The multimorbidity profile of South African women newly diagnosed with breast cancer.

Multimorbidity in women with breast cancer may delay presentation, affect treatment decisions and outcomes. We described the multimorbidity profile of women with breast cancer, its determinants, associations with stage at diagnosis and treatments received. We collected self‐reported data on five chronic conditions (hypertension, diabetes, cerebrovascular diseases, asthma/chronic obstructive pulmonary disease, tuberculosis), determined obesity using body mass index (BMI) and tested HIV status, in women newly diagnosed with breast cancer between January 2016 and April 2018 in five public hospitals in South Africa. We identified determinants of ≥2 of the seven above‐mentioned conditions (defined as multimorbidity), multimorbidity itself with stage at diagnosis (advanced [III–IV] vs. early [0–II]) and multimorbidity with treatment modalities received. Among 2,281 women, 1,001 (44%) presented with multimorbidity. Obesity (52.8%), hypertension (41.3%), HIV (22.0%) and diabetes (13.7%) were the chronic conditions that occurred most frequently. Multimorbidity was more common with older age (OR = 1.02; 95% CI 1.01–1.03) and higher household socioeconomic status (HSES) (OR = 1.06; 95% CI 1.00–1.13). Multimorbidity was not associated with advanced‐stage breast cancer at diagnosis, but for self‐reported hypertension there was less likelihood of being diagnosed with advanced‐stage disease in the adjusted model (OR 0.80; 95% CI 0.64–0.98). Multimorbidity was associated with first treatment received in those with early‐stage disease, p = 0.003. The prevalence of multimorbidity is high among patients with breast cancer. Our findings suggest that multimorbidity had a significant impact on treatment received in those with early‐stage disease. There is need to understand the impact of multimorbidity on breast cancer outcomes. What's new? Multimorbidity in women with breast cancer increases with age and may influence treatment decisions and outcome. The authors find that in South Africa 44%, of women newly diagnosed with breast cancer also suffered from other chronic conditions, most prevalently obesity, hypertension, HIV and diabetes. Asian and white women were less likely to present with multimorbidity when compared to black women, but multimorbidity was more common in women with higher socioeconomic status. The authors propose to evaluate the effect of multimorbidity on the South African health system and its impact on scarce health care resources. [ABSTRACT FROM AUTHOR]