADJUVANT treatment of cancer, ONCOLOGY, RADIOTHERAPY
Abstract

PURPOSE: The quality of breast cancer care in sub-Saharan Africa contributes to the region's dismal breast cancer mortality. ASCO has issued quality measures focusing on delivery of adjuvant chemotherapy, radiotherapy, and endocrine therapy. We applied these measures in five South African public hospitals and analyzed factors associated with care concordance. MATERIALS AND METHODS: Among 1,736 women with breast cancer who were enrolled in the South African Breast Cancer and HIV Outcomes study over 24 months, we evaluated care using ASCO's three measures. We also evaluated adjuvant chemotherapy receipt in 957 women with an indication. We used logistic regression to estimate associations between measure-concordant care and patient factors. RESULTS: Of 235 women with hormone receptor–negative cancer, 173 (74%) began adjuvant chemotherapy within 120 days from diagnosis. Of 194 patients who received breast-conserving surgery, 73 (37%) began radiotherapy within 365 days from diagnosis. Of 999 women with hormone receptor–positive cancer, 719 (72%) initiated endocrine therapy within 365 days from diagnosis. Chemotherapy and radiotherapy measure-concordant care were more common among women residing < 20 km from the hospital (odds ratio [OR], 1.79; 95% CI, 1.32 to 2.44 and OR, 3.17; 95% CI, 1.57 to 6.42). Endocrine therapy measure-concordant care was more common among English-speaking women (OR, 2.12; 95% CI, 1.12 to 4.02). Participating hospitals varied in care concordance. HIV infection did not affect care quality. CONCLUSION: More timely delivery of chemotherapy, radiotherapy, and endocrine therapy is needed in South Africa, particularly for women living > 20 km from the hospital or not speaking English. Focused quality improvement efforts could support that goal. [ABSTRACT FROM AUTHOR]

Published
2019
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