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A prospective, multi-center cohort study estimated 5-year overall survival, identified survival determinants, and quantified mediating effects linking socioeconomic status to overall survival among South African women diagnosed with invasive breast cancer. Participants were enrolled from four public hospitals (July 1, 2015 to January 31, 2019). Survival determinants were modeled using Cox proportional hazards, while socioeconomic pathway effects were analyzed via generalized structural equation models.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/overall-survival-poverty-differentials-and-mediating-pathways-among-women-with-breast-cancer-south-african-breast-cancer-and-hiv-outcomes-cohort/449842/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/overall-survival-poverty-differentials-and-mediating-pathways-among-women-with-breast-cancer-south-african-breast-cancer-and-hiv-outcomes-cohort/449842.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-03","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s main objective regarding socioeconomic status and survival?","Question",{"text":112,"@type":113},"To estimate 5-year overall survival rates, identify overall survival determinants, and test mediating effects between socioeconomic status and overall survival among South African women with invasive breast cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were survival determinants and socioeconomic pathway effects analyzed?",{"text":117,"@type":113},"Survival determinants were assessed using Cox proportional hazard models adjusted for age, background mortality, and treatments. Socioeconomic pathway effects were evaluated using generalized structural equation models.",{"name":119,"@type":110,"acceptedAnswer":120},"Which factors showed significant associations with mortality in the results?",{"text":121,"@type":113},"Late stage at diagnosis, HIV-positive status, unemployment, and low education were associated with higher mortality risk, with stage III and IV showing particularly elevated hazard ratios.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449842,1790811654,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Overall survival, poverty differentials, and mediating pathways among women with breast cancer: South African Breast Cancer and HIV Outcomes cohort  \nMaureen Joffe, PhD1,2, *,, Wenlong Carl Chen, PhD1,2,3,4,, Ashleigh Craig, PhD5,,  \nDaniel S. O’Neil, MD6, Alfred I. Neugut, MD7,8,9,, Judith S. Jacobson8,, Paul Ruff, MD1, 10, 11,, Rofhiwa Margaret Mathiba, MD11,, Nivashini Murugan, MD12,, Herbert Cubasch, MD12,, Charmaine Blanchard, MD1,, Sarah Nietz, PhD12,, Jennifer Edge, MD12, Ines Buccimazza, MD13,, Sharon Čačala, MD14, Valerie A. McCormack, MD15,, Yoanna Pumpalova, PhD7,9,,  \nShane A. Norris, PhD5, 16,  \n1Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa  \n2 Network for Oncology Research in Africa (NORA), Global Health Working Group, Martin-Luther-University, Halle-Wittenberg, 06888, Germany  \n3 National Cancer Registry, a Division of the National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, 2000, South Africa  \n4Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa  \n5SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa  \n6Yale Cancer Center, Yale School of Medicine, Yale University, Connecticut, CT, 06511, United States  \n7 Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, United States  \n8Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, United States 9Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States 10South Africa Medical Research Council Common Epithelial Cancers Research Centre, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa  \n11Division of Medical Oncology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, J12oDapnanesrtmurntgo,f21Sg, eSroy,utFAcuflrticyaof Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa 13Department of Specialized Surgery, Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezane Hospital, University of KwaZulu-Natal, Empangeni, 3880, South Africa  \n14Division of Surgery, Stellenbosch University and Tygerberg Hospital, Cape Town, 7500, South Africa 15Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, 69366, France 16School of Human Development and Health, University of Southampton, Southampton, SO17 1BJ, United Kingdom  \n*Corresponding author: Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa ([mjoffe@witshealth.co.za](mjoffe@witshealth.co.za)) .  \nAbstract  \nBackground: Breast cancer survival rates in sub-Saharan Africa are low. In a prospective, multi-center cohort study, we estimated 5-year overall survival rates, overall survival determinants, and mediating effects between socioeconomic status on overall survival among South African women diagnosed with invasive BC.  \nPatients and methods: Patients from 4 public hospitals were enrolled between July 1, 2015 and January 31, 2019. Survival determinants were assessed using Cox proportional hazard models adjusted for age, background mortality, and treatments. Socioeconomic pathway effects on overall survival were determined through generalized structural equation models.  \nResults: Of 2838 participants, 58% had advanced-stage (III/IV) disease. Five-year crude overall survival was 44.3%(95% CI 42.5-46.2) . Significant mortality risks were late stage at diagnosis (hazard ratio [HR] = 2.31 [95% CI 1.99-2.69][stage III]; 4.79 [95% CI 3.96-5.80][stage IV]), HIV-p","cbCaik6HXTzpAs21","https://ap.wps.com/l/cbCaik6HXTzpAs21","pdf",1836897,11,"English","# Abstract\n## Background\n## Patients and methods\n## Results\n## Conclusion\n## Implications for Practice","[{\"question\":\"What was the study’s main objective regarding socioeconomic status and survival?\",\"answer\":\"To estimate 5-year overall survival rates, identify overall survival determinants, and test mediating effects between socioeconomic status and overall survival among South African women with invasive breast cancer.\"},{\"question\":\"How were survival determinants and socioeconomic pathway effects analyzed?\",\"answer\":\"Survival determinants were assessed using Cox proportional hazard models adjusted for age, background mortality, and treatments. Socioeconomic pathway effects were evaluated using generalized structural equation models.\"},{\"question\":\"Which factors showed significant associations with mortality in the results?\",\"answer\":\"Late stage at diagnosis, HIV-positive status, unemployment, and low education were associated with higher mortality risk, with stage III and IV showing particularly elevated hazard ratios.\"}]","Overall survival, poverty differentials, and mediating pathways among women with breast cancer: South African Breast Cancer and HIV Outcomes cohort | PDF",1790731210,28]