1
|
Pizzato M, Santucci C, Parazzini F, Negri E, La Vecchia C. Cancer mortality patterns in selected Northern and Southern African countries. Eur J Cancer Prev 2024; 33:192-199. [PMID: 37997906 DOI: 10.1097/cej.0000000000000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Non-communicable diseases have been rapidly increasing in African countries. We provided updated cancer death patterns in selected African countries over the last two decades. METHODS We extracted official death certifications and population data from the WHO and the United Nations Population Division databases. We computed country- and sex-specific age-standardized mortality rates per 100 000 person-years for all cancers combined and ten major cancer sites for the periods 2005-2007 and 2015-2017. RESULTS Lung cancer ranked first for male cancer mortality in all selected countries in the last available period (with the highest rates in Réunion 24/100 000), except for South Africa where prostate cancer was the leading cause of death (23/100 000). Prostate cancer ranked second in Morocco and Tunisia and third in Mauritius and Réunion. Among Egyptian men, leukemia ranked second (with a stable rate of 4.2/100 000) and bladder cancer third (3.5/100 000). Among women, the leading cancer-related cause of death was breast cancer in all selected countries (with the highest rates in Mauritius 19.6/100 000 in 2015-2017), except for South Africa where uterus cancer ranked first (17/100 000). In the second rank there were colorectal cancer in Tunisia (2/100 000), Réunion (9/100 000) and Mauritius (8/100 000), and leukemia in Egypt (3.2/100 000). Colorectal and pancreas cancer mortality rates increased, while stomach cancer mortality rates declined. CONCLUSION Certified cancer mortality rates are low on a global scale. However, mortality rates from selected screening detectable cancers, as well as from infection-related cancers, are comparatively high, calling for improvements in prevention strategies.
Collapse
Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Claudia Santucci
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| |
Collapse
|
2
|
Mapanga W, Ayeni OA, Chen WC, Jacobson JS, Neugut AI, Ruff P, Cubasch H, O’Neil DS, Buccimazza I, Čačala S, Stopforth LW, Farrow HA, Nietz S, Phakathi B, Chirwa T, McCormack VA, Joffe M. The South African breast cancer and HIV outcomes study: Profiling the cancer centres and cohort characteristics, diagnostic pathways, and treatment approaches. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002432. [PMID: 37874786 PMCID: PMC10597516 DOI: 10.1371/journal.pgph.0002432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/31/2023] [Indexed: 10/26/2023]
Abstract
The South African Breast Cancer and HIV Outcomes prospective cohort (SABCHO) study was established to investigate survival determinants among HIV-positive and HIV-negative SA women with breast cancer. This paper describes common and unique characteristics of the cancer centres and their participants, examining disparities in pathways to diagnosis, treatment resources and approaches adopted to mitigate resource constraints. The Johannesburg (Jhb), Soweto (Sow), and Durban (Dbn) sites treat mainly urban, relatively better educated and more socioeconomically advantaged patients whereas the Pietermaritzburg (Pmb) and Empangeni (Emp) sites treat predominantly rural, less educated and more impoverished communities The Sow, Jhb, and Emp sites had relatively younger patients (mean ages 54 ±14.5, 55±13.7 and 54±14.3 respectively), whereas patients at the Dbn and Pmb sites, with greater representation of Asian Indian women, were relatively older (mean age 57 ±13.9 and 58 ±14.6 respectively). HIV prevalence among the cohort was high, ranging from 15%-42%, (Cohort obesity (BMI ≥ 30 kg/m2) at 60%, self-reported hypertension (41%) and diabetes (13%). Direct referral of patients from primary care clinics to cancer centre occurred only at the Sow site which uniquely ran an open clinic and where early stage (I and II) proportions were highest at 48.5%. The other sites relied on indirect patient referral from regional hospitals where significant delays in diagnostics occurred and early-stage proportions were a low (15%- 37.3%). The Emp site referred patients for all treatments to the Dbn site located 200km away; the Sow site provided surgery and endocrine treatment services but referred patients to the Jhb site 30 Km away for chemo- and radiation therapy. The Jhb, Dbn and Pmb sites all provided complete oncology treatment services. All treatment centres followed international guidelines for their treatment approaches. Findings may inform policy interventions to address national and regional disparities in breast cancer care.
