{"doi":"10.1016/j.eclinm.2025.103104","title":"Measuring the WHO Global Breast Cancer Initiative Pillars’ key performance indicators in Sub-Saharan Africa: experience in the African Breast Cancer—Disparities in Outcomes hospital-based cohort study","abstract":"Background: The World Health Organization Global Breast Cancer Initiative aims to reduce breast cancer (BC) mortality through three pillars, whose key performance indicators (KPIs) and benchmarks are: (KPI-1) ≥60% BC diagnosed at early stage (I/II), (KPI-2) all suspected BC diagnosed ≤60 days from health system presentation, and (KPI-3) ≥80% of BC patients completing recommended treatment. We aimed to inform measurement of these KPIs in the context of a multi-country hospital-based study. Methods: We included all women who participated to the African Breast Cancer-Disparities in Outcomes (ABC-DO) prospective cohort study (excluding South Africa), recruited between 2014 and 2017, across five population-race groups spanning low to high survival: Nigeria, Uganda, Zambia, Namibian black and Namibian non-black women. Follow-up was up to five years post-diagnosis. For each KPI, we reported challenges, assumptions and consistencies in measuring them; completeness and group-level estimations of each KPI were assessed using descriptive analyses. To evaluate their discriminatory ability, we assessed group-level correlations between KPI estimates and five-year net survival. Findings: KPI-1 was extracted from study or medical records for 1389/1473 (94%). KPI-2 relied upon the woman's recall of her date of first contact with the healthcare system and a pathology date, both of which were available for 1222/1473 (83%) but inconsistent for 114/1222 (9.3%). KPI-3, estimated using dates of receipt of multiple therapies from medical records and patient interviews over 12 months, was estimated for 1129/1188 (95%), but uncertain in 113/1129 (10%). For each population group, KPIs achievements were similar for KPI-1 and KPI-2, at 22-49%, and lowest for KPI-3 (<30%). Highest KPIs values were observed in Namibian non-black women who had the highest survival. Interpretation: Data collection systems specifically set up for prospective hospital-based studies can be used to collect the necessary data to measure these three GBCI KPIs. Funding: National Cancer Institute (United States).","journal":"EClinicalMedicine","year":2025,"id":516085,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8707,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":432663,"name":"Annelle Zietsman","orcid":"0000-0001-5103-1489","position":1,"is_corresponding":false},{"id":432665,"name":"Angelica A. Anele","orcid":"0000-0001-8441-5956","position":2,"is_corresponding":false},{"id":928998,"name":"A.U. Offiah","orcid":"0000-0002-1691-7863","position":3,"is_corresponding":false},{"id":432662,"name":"Moses Galukande","orcid":"0000-0001-9086-968X","position":4,"is_corresponding":false},{"id":432664,"name":"Groesbeck P. Parham","orcid":"0000-0001-5922-5990","position":5,"is_corresponding":false},{"id":490913,"name":"Leeya F. Pinder","orcid":"0000-0002-8929-7810","position":6,"is_corresponding":false},{"id":1381435,"name":"Tingting Mo","orcid":null,"position":7,"is_corresponding":false},{"id":432666,"name":"Milena Foerster","orcid":"0000-0003-3912-1718","position":8,"is_corresponding":false},{"id":390243,"name":"Joachim Schüz","orcid":"0000-0001-9687-2134","position":9,"is_corresponding":false},{"id":22360,"name":"Benjamin O. Anderson","orcid":"0000-0001-7217-7428","position":10,"is_corresponding":false},{"id":1105755,"name":"Mary Nyangasi","orcid":"0000-0003-1889-0702","position":11,"is_corresponding":false},{"id":55321,"name":"Isabel dos‐Santos‐Silva","orcid":"0000-0002-6596-8798","position":12,"is_corresponding":false},{"id":13053,"name":"Valerie McCormack","orcid":null,"position":13,"is_corresponding":false},{"id":764240,"name":"Pauline Boucheron","orcid":"0000-0001-8896-0740","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T02:48:44.647022Z","pmid":"40034567","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}