Table 1.

Characteristics of ABC-DO participating hospital, their catchment populations and expected patient with breast cancer profile

Country (ordered by date recruitment started)	Namibia	Nigeria	Uganda	South Africa	Zambia
National estimates of age-standardised breast cancer rates, per 100 000 women*
Incidence	24.4	50.4	27.5	41.5	22.4
Mortality	9.6	25.9	13.6	16.5	11.1
National adult HIV prevalence in adults aged 15–49 years, 2011–2015†	16.0%	3.2%	7.3%	19%	12.4%
ABC-DO recruitment hospital	Windhoek Central Hospital, Windhoek (capital)	ABSUTH, Aba, Abia State Owerri Federal Medical Centre, Owerri, Imo State	Mulago Hospital Complex in Kampala (capital), including: Uganda Cancer Institute Mulago Hospital	Chris Hani Baragwanath Hospital, Soweto, Gauteng	UTH, Lusaka CDH, Lusaka KGH, Kabwe, Central province
Initiation of recruitment	September 2014	November 2014	December 2014	August 2015‡	April 2016
Type of hospital	National tertiary referral	Federal secondary hospital	National tertiary referral	Tertiary referral	UTH: national tertiary; CDH: cancer-specialised tertiary; KGH: provincial hospital
Source population of hospital(s) (both sexes, all ages)	Entire population (2.4 million) of Namibia, residing up to 800 km away	Abia State: 3 million, Imo State: 4 million	National public referral hospital, serving the entire population (35.6 million) of Uganda, residing up to 500 km away	Population of Soweto (2 million) mostly residing within 50 km	For UTH and CDH: entire population (13.9 million) of Zambia, residing up to 800 km away
Majority ethnic groups of patients	Various, including white, Ovambo, Damara.	Igbo	Bantu—Ganda, Nkole	90% black Xhosa, Sotho, Zulu	Bantu—Bemba, Tonga
Expected annual number of newly diagnosed women with breast cancers	250	150	250	300	150
Mean or median age at diagnosis§	53	43	45	55	49¶
Referral routes	Nationwide referrals from public and private sectors	Nationwide referrals from public and private sectors	Primary hospital referrals and self-referral	Referred from local hospital	Referred from local hospitals and outreach clinics
Stage at diagnosis (%)§ I, II, III, IV	5, 14, 71, 10	10, 20, 50, 20	5, 15, 40, 40	7, 45, 40, 8	10¶, 36¶, 54¶
Availability of diagnostic and treatment facilities
Mammography–ultrasound	Yes–Yes	Yes–Yes	Yes–Yes	Yes–Yes	Yes–Yes
Cytology–histology	Yes–Yes	Yes–Yes	Yes–Yes	Yes–Yes	Yes–Yes
Surgery–chemotherapy–radiotherapy	Yes–Yes–Yes	Yes–Yes–Not locallys**	Yes–Yes–Yes	Yes–Yes–Yes	Yes–Yes–Yes
Routine receptor status testing (ER, PR, HER2)	Yes	No	No	Yes	No
Routine HIV testing at diagnosis	No	No	No	Yes	Yes
Treatment costs to the patient	Minimal fee, that can be waived	Patients or relatives	Free chemotherapy and surgery. If drugs run out, patient pays.	US$5, but waived if cannot be paid	Cost shared between patient and government

*Source of incidence and mortality data.²

†Source of HIV data.³⁰

‡Some retrospective inclusions since January 2015 for women who consented and had already completed a questionnaire, at diagnosis, on barriers to early diagnosis.

§Sources of age and stage data.^{6 31 32}

¶Sourced from CDH hospital database (stage data corresponds to: early, locally advanced, metastatic).

**Patients are referred to the University of Nigeria Teaching Hospital in Enugu.³³

ABC-DO, African Breast Cancer—Disparities in Outcomes; ABSUTH, Abia State University Teaching Hospital; CDH, Cancer Diseases Hospital; ER, oestrogen receptor; HER2, human epidermal growth factor receptor 2; KGH, Kabwe General Hospital; PR, progesterone receptor; UTH, University Teaching Hospital.