Collapse
Affiliation(s)
- Witness Mapanga
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, DSI-NRF Centre of Excellence in Human Development, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Medicine, Division of Medical Oncology, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Oluwatosin A. Ayeni
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Radiation Oncology, University of the Witwatersrand, Johannesburg, South Africa
| | - Wenlong Carl Chen
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Judith S. Jacobson
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Alfred I. Neugut
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Paul Ruff
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Medicine, Division of Medical Oncology, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Centre, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Herbert Cubasch
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Centre, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Daniel S. O’Neil
- Yale Cancer Center and Department of Medicine, Yale University, New Haven, CT, United States of America
| | - Ines Buccimazza
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Specialized Surgery, Inkosi Albert Luthuli Central Hospital, Durban and Ngwelezane Hospital, University of KwaZulu-Natal, Empangeni, KwaZulu-Natal, South Africa
| | - Sharon Čačala
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Laura W. Stopforth
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Hayley A. Farrow
- Departments of Surgery and Radiation Oncology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Sarah Nietz
- Faculty of Health Sciences, Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
- Charlotte Maxeke Surgical Breast Unit, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Boitumelo Phakathi
- Charlotte Maxeke Surgical Breast Unit, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Surgery, School of Clinical Medicine, University of Kwa-Zulu Natal, Durban, South Africa
| | - Tobias Chirwa
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Valerie A. McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Maureen Joffe
- Faculty of Health Sciences, Strengthening Oncology Services Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- South Africa Medical Research Council Common Epithelial Cancers Research Centre, University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| |
Collapse
|
3
|
Wuraola FO, Olasehinde O, Di Bernardo M, Akinkuolie AA, Adisa AO, Aderounmu AA, Mohammed TO, Omoyiola OZ, Kingham TP, Alatise OI. Breast cancer in elderly patients: a clinicopathological review of a Nigerian database. Ecancermedicalscience 2022; 16:1484. [PMID: 36819793 PMCID: PMC9934965 DOI: 10.3332/ecancer.2022.1484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Indexed: 12/13/2022] Open
Abstract
Background Breast cancer in the elderly population has not been evaluated in the Nigerian context. With the rising incidence of breast cancer and the changing demographics, it is likely that an increasing number of elderly patients will be managed in the coming years in Nigeria. This review describes the clinicopathological profile of elderly patients with breast cancer in a Nigerian database. Method From a prospective institutional database, elderly patients (65 years and above) managed for breast cancer over a 9-year period were reviewed. Details of their socio-demographic characteristics, patterns of presentation, pathology, treatment and outcome were obtained and analysed. Results Of the 607 patients managed during the study period, there were 87 older patients accounting for 14.3% of the total. There was a progressive rise in the number of patients with breast cancer towards the latter part of the study. Expectedly, they were all post-menopausal, with their ages ranging from 65 to 92 years, with a mean of 71 ± 6.58 years. Systemic hypertension was the commonest co-morbidity (29.8%). The mean tumour size at presentation was 10 cm, with the majority presenting with stage 3 disease. Invasive ductal carcinoma was the predominant histological type 83 (95.4%); 44.4% of those who had immunohistochemistry were oestrogen receptor-positive. Approximately half underwent mastectomy (52.8%), 63 (72.4%) had chemotherapy, 8 (44.4%) had hormonal therapy and only 6 (6.9%) had combined multimodal therapy in addition to surgery. Overall 5-year survival was 42.1%. Conclusion The pattern of presentation and outcomes of care in this elderly cohort is similar to the general population. Early presentation and use of multimodal treatment is still the mainstay of survival.
