Addressing breast cancer inequalities in the South African public health sector: a modelling approach in a LMIC setting

Breast cancer constitutes a significant proportion of the burden of disease worldwide, with a worse prognosis in lower- and middle-income countries. Within the population at national level, inequalities in breast cancer outcomes are also observed, typically reflecting differences in socioeconomic and demographic factors. In South Africa, which is the setting for this project, breast cancer is associated with late stage at diagnosis and a high mortality rate, with those at lower socioeconomic status having a poorer prognosis compared to those at higher socioeconomic status.

The overarching aim of this project is to characterise and understand breast cancer pathways and inequalities in the South African public health sector, and to determine and model appropriate approaches to improve equity in breast cancer outcomes. To achieve this aim, the research project explores objectives aimed at understanding the documented inequalities in the South African context and possible interventions in similar settings that can be utilised to address these inequalities. This is then followed by objectives aimed at modelling the observed inequalities and the impact of the intervention of choice. This will constitute model formulation and analyses of the model outcomes.

This research project aims to contribute to the knowledge on breast cancer modelling in
resource constrained areas such as South Africa. The project has the capacity to directly inform policy decision making pertaining to breast cancer, not only in South Africa but also in similar settings. Addressing cancer inequalities is an important aspect of achieving the goal of reducing within- country health inequalities associated with the Sustainable Development Goal 10 (SDG 10) for which South Africa is a signatory. SDG 10 aims to reduce inequalities within and among countries, with the focus being addressing inequalities in income and opportunity, to ensure that no one is left behind due to factors like gender, age, disability, ethnicity, or economic status.