Breast cancer survival in a rural setting in the Busoga Region of Uganda

Breast cancer (BC) poses a significant health challenge globally. While high-income countries benefit from robust healthcare systems, sub-Saharan Africa (SSA) faces elevated BC mortality rates. Despite extensive research on BC survival, rural populations in SSA, including Uganda, remain underrepresented in scientific literature. We performed a cohort study aiming to bridge this gap by investigating BC survival among the rural population of the Busoga Region, Uganda, leveraging data from patient registers of Rays of Hope Hospice Jinja. Using a retrospective survival study design, we estimated 1-, 3-, and 5-year survival rates (SRs) for BC cases from 2016 to 2022 via Kaplan-Meier plots. Our compiled diagnosis model found a 1-year SR of 57.7% (95%-CI: 51.6-64.4), a 3-year SR of 19.1% (95%-CI: 13.9-26.1) and a 5-year SR of 16.3% (95%-CI: 11.4-23.4). Our biopsy-confirmed documented date model finds a 1-year SR of 66.3% (95%-CI: 56.3-78.1) and a 3-year SR of 31.3% (95%-CI: 20.6-47.6). We found age ≥50 and higher education to be positively correlated with survival and a clinical presentation of advanced-stage disease to be negatively correlated. This cohort study implies that rural populations have lower BC survival and hold implications for interventions to improve BC outcomes in SSA.