Collapse
Affiliation(s)
- Funmilola Olanike Wuraola
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Olalekan Olasehinde
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | | | - Akinbolaji A Akinkuolie
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Adewale O Adisa
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Adewale A Aderounmu
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Tajudeen O Mohammed
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| | - Oluwatosin Z Omoyiola
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Thomas P Kingham
- African Research Group for Oncology, Ile-Ife, Nigeria,Memorial Sloan Kettering Cancer Center, NY, USA
| | - Olusegun I Alatise
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, PMB 13, Nigeria,Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,African Research Group for Oncology, Ile-Ife, Nigeria
| |
Collapse
|
4
|
Banda CH, Wilson E, Malata CM, Narushima M, Ogawa T, Hassanein ZM, Shiraishi M, Okada Y, Ghorra DT, Ishiura R, Danno K, Mitsui K, Oni G. Clinical application and outcomes of reconstructive microsurgery in Africa: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2022; 75:2035-2048. [PMID: 35643598 DOI: 10.1016/j.bjps.2022.04.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/20/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Reconstructive microsurgical free flap techniques are often the treatment of choice for a variety of complex tissue defects across multiple surgical specialties. However, the practice is underdeveloped in low- and middle-income countries. The aim of this systematic review was to evaluate the clinical application and outcomes of reconstructive microsurgery performed in Africa. METHODS Seven databases (PubMed, Web of Science, MEDLINE, CINAHL, Academic Search Complete, Embase, and Google Scholar) were searched for studies reporting microsurgical procedures performed in Africa. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tools and quality of evidence using the GRADE approach. Meta-analysis was performed using a random effects model to estimate the pooled proportion of events with 95% confidence intervals. The primary outcome was free flap success rate, and the secondary outcomes were the complication and flap salvage rates. RESULTS Ninety-two studies were included in the narrative synthesis and nine in the pooled meta-analysis. In total, 1376 free flaps in 1327 patients from 1976 to 2020 were analyzed. Head and neck oncologic reconstruction made up 30% of cases, while breast reconstruction comprised 2%. The pooled flap survival rate was 89% (95% CI: 0.84, 0.93), complication rate 51% (95% CI: 0.36, 0.65), and free flap salvage rate was 45% (95% CI: 0.08, 0.84). CONCLUSION This meta-analysis showed that the free flap success rates in Africa are high and comparable to those reported in high-income countries. However, the comparatively higher complication rate and lower salvage rate suggest a need for improved perioperative care. REVIEW REGISTRATION Registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 25th September 2020, ID: CRD42020192344.
Collapse
Affiliation(s)
- Chihena H Banda
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan; Department of Surgery, Arthur Davison Children's Hospital, Ndola, Zambia.
| | - Emma Wilson
- Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, United Kingdom
| | - Charles M Malata
- Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Anglia Ruskin University, School of Medicine, Chelmsford, Cambridge, United Kingdom
| | - Mitsunaga Narushima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Tomoko Ogawa
- Department of Breast Surgery, Mie University, Tsu, Japan
| | - Zeinab M Hassanein
- Division of Epidemiology and Public Health, The University of Nottingham, Nottingham, United Kingdom
| | - Makoto Shiraishi
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Yoshimoto Okada
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Dina T Ghorra
- Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Plastic and Reconstructive Surgery, Alexandria University, Alexandria, Egypt
| | - Ryohei Ishiura
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Kanako Danno
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Kohei Mitsui
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Georgette Oni
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| |
Collapse
|
5
|
Ezeome ER, Yawe KDT, Ayandipo O, Badejo O, Adebamowo SN, Achusi B, Fowotade A, Ogun G, Adebamowo CA. The African Female Breast Cancer Epidemiology Study Protocol. Front Oncol 2022; 12:856182. [PMID: 35494056 PMCID: PMC9044037 DOI: 10.3389/fonc.2022.856182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/08/2022] [Indexed: 11/21/2022] Open
Abstract
Breast cancer is now the commonest cancer in most sub-Saharan African countries. Few studies of the epidemiology and genomics of breast cancer and its molecular subtypes in these countries have been done. The African Female Breast Cancer Epidemiology (AFBRECANE) study, a part of the Human Heredity and Health in Africa (H3Africa) initiative, is designed to study the genomics and epidemiology of breast cancer and its molecular subtypes in Nigerian women. We link recruitment of breast cancer cases at study sites with population-based cancer registries activities to enable ascertainment of the incidence of breast cancer and its molecular subtypes. We use centralized laboratory processing to characterize the histopathological and molecular diagnosis of breast cancer and its subtypes using multiple technologies. By combining genome-wide association study (GWAS) data from this study with that generated from 12,000 women participating in our prospective cohort study of cervical cancer, we conduct GWAS of breast cancer in an entirely indigenous African population. We test associations between dietary intakes and breast cancer and focus on vitamin D which we measure using dietary intakes, serum vitamin D, and Mendelian randomization. This paper describes the AFBRECANE project, its design, objectives and anticipated contributions to knowledge and understanding of breast cancer.
