The evolving epidemic of breast cancer in sub‐Saharan Africa: Results from the African Cancer Registry Network. Issue 8 (30th April 2020)

• Record Type: Journal Article
• Authors: Joko‐Fru, Walburga Yvonne; Jedy‐Agba, Elima; Korir, Anne; Ogunbiyi, Olufemi; Dzamalala, Charles P.; Chokunonga, Eric; Wabinga, Henry; Manraj, Shyam; Finesse, Anne; Somdyala, Nontuthuzelo; Liu, Biying; McGale, Paul; Jemal, Ahmedin; Bray, Freddie; Parkin, Donald Maxwell
• Is Part Of: International journal of cancer. Volume 147:Issue 8(2020)
• Page Start: 2131
• Page End: 2141
• Publication Date: 2020-04-30
• Subjects: Africa -- breast cancer -- incidence -- population‐based cancer registry -- trends; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.33014
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Breast cancer (BC) is the leading cause of cancer in sub‐Saharan Africa (SSA) with rapidly increasing incidence rates reported in Uganda and Zimbabwe. However, the magnitude of these rising trends in premenopausal and postmenopausal women is unknown in most African countries. We used data from the African Cancer Registry Network on incident breast cancers in women from 11 population‐based cancer registries in 10 countries representing each of the four SSA regions. We explored incidence changes among women before and after age 50 by calendar period and, where possible, generational effects in this unique sub‐Saharan African cohort. Temporal trends revealed increasing incidence rates in all registries during the study period, except in Nairobi where rates stabilised during 2010 to 2014 after rapidly increasing from 2003 to 2010 (APC = 8.5 95%, CI: 3.0‐14.2). The cumulative risk varied between and within regions, with the highest risks observed in Nairobi‐Kenya, Mauritius and the Seychelles. There were similar or more rapidly increasing incidence rates in women aged 50+ compared to women <50 years in all registries except The Gambia. Birth cohort analyses revealed increases in the incidence rates in successive generations of women aged 45 and over in Harare‐Zimbabwe and Kampala‐Uganda. In conclusion, the incidence of BC is increasing rapidly in many parts of Africa; however, the magnitude of these changes differs. These results highlight the need for urgent actions across the cancer continuum from in‐depth risk factor studies to provision of adequate therapy as well as the necessity of supporting the maintenance of good quality population‐based cancer registration in Africa. Abstract : What's new? Breast cancer is the leading cause of cancer in sub‐Saharan Africa (SSA), and may be on the rise. In this study, the authors examined registries from ten SSA countries, and found that this is indeed the case, especially in older women. Changing risk‐factor profiles may account for these trends. These results indicate an urgent need for strengthening the healthcare systems of SSA, including improved public health programs such as screening programs for breast cancer, in‐depth risk‐factor analysis, etc., as well as planning for adequate therapy for an increasing number of patients.