{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:55:05Z","timestamp":1789034105038,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1R01CA244559"],"award-info":[{"award-number":["1R01CA244559"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000869","name":"Susan G Komen for the Cure","doi-asserted-by":"crossref","award":["IIR 13264158"],"award-info":[{"award-number":["IIR 13264158"]}],"id":[{"id":"10.13039\/100000869","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000869","name":"Susan G Komen for the Cure","doi-asserted-by":"crossref","award":["GSP18IARC001"],"award-info":[{"award-number":["GSP18IARC001"]}],"id":[{"id":"10.13039\/100000869","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000869","name":"Susan G Komen for the Cure","doi-asserted-by":"crossref","award":["GSP19IARC001"],"award-info":[{"award-number":["GSP19IARC001"]}],"id":[{"id":"10.13039\/100000869","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008700","name":"International Agency for Research on Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women diagnosed with breast cancer at young ages (younger than 40\u2009years) generally have lower survival than their older counterparts. With its young population structure, sub-Saharan Africa provides an informative setting to examine survival among young patients with breast cancer, including consideration of the extended reproductive lives and HIV comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We established a prospective cohort of women aged 18\u2009years and older newly diagnosed with breast cancer in five sub-Saharan African countries during 2014-2017, who were actively followed for up to 7\u2009years. Overall survival, net survival, and Cox model hazard ratios (HRs) were used to assess the association between age at diagnosis and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2093 women, 459 (21.9%) were diagnosed under age 40\u2009years (\"young\" women). Five-year net survival was 36% (95% confidence interval [CI] = 31% to 40%) in these young women, which was 8-14 percentage points lower than that for those diagnosed in their 40s, 50s, 60s, and 70s or older, being 43%, 45%, 47%, and 50%, respectively. Compared with women diagnosed at age 40-59\u2009years, young women had 1.17-fold (95% CI = 1.02 to 1.35) higher mortality rates, unexplained by triple-negative breast cancer and HIV which were both less prevalent in young women than in those aged 40-59\u2009years. Adjustment for sociodemographic, clinical, and treatment factors hardly altered results, except for adjustment for having had a pregnancy within the past 3\u2009years (HR = 1.09, 95% CI = 0.93 to 1.28).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early onset breast cancer in sub-Saharan Africa was associated with lower survival compared with women aged 40-59 years. This excess mortality was restricted to young women whose breast cancer was diagnosed within 3\u2009years postpartum, thus identifying a patient group with specific early detection, treatment support and research needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djaf213","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T11:36:41Z","timestamp":1754393801000},"page":"2298-2307","source":"Crossref","is-referenced-by-count":5,"title":["Survival deficits in young women with breast cancer in sub-Saharan Africa: the African Breast Cancer\u2013Disparities in Outcomes cohort"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8651-398X","authenticated-orcid":false,"given":"Tingting","family":"Mo","sequence":"first","affiliation":[{"name":"Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer , 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