Collapse
Affiliation(s)
- Emmanuel R. Ezeome
- Department of Surgery, College of Medicine, University of Nigeria, Enugu, Nigeria
- Oncology Center, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - King-David T. Yawe
- Department of Surgery, University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | - Olawale Badejo
- Department of Pathology, National Hospital, Abuja, Nigeria
| | - Sally N. Adebamowo
- Department of Epidemiology and Public Health, and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Benerdin Achusi
- Department of Anatomic Pathology, Federal Medical Center, Abuja, Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology, University College Hospital, Ibadan, Nigeria
| | - Gabriel Ogun
- Department of Pathology, University College Hospital, Ibadan, Nigeria
| | | | - Clement A. Adebamowo
- Department of Epidemiology and Public Health, and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
- Institute of Human Virology Nigeria, Abuja, Nigeria
| |
Collapse
|
6
|
Ntirenganya F, Twagirumukiza J, Bucyibaruta G, Rugwizangoga B, Rulisa S. Breast cancer heterogeneity: Comparing pre- and postmenopausal breast cancer in an African population. JOURNAL OF CLINICAL SCIENCES 2022. [DOI: 10.4103/jcls.jcls_47_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
7
|
Akokuwebe ME, Idemudia ES, Lekulo AM, Motlogeloa OW. Determinants and levels of cervical Cancer screening uptake among women of reproductive age in South Africa: evidence from South Africa Demographic and health survey data, 2016. BMC Public Health 2021; 21:2013. [PMID: 34740352 PMCID: PMC8571865 DOI: 10.1186/s12889-021-12020-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 09/30/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Cervical cancer (CC) is the cancer with the most incidents and the leading cause of cancer mortality among women in South Africa. CC screening is one of the most cost-effective control approaches for the disease burden. This study assessed the determinants and individual-level indicators of cervical cancer screening uptake among women of reproductive age in South Africa. METHODS We analyzed data from the 2016 South Africa Demographic Health Survey. Our analysis focused on 5903 women (15-49 years). We conducted Chi-square test for bivariate analysis, and multivariate binary logistics regression was used to analyze independent association between individual-level factors and women who have had Pap smear testing. Statistical significance was set at p < 0.05. RESULTS The mean age at cervical cancer screening uptake among women in South Africa was 40.8 years (SD 18.6, range 15-95 years). A majority of the women (39.3%) were aged 45 years and above and 54.6% of them resides in urban settlements. About 35.4% of women (n = 2098) have had a Pap smear test, with 66.5% of them who had a Pap smear test resides in Western Cape province. The proportion of women who had a Pap smear test was significantly higher among those with higher educational attainment (68.7%, p = 0.000), in the rich wealth index (50.1%, p = 0.000), and those with health insurance cover (60.3%, p = 0.000). Pap smear testing was found to be more prevalent among women aged 45+ years, were in the white population group, had higher education, were divorced, and had health insurance cover. The predominance of Pap smear test was 14% higher among women who are working in the professional/formal sector (AOR; 1.38, 95% CI; 1.14-1.69). The uptake of Pap smear test was also higher among women aged 35-44 years. CONCLUSIONS The prevalence of cervical cancer uptake is substantially low among women aged 15-24 years in South Africa and shows a degree of between-provinces differences. Therefore, heath educational interventions aimed at increasing the uptake of cervical cancer screening services in South Africa are critically needed.
