Breast cancer patients in Libya: Comparison with European and central African patients

Abstract

Abstract. The present study evaluated the incidence of breast cancer in Libya and described the clinicopathological and demographic features. These features were then compared with corresponding data from patients from sub-Saharan Africa (Nigeria) and Europe (Finland). The study consisted of 234 patients with breast carcinoma, admitted to the African Oncology Institute in Sabratha, Libya, during the years [2002][2003][2004][2005][2006]. The pathological features were collected from pathology reports, patient histories from hospital files and the Sabratha Cancer Registry. The demographic differences between the Libyan, Nigerian and Finnish populations were prominent. The mean age of breast cancer patients in Libya was 46 years which was almost identical to that of Nigeria, but much lower than that of Finland. The Libyan breast cancer incidence was evaluated as 18.8 per 100,000 female individuals. This incidence was markedly higher in Finland, but was also high in Nigeria. Libyan and Nigerian breast cancer is predominantly of premenopausal type and exhibits unfavorable characteristics such as high histological grade and stage, large tumor size and frequent lymph node metastases. However, the histological types and histopathological risk features show similar importance regarding survival as European breast cancer cases. Survival in Libya ranks between the rates of survival in Nigeria (lowest) and Finland (highest). In conclusion, in Libya and other African countries, premenopausal breast cancer is more common than postmenopausal breast cancer. However, the opposite is true for Europe. Population differences may be involved, as suggested by the known variation, in the distribution of genetic markers in these populations. Different types of environmental impacts, however, cannot be excluded.

Survival Outcomes of Breast Cancer in Ghana: An Analysis of Clinicopathological Features

“…This is consistent with some studies done in Ghana [9] [32] [33] and Africa [34] [35]. Breast cancer mortality was found to be correlated to the stage at diagnosis.…”

Proliferative Activity in Libyan Breast Cancer with Comparison to European and Central African Patients

“…In fact, Nigerian and Libyan results are near each other. In premenopausal patients, SMI shows statistical significance between Libyan and Nigerian and between Libyan and Finnish tumours, which may reflect biological differences between Central African, North African, and European population, possibly explained by variation in genetic marker distribution in these populations [28, 29]. …”

“…This may be explained by that the peak of oestrogen effect is expected in patients with age below 40, because this period shows high level of serum oestrogen, and the fraction of unmarried female individual was higher among the Libyan breast cancer patients as compared to the North African population (23.8% and 15–21%, resp.) [29]. On other hand, the high mitotic activity of Libyan patients older than 49 years can be explained by diagnosis delay which is a serious problem in Libya [30].…”

“…Another important factor is that the screening programs for BC are well established in Finland and other European countries as compared to African countries, which might indicate that the European breast cancers are detected at earlier localized stages and low proliferative activity. On the other hand, it may partly be related to biological difference and variation in genetic marker distribution between Central and North African and European populations [28, 29]. We cannot exclude “African” genomic haplotypes (as contrasted to “European” genomic haplotypes in breast cancer).…”

Breast Cancer in Iraq, Incidence Trends from 2000-2009

“…A marked increase in the annual number of breast cancer among Iraqi women between 2000 and 2009, this most probably due to the improvement awareness in connection with the Iraqi National Breast Cancer Research Program that began in 2000, Improvement of Iraqi national cancer research center data collection, opening of new breast cancer screening mammograms that were implemented from 2000 onward led to increased mammography screening. In a report from Arab countries, show that the rising in incidence in Arab countries and the change may be due to a westernized life style including dietary habits, lack of exercise, delay of age of marriage, women have their diagnosis of breast cancer delayed because of lack of awareness, social customs and most important is a low index of suspicion from primary care (Saadat, 2008 (Lakkis et al, 2010), 44.5-47.15% in Jordan (Tarawneh et al 2009, Tarawneh et al 2011), Kuwait 47.5% (Al-Madouj et al, 2011, and less than those observed in UAE 56.7%,, Qatar 59.7%, Saudi 58.8(AlLibya (71%) (Boder et al, 2011), 74% Sudan (Elgaili et al, 2010), Iran 67.5% (Montazeri et al, 2008). An article from developing countries including Arab countries, show that breast cancer among women with a young age of around 50 years at presentation (El Saghir, et al, 2007).…”