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Komen for the Cure","doi-asserted-by":"publisher","award":["IIR 13264158"],"award-info":[{"award-number":["IIR 13264158"]}],"id":[{"id":"10.13039\/100000869","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005921","name":"IARC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2018,4,15]]},"abstract":"<jats:p>Breast cancer (BC) survival rates in sub\u2010Saharan Africa (SSA) are low in part due to advanced stage at diagnosis. As one component of a study of the entire journey of SSA women with BC, we aimed to identify shared and setting\u2010specific drivers of advanced stage BC. Women newly diagnosed in the multicountry African Breast Cancer\u2013Disparities in Outcomes (ABC\u2010DO) study completed a baseline interview and their stage information was extracted from medical records. Ordinal logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for advanced stage (I, II, III, IV) in relation to individual woman\u2010level, referral and biological factors. A total of 1795 women were included from Nigeria, Uganda, Zambia, and the multiracial populations of Namibia and South Africa, 1091 of whom (61%) were stage III\/IV. Stage was lower in women with greater BC knowledge (OR 0.77 (95% CI: 0.70, 0.85) per point on a 6 point scale). More advanced stage was associated with being black (4.00 (2.79, 5.74)), having attended &lt;secondary education (1.75 (1.42, 2.16)), having never heard of BC (1.64 (1.31, 2.06)), an unskilled job (1.77 (1.43, 2.20)) and pregnancy in the past 3 years (30% of \u226445 year olds) (1.63 (1.15, 2.31)), and were mediated through delays to diagnosis: symptom duration of\u2009\u2265\u20091 year (OR 2.47 (1.93, 3.15)). These findings provide further evidence that late\u2010stage BC in SSA is largely attributed to modifiable factors and strategies to improve BC education and awareness in women and the health system should be intensified.<\/jats:p>","DOI":"10.1002\/ijc.31187","type":"journal-article","created":{"date-parts":[[2017,12,2]],"date-time":"2017-12-02T08:16:38Z","timestamp":1512202598000},"page":"1568-1579","source":"Crossref","is-referenced-by-count":83,"title":["Drivers of advanced stage at breast cancer diagnosis in the multicountry<scp>A<\/scp>frican breast cancer \u2013 disparities in outcomes (ABC\u2010DO) study"],"prefix":"10.1002","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0790-1752","authenticated-orcid":false,"given":"Fiona","family":"McKenzie","sequence":"first","affiliation":[{"name":"Section of Environment and Radiation International Agency for Research on Cancer Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelle","family":"Zietsman","sequence":"additional","affiliation":[{"name":"Windhoek Central Hospital Windhoek Namibia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Galukande","sequence":"additional","affiliation":[{"name":"Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Anele","sequence":"additional","affiliation":[{"name":"Federal Medical Centre Owerri Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Adisa","sequence":"additional","affiliation":[{"name":"Abia State University Teaching Hospital Aba Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Groesbeck","family":"Parham","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leeya","family":"Pinder","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Cubasch","sequence":"additional","affiliation":[{"name":"University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Joffe","sequence":"additional","affiliation":[{"name":"University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Kidaaga","sequence":"additional","affiliation":[{"name":"Namibian Institute of Pathology Windhoek Namibia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Lukande","sequence":"additional","affiliation":[{"name":"Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awa U.","family":"Offiah","sequence":"additional","affiliation":[{"name":"Abia State University Teaching Hospital Aba Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph O.","family":"Egejuru","sequence":"additional","affiliation":[{"name":"Federal Medical Centre Owerri Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Shibemba","sequence":"additional","affiliation":[{"name":"University Teaching Hospital Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Schuz","sequence":"additional","affiliation":[{"name":"Section of Environment and Radiation International Agency for Research on Cancer Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin O.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"dos Santos Silva","sequence":"additional","affiliation":[{"name":"Department of Non\u2010Communicable Disease Epidemiology London School of Hygiene &amp; 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