Collapse
Affiliation(s)
- Monica Ewomazino Akokuwebe
- grid.25881.360000 0000 9769 2525North-West University Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Erhabor Sunday Idemudia
- grid.25881.360000 0000 9769 2525North-West University Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Abiel M. Lekulo
- grid.25881.360000 0000 9769 2525North-West University Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Ogone Warona Motlogeloa
- grid.25881.360000 0000 9769 2525North-West University Faculty of Humanities, North-West University, Mafikeng, South Africa
| |
Collapse
|
8
|
Mampunye L, van der Merwe NC, Grant KA, Peeters AV, Torrorey-Sawe R, French DJ, Moremi KE, Kidd M, van Eeden PC, Pienaar FM, Kotze MJ. Pioneering BRCA1/2 Point-Of-Care Testing for Integration of Germline and Tumor Genetics in Breast Cancer Risk Management: A Vision for the Future of Translational Pharmacogenomics. Front Oncol 2021; 11:619817. [PMID: 34660253 PMCID: PMC8513538 DOI: 10.3389/fonc.2021.619817] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Research performed in South African (SA) breast, ovarian and prostate cancer patients resulted in the development of a rapid BRCA point-of-care (POC) assay designed as a time- and cost-effective alternative to laboratory-based technologies currently used for first-tier germline DNA testing. In this study the performance of the new assay was evaluated for use on a portable screening device (ParaDNA), with the long-term goal to enable rollout at POC as an inventive step to meet the World Health Organization’s sustainable development goals for Africa. DNA samples for germline testing were obtained retrospectively from 50 patients with early-stage hormone receptor-positive breast cancer referred for genomic tumor profiling (MammaPrint). Currently, SA patients with the luminal-type breast cancer are not routinely selected for BRCA1/2 testing as is the case for triple-negative disease. An initial evaluation involved the use of multiple control samples representing each of the pathogenic founder/recurrent variants included in the BRCA 1.0 POC Research Assay. Comparison with a validated laboratory-based first-tier real-time polymerase chain reaction (PCR) assay demonstrated 100% concordance. Clinical utility was evident in five patients with the founder BRCA2 c.7934delG variant, identified at the 10% (5/50) threshold considered cost-effective for BRCA1/2 testing. BRCA2 c.7934delG carrier status was associated with a significantly younger age (p=0.03) at diagnosis of breast cancer compared to non-carriers. In three of the BRCA2 c.7934delG carriers a high-risk MammaPrint 70-gene profile was noted, indicating a significantly increased risk for both secondary cancers and breast cancer recurrence. Initiating germline DNA testing at the POC for clinical interpretation early in the treatment planning process, will increase access to the most common pathogenic BRCA1/2 variants identified in SA and reduce loss to follow-up for timely gene-targeted risk reduction intervention. The ease of using cheek swabs/saliva in future for result generation within approximately one hour assay time, coupled with low cost and a high BRCA1/2 founder variant detection rate, will improve access to genomic medicine in Africa. Application of translational pharmacogenomics across ethnic groups, irrespective of age, family history, tumor subtype or recurrence risk profile, is imperative to sustainably implement preventative healthcare and improve clinical outcome in resource-constrained clinical settings.
