Breast cancer in sub-Saharan Africa: The current state and uncertain future

Anyigba, Claudia; Awandare, Gordon A.; Paemka, Lily

doi:10.1177/15353702211006047

Cited by 53 publications

(48 citation statements)

References 83 publications

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“…In Sub-Saharan Africa (SSA), declining rates of extreme poverty [1,2] have been accompanied by increasing rates of non-communicable diseases (NCDs) [3][4][5][6][7], persistent burdens of infectious disease [8][9][10][11][12], and emerging pathogens such as the novel coronavirus (COVID-19) [13]. Given the magnitude of the epidemics of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and tuberculosis (TB), targeted resources have come from donor nations, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), and ministries of health to scale-up testing and treatment [14].…”

Section: Introductionmentioning

confidence: 99%

Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

Brault

Vermund

Aliyu

et al. 2021

IJERPH

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In Sub-Saharan Africa, communicable and other tropical infectious diseases remain major challenges apart from the continuing HIV/AIDS epidemic. Recognition and prevalence of non-communicable diseases have risen throughout Africa, and the reimagining of healthcare delivery is needed to support communities coping with not only with HIV, tuberculosis, and COVID-19, but also cancer, cardiovascular disease, diabetes, and depression. Many non-communicable diseases can be prevented or treated with low-cost interventions, yet implementation of such care has been limited in the region. In this Perspective piece, we argue that deployment of an integrated service delivery model is an urgent next step, propose a South African model for integration, and conclude with recommendations for next steps in research and implementation. An approach that is inspired by South African experience would build on existing HIV-focused infrastructure that has been developed by Ministries of Health with strong support from the U.S. President’s Emergency Response for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. An integrated chronic healthcare model holds promise to sustainably deliver infectious disease and non-communicable disease care. Integrated care will be especially critical as health systems seek to cope with the unprecedented challenges associated with COVID-19 and future pandemic threats.

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Section: Introductionmentioning

confidence: 99%

Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

Brault

Vermund

Aliyu

et al. 2021

IJERPH

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“…Breast cancer is a significant threat to women's health and is the most commonly diagnosed cancer and the leading cause of cancer mortality among women worldwide in 2020 [1]. Mortality rates are much higher in low-and middle-income countries than in high-income countries due to the delayed detection and treatment [2], [3]. Mammography and breast ultrasound (BUS) are two popular screening modalities for early breast cancer detection, which leads to appropriate treatment and increased survival rates.…”

Section: Introductionmentioning

confidence: 99%

A Regional-Attentive Multi-Task Learning Framework for Breast Ultrasound Image Segmentation and Classification

Huang

2023

IEEE Access

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Breast ultrasound (BUS) imaging is commonly used in the early detection of breast cancer as a portable, valuable, and widely available diagnosis tool. Automated BUS image classification and segmentation can assist radiologists in making accurate and fast decisions. Recent studies illustrate that tumor, peritumoral, and background regions of BUS images provide valuable information for BUS image segmentation or classification. However, few studies have investigated the influence of these three regions on multi-task learning. In this study, we propose an RMTL-Net to simultaneously segment tumor regions and classify tumors in BUS images into benign or malignant categories. To improve both segmentation and classification performance, we design a regional attention (RA) module that employs the predicted probability maps to automatically guide the classifier to learn important category-sensitive information in the tumor, peritumoral, and background regions and seamlessly fuse them to obtain a better feature representation. We conduct detailed ablation experiments of the proposed RA module and comparative experiments with four recent state-of-the-art peer multi-task learning methods, three single-task segmentation methods, and four single-task classification methods on two public BUS datasets. Experimental results show that the proposed RMTL-Net achieves the best overall segmentation and classification accuracy in terms of five segmentation metrics and six classification metrics.

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“…Despite the evidence on CBE, the screening rate among women of reproductive-age in SSA [ 20 – 23 ] including Lesotho remains very low. Although breast cancer incidence is prevalent among postmenopausal women, in the last decade, breast cancer has been observed to occur among women of young age and the trend seems to be increasing in SSA [ 24 ]. Therefore, it is also important to consider this cadre of women in the screening process to ensure early detection and treatment.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the uptake of clinical breast examination among women of reproductive age in Lesotho: analysis of a national survey

et al. 2023

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Background In low-resource settings with weak health systems, the WHO recommends clinical breast examination (CBE) as the most cost-effective breast screening modality for women. Evidence shows that biennial CBE leads to significant downstaging of breast cancer in all women. Breast cancer is the second most common cancer among women in Lesotho with a weaker healthcare system and a low breast cancer screening rate. This study investigated the prevalence and factors associated with the uptake of CBE among women of reproductive age in Lesotho. Methods This study used cross-sectional data from the 2014 Lesotho Demographic and Health Survey. A sample of 6584 reproductive-age women was included in this study. We conducted both descriptive and multivariable logistic regression analyses. The study results were presented in frequencies, percentages, and adjusted odds ratios (aOR) with their corresponding confidence intervals (CIs). Results The prevalence of CBE uptake was 9.73% (95% CI: 8.91, 10.61). Women who were covered by health insurance (aOR = 2.31, 95% CI [1.37, 3.88]), those who were pregnant (aOR = 2.34, 95% CI [1.64, 3.35]), those who had one to three children (aOR = 1.81, 95% CI [1.29,2.52]), and women who frequently read newspapers or magazines (aOR = 1.33, 95% CI [1.02,1.72]) were more likely to undergo CBE than their counterparts. Women who were aware of breast cancer (aOR = 2.54, 95% CI [1.63,3.97]), those who have ever had breast self-examination (BSE) within the last 12 months prior to the study (aOR = 5.30, 95% CI [4.35,6.46]), and those who visited the health facility in the last 12 months prior to the study (aOR = 1.57, 95% CI [1.27,1.95]) were also more likely to undergo CBE than their counterparts. Women residing in the Qacha’s-nek region (aOR = 0.42, 95% CI [0.26,0.67]) were less likely to undergo CBE than those in the Botha-bothe region. Conclusion The study found a low prevalence of CBE uptake among reproductive-age women in Lesotho. Factors associated with CBE uptake include health insurance coverage, being pregnant, those who had one to three children, exposure to media, breast cancer awareness, ever had BSE, and those who visited a health facility. To increase CBE uptake, these factors should be considered when designing cancer screening interventions and policies in order to help reduce the burden of breast cancer in Lesotho.

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Breast cancer in sub-Saharan Africa: The current state and uncertain future

Cited by 53 publications

References 83 publications

Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

A Regional-Attentive Multi-Task Learning Framework for Breast Ultrasound Image Segmentation and Classification

Factors associated with the uptake of clinical breast examination among women of reproductive age in Lesotho: analysis of a national survey

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