Benchmarking female breast cancer survival in africa, Central and South america, and asia (SURVCAN-3)

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BACKGROUND: In limited-resource settings with high cancer mortality, conditional survival which is the probability of surviving given on survival after a certain period of time since diagnosis, can provide a patient-centred and clinically relevant prognosis indicator. We aimed to benchmark breast cancer prognosis using conditional survival estimates in Africa, Central and South America, and Asia. METHODS: We included data for 197,766 females with breast cancer diagnosed in 2008-2012, from 53 population-based cancer registries with at least 3 years of follow-up across 22 countries. We estimated 3-year age-standardised net survival at diagnosis and 1-year post-diagnosis using period approach. RESULTS: In all countries, 3-year survival estimates improved for females with breast cancer who had survived 1 year as compared to the 3-year survival estimates at diagnosis. Countries with poorer initial survival showed the largest increases in conditional survival at 3 years with the highest improvement seen in Zimbabwe (68% vs. 57%), Mauritius (90% vs. 83%), India (80% vs. 74%), and Malaysia (83% vs. 77%, conditional and at diagnosis survival, respectively). Improvement in survival was mainly found among females ≥70 years. Inequalities in survival across countries persisted, whereas 6 out of 10 countries of the Americas and 4 out of 8 Asian countries had conditional survival >90%, this was observed only in 1 out of 4 African countries. CONCLUSION: Our results highlight the importance of early care on improving breast cancer survival over time and serve as a resource for physicians and patients who are seeking an updated indicator of breast cancer prognosis.