Collapse
Affiliation(s)
- Lwando Mampunye
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Nerina C van der Merwe
- Division of Human Genetics, National Health Laboratory Service, Universitas Hospital, Bloemfontein, South Africa.,Division of Human Genetics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Kathleen A Grant
- Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Armand V Peeters
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rispah Torrorey-Sawe
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Immunology Department, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - David J French
- Division of Health Science and Innovation, LGC Limited, Teddington, United Kingdom
| | - Kelebogile E Moremi
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Martin Kidd
- Centre for Statistical Consultation, University of Stellenbosch, Stellenbosch, South Africa
| | | | | | - Maritha J Kotze
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Division of Chemical Pathology, National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| |
Collapse
|
9
|
Zouré AA, Amegnona LJ, Zongo N, Kiendrebeogo IT, Sorgho PA, Zongo FI, Yonli AT, Sombié HK, Bambara AH, Sawadogo AY, Ouedraogo MNL, Traoré L, Zongo SV, Lallogo DT, Bazié BVJTE, Zohoncon TM, Dijgma FW, Simpore J. Carriage of HLA-DRB1*11 and 1*12 alleles and risk factors in patients with breast cancer in Burkina Faso. Open Life Sci 2021; 16:1101-1110. [PMID: 34712820 PMCID: PMC8511965 DOI: 10.1515/biol-2021-0113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/28/2021] [Accepted: 08/16/2021] [Indexed: 01/20/2023] Open
Abstract
Several factors contribute to the development of breast cancer, including the immune system. This study is aimed to characterize the carriage of human leukocyte antigen (HLA)-DRB1*11 and 1*12 alleles in patients with breast cancer. This case-control study consisted of 96 histologically diagnosed breast cancer cases and 102 controls (cases without breast abnormalities). A multiplex polymerase chain reaction (PCR) was used to characterize the carriage of HLA-DRB1*11 and 1*12 alleles. The HLA-DRB1*11 allele was present in 26.59% of cases and 22.55% of controls. The HLA-DRB1*12 allele was present in 56.63% of cases and 55.88% of controls. This study found no direct association between the carriage of the HLA-DRB1*11 and HLA-DRB1*12 alleles and the occurrence of breast cancer. In addition, the deletion of the HLA-DRB1*11 allele is associated (beneficial effect) with obesity/overweight (OR = 0.13; 95% CI [0.01-1.14]; and p = 0.03) which is a risk for breast cancer. No direct association was found between the carriage of HLA-DRB1*11 and 1*12 alleles and breast cancer risk. However, further investigation of other HLA alleles involved in the occurrence of breast cancer may provide more information.
Collapse
Affiliation(s)
- Abdou Azaque Zouré
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
- Department of Biomedical and Public Health/Institute of Health Sciences Research, (IRSS/CNRST), Institute of Health Sciences Research, 03 BP 7192, Ouagadougou 03, Burkina Faso
| | - Lanyo Jospin Amegnona
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
| | - Nayi Zongo
- Department of Surgery and Surgical Specialties, Service of General and Digestive Surgery, University Hospital Centre-Yalgado OUEDRAOGO, UFR/SDS, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Isabelle Touwendpoulimdé Kiendrebeogo
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Pegdwendé Abel Sorgho
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Fabienne Ingrid Zongo
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Albert Théophane Yonli
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Herman Karim Sombié
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Aboubacar Hierrhum Bambara
- Department of Medicine and Medical Specialties, Service of Oncology, University Hospital Centre-BOGODOGO, University Joseph KI-ZERBO, UFR/SDS, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Alexis Yobi Sawadogo
- Department of Gynecology-Obstetrics, Service of Gynecology, University Hospital Centre-BOGODOGO, University Joseph KI ZERBO, UFR/SDS, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Marie N. L. Ouedraogo
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
- Faculty of Medicine, University Saint Thomas d’Aquin, 06 BP 10212, Ouagadougou 01, Burkina Faso
| | - Lassina Traoré
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Sidnooma Véronique Zongo
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Doriane Tatiana Lallogo
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Bapio Valery Jean Télesphore Elvira Bazié
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Théodora M. Zohoncon
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
- Faculty of Medicine, University Saint Thomas d’Aquin, 06 BP 10212, Ouagadougou 01, Burkina Faso
| | - Florencia W. Dijgma
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Jacques Simpore
- Departement of Biochemistry and Microbiology, Laboratory of Molecular Biology and Genetics (LABIOGENE), UFR/SVT, University Joseph KI-ZERBO, 03 P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Departement of Molecular Biology, Pietro Annigoni Biomolecular Research Center (CERBA), 01 P.O. Box 364, Ouagadougou 01, Burkina Faso
| |
Collapse
|
10
|
