Breast cancer is currently the most common female cancer in sub-Saharan Africa (SSA), and the second leading cause of female cancer deaths. With the number of breast cancer deaths in SSA projected to more than double by 2040, effective strategies to improve survival from the disease across the region are urgently needed if premature deaths from this potentially curable cancer are to be prevented.

The African Breast Cancer – Disparities in Outcomes (ABC-DO) study, the largest breast cancer survival cohort in SSA, was set up to identify modifiable and non-modifiable drivers of the poor survival from the disease in the region. Women with a newly-diagnosed breast cancer were recruited between September 2014 and December 2017 in eight hospitals across five sub-Saharan countries (Namibia, Nigeria, South Africa, Uganda and Zambia) chosen to represent populations at different stages of the demographic and epidemiological transitions, varying HIV prevalence, and diverse health care systems. The cohort benefits from a wealth of clinic-epidemiological data on the women’s socio-economic status, breast cancer awareness, barriers to timely diagnosis and treatment, tumour characteristics, and treatment as well as data on both survival and survivorship outcomes. Study implementation was through a specifically-tailored m-health application to ensure effective study management and high-quality data collection across all participating centres whilst minimizing losses to follow-up. The cohort is being followed-up to the end of 2022 to allow calculation of standard 5-year survival estimates.

In line with the rest of SSA, breast cancer is the second most important cause of female cancer deaths in Portuguese-speaking African countries (PALOPs) but little survival data are available on which to draw locally-appropriate cancer control strategies. In this talk, we will highlight the strengths and limitations of the ABC-DO methodology, and their potential relevance for the design and conduct of breast cancer survival studies in the PALOPs.