Rising global burden of breast cancer: the case of sub-Saharan Africa (with emphasis on Nigeria) and implications for regional development: a review

Abstract

BackgroundDespite mortality from breast cancer in Africa being higher than in high income countries, breast cancer has not been extensively studied in the region. The aim of this paper was to highlight the rising burden of breast cancer with an emphasis on sub-Saharan Africa as well as trends, characteristics, controversies and their implications for regional development.MethodologyA review of published studies and documents was conducted in Medline, Scopus, Pubmed and Google using combinations of key words-breast neoplasm, breast cancer, cancer, incidence, mortality, Africa, Nigeria. Graphical and frequency analyses were carried out on some of the incidence and mortality figures retrieved from published papers and the GLOBOCAN website.FindingsGlobally, about 25% and 15% of all new cancer cases and cancer deaths respectively among females were due to breast cancer. Africa currently had the highest age-standardized breast cancer mortality rate globally, with the highest incidence rates being recorded within the sub-Saharan African sub-region. Incidence trends such as inherently aggressive tumour and younger age profile had been subject to controversies. Certain factors such as westernized diet, urbanization and possibly increasing awareness had been implicated, though their specific contributions were yet to be fully established.ConclusionUnless urgent action is taken, breast cancer will compound sub-Saharan Africa’s disease burden, increase poverty and gender inequality as well as reverse the current global gains against maternal and neonatal mortality.

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“…Physicians and nurses ranked educational/training programs as their highest-priority need, but physicians ranked training programs conducted in Africa higher than programs involving training in the US individuals and European individuals 6 ; as longevity increases with improvements in general medical resources, and as Western lifestyles and diets are adopted in Africa, breast cancer burden rises. [2][3][4] International initiatives featuring investment of resources into cancer services in Africa are therefore important but should be aligned with needs defined by local clinicians and other relevant stakeholders, such as the patient and advocacy communities and local and national governing bodies. This study demonstrated that African physicians and nurses prioritize provision of educational/training programs and medical/hospital supplies over direct monetary contributions.…”

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“…For example, only 32% of the women are still alive five years after a breast cancer diagnosis in sub-Sahara Africa as compared to 81% in the USA [6]. Again, Africa is reported to have the highest age-standardized mortality rates of breast cancer in the world even though the incidence rates are lower in Africa as compared to Western countries [7]. The increase in breast cancer incidents and mortality, especially in developing countries, has been attributed partly to the increasing population and the increased prevalence of risk factors associated with economic transition and the certain infectious agents of importance in cancer etiology [8].…”

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“…It starts in a milk passage (a duct), breaks through the wall of the duct and invades the tissue of the breast [302]. In US, 232,000 new cases of breast cancer were diagnosed [303] and claimed the lives of 40,290 women [304] in 2015. First-degree relatives of patients with breast cancer have a 2-fold to 3-fold excess risk for development of the disease [305].…”