Tesfaw A, Berihun H, Molla E, Mihret G, Feleke DG, Chanie ES, Demissie B, Yosef T, Shita A, Tadele F, Fenta E. Level of knowledge and practice of female healthcare providers about early detection methods of breast cancer at Debre Tabor Comprehensive Specialised Hospital: a cross-sectional study. Ecancermedicalscience 2021; 15:1268. [PMID: 34567253 PMCID: PMC8426027 DOI: 10.3332/ecancer.2021.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Indexed: 11/26/2022] Open
Abstract
Background Despite the higher mortality rate of breast cancer in low and middle-income countries, the practice of early detection methods is low and the majority of the patients presenting at an advanced stage of the disease need palliative care with low survival rates. Although healthcare providers are the key for practicing early detection methods of breast cancer for themselves and their clients, little is known about their knowledge and practice of early detection methods of breast cancer in Northcentral Ethiopia. Methods An institution-based cross-sectional study was conducted among female healthcare providers at Debre Tabor Comprehensive Specialised Hospital. Data were collected using a structured self-administered questionnaire. The data were analysed using SPSS version 23. Descriptive statistics were used to describe the socio-demographic information of participants. Binary and multivariable logistic regression with adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was declared at p < 0.05. Result The mean (±SD) age of the participants was 31.4 (±7.8) years. About 106 (79.7%) participants had good knowledge about breast cancer early detection methods and only 56 (42.1%) of them practiced breast self-examination regularly. Work experience of >2 years (AOR = 3.2; 95% CI: 1.72, 5.29), history of any breast problem (AOR = 1.4; 95% CI: 1.02, 2.37), family history of breast cancer (AOR = 4.0; 95% CI: 2.58, 15.84), having good knowledge (AOR = 2.9; 95% CI: 1.3, 6.52) and history of comorbidities (AOR = 1.09; 95% CI: 1.09, 3.59) were the factors associated with the practice of breast self-examination. Conclusion Our study found that the knowledge and practice of breast cancer early detection methods was low in the study setting. Only less than half of female healthcare providers practiced regular breast self-examination, which suggests the need to provide training for healthcare providers to fill the gap and to promote early detection of breast cancer cases.
Collapse
Affiliation(s)
- Aragaw Tesfaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hanna Berihun
- College of Health Sciences, School of Medicine, Debre Tabor University, Debre Tabor, Ethiopia
| | - Eshetie Molla
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Mihret
- College of Health Sciences, School of Medicine, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dejen Getaneh Feleke
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Biruk Demissie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tewodros Yosef
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| | - Abel Shita
- Department of Public Health, Mizan Aman College of Health Sciences, Mizan Aman, Ethiopia
| | - Fitalew Tadele
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Efrem Fenta
- Department of Anaesthesia, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
11
|
Mekonen S, Ibrahim M, Astatkie H, Abreha A. Exposure to organochlorine pesticides as a predictor to breast cancer: A case-control study among Ethiopian women. PLoS One 2021; 16:e0257704. [PMID: 34555072 PMCID: PMC8460037 DOI: 10.1371/journal.pone.0257704] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022] Open
Abstract
Breast cancer (BC) is becoming one of the most prevalent non-infectious disease in low and middle income countries. The steady rise of BC incidence may be related to the different risk factors. Among many, rampant presence of environmental pollutants might be one of the risk factors. Therefore, the aim of this study is to investigate exposure to organochlorine pesticides as a risk factor to breast cancer. A case-control study design was employed among breast cancer patients and non-breast cancer individuals (controls). Blood samples were collected from 100 study participants (50 cases and 50 controls) followed by serum separation, extraction and cleanup using standard analytical procdures. The findings revealed that ten organochlorine pesticides were detected in the serum of the study participants. From the detected organochlorine pesticides, heptachlor was observed at higher concentration for breast cancer patients (6.90±4.37 μg/L) and controls (9.15±3.84 μg/L). Mean serum level of p,p’-DDE, p,p’-DDT, heptachlor, gamma-chlordane, endosulfan, and dibutyl-chlorendate were significantly higher in the serum of breast cancer patients than the controls. From the studied pesticides, p,p’-DDT and gamma-chlordane are significant predictors for BC, while, others are equivocal. A unit increment of the concentration of p,p’-DDT (AOR; 2.03, 95% CI: 1.041–3.969) increased the odds of developing breast cancer by two, while for gamma-chlordane (AOR;3.12, 95% CI; 1.186–8.203) by three. Our study results suggesting that, organochlorines are a risk factors for breast cancer in Ethiopia. Decreasing exposure to such organochlorines might have a significant public health relevance in reducing non-communicable chronic illnesses. Besides, continues monitoring of persistent organic pollutants using body biomarkers is important for disease prevention and device mitigation measures.
