Abstract Breast cancer and its treatments impact on women's health‐related quality of life, but few studies have assessed these outcomes among survivors in sub‐Saharan Africa (SSA). We investigated longitudinal changes in Global Health Status (GHS) and their correlates within the African Breast Cancer‐Disparities in Outcomes cohort. Newly diagnosed women (≥18 years) across five SSA countries were recruited in 2014–2017. In four countries, follow‐up interviews were conducted 3‐monthly over 7 years using the European Organisation for Research and Treatment of Cancer Quality of Life 30‐item core questionnaire version 3. Multilevel mixed‐effects models identified correlates of GHS. Overall, 1358 women from Namibia, Nigeria, Uganda and Zambia were included, with a mean age of 50.6 (SD = 13.7) years. Median follow‐up time was 3 (IQR = 2–5) years, with a median of 18 GHS assessments per woman (IQR = 10–23). GHS was lowest in the first 6 months post‐diagnosis but improved gradually thereafter. GHS increased with increasing education ( p ‐value for linear trend p t < .0001), breast cancer awareness (adjusted‐odds ratio: 1.32; 95% confidence interval 1.22–1.42), surgical treatment (1.90; 1.53–2.37), family support (1.46; 1.24–1.71) and maintaining pre‐diagnosis employment (1.54; 1.41–1.68). In contrast, GHS decreased with increasing age at diagnosis ( p t <.0001), rural residence (0.76; 0.70–0.82), advanced tumour stage at diagnosis ( p t <.0001) and having non‐HIV comorbidities (0.74; 0.60–0.92). GHS was not affected by HIV status, but it was higher during COVID‐19 lockdowns than pre‐/post‐lockdown (1.27; 1.09–1.49). These patterns were similar at young and older ages, and in the short‐ and long‐term. The potentially modifiable factors associated with GHS are known to influence breast cancer survival in SSA. Addressing them could improve survivorship and survival from this cancer in the region.
Mohammed et al. (2026) studied this question.