Collapse
Affiliation(s)
- Seblework Mekonen
- Department of Environmental Health Science and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- * E-mail:
| | - Mohammedgezali Ibrahim
- Department of Environmental Health Science and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Higemengist Astatkie
- Department of Environmental Health Science and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Aynalem Abreha
- Department of Oncology Addis Ababa, College of Health Sciences, University, Addis Ababa, Ethiopia
| |
Collapse
|
12
|
Muddather HF, Elhassan MMA, Faggad A. Survival Outcomes of Breast Cancer in Sudanese Women: A Hospital-Based Study. JCO Glob Oncol 2021; 7:324-332. [PMID: 33617296 PMCID: PMC8081542 DOI: 10.1200/go.20.00538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Breast cancer (BC) is the leading malignancy among Sudanese women. Yet, data on survival are limited. This study aimed to determine 5-year overall survival (OS) of BC in Sudanese women, and identify prognostic demographic and clinicopathologic factors. PATIENTS AND METHODS A hospital-based retrospective study was conducted by reviewing data of women with BC diagnosed and treated at the National Cancer Institute—University of Gezira during 2012, and followed up to end of August 2018. Data were retrieved from medical records and analyzed, OS was determined, and the prognostic factors were explored. RESULTS A total of 225 cases were recruited. The median age at presentation was 45 years (range, 22-85 years). Clinical stage I, II, III, and IV represented 3.1%, 31.6%, 48%, and 17.3%, respectively. Most women (81.3%) were treated with curative intent. Of those, 25.1% received neoadjuvant chemotherapy. Mastectomy was the commonest (61.7%) type of surgery. The median follow-up period was 59.8 months with mean OS time of 55.7 months. The 5-year cumulative survival rate was 58%. The 5-year OS rates for stages I, II, III, and IV were 71.5%, 82.4%, 56.5%, and 8.4%, respectively. For lymph node (LN)-positive cases, 5-year OS rate was 63% and for LN-negative was 83.5%. Presenting with advanced-stage disease and positive LN status associated with short OS times (P < .005). CONCLUSION OS of women with BC in Central Sudan is worse than in the developed world, but similar to African countries. Our findings indicate that advanced stage at diagnosis and lymph nodal involvement are strong predictors of short survival times. Raising awareness and introducing early detection programs are critical for better survival of these patients.
Collapse
Affiliation(s)
- Hiba F Muddather
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan
| | - Moawia M A Elhassan
- Department of Oncology, National Cancer Institute-University of Gezira (NCI-UG), Wad Medani, Sudan
| | - Areeg Faggad
- Department of Molecular Biology, National Cancer Institute-University of Gezira (NCI-UG), Wad Medani, Sudan
| |
Collapse
|
13
|
Saberian M, Mehrabani K, Shahraki HR. Clustering time trends of breast cancer incidence in Africa: a 27-year longitudinal study in 53 countries. Afr Health Sci 2021; 21:47-53. [PMID: 34394280 PMCID: PMC8356619 DOI: 10.4314/ahs.v21i1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Breast cancer is the most common, frequently diagnosed cancer with the highest incidence among female worldwide. Although the incidence is decreasing in developed countries, it is on increase in most of the African countries. Objective This study aimed to identify different time trends of breast cancer incidence among African countries using latent mixture approach. Methods The information includes newly diagnosed breast cancer patients per 100,000 women for 53 African countries in a period of 1990–2016. Latent mixture modeling was performed in Mplus 7.4 software. Results The overall trend of breast cancer in Africa was increasing. Latent mixture model with 5 clusters was estimated as the best using fit indices and linear growth trajectories were specified for each cluster. Nigeria was the only country which belongs to a cluster with negative slope indicating a slow decrease in the breast cancer incidence; also, Seychelles was the only country that showed a sharp increase over time. 31 countries belonged to a cluster with a slope of 0.08, indicating that the incidence of breast cancer is almost constant over time. Cluster 3 including Algeria, Angola, Botswana, Central African Republic, Cote d'lvoire, Equatorial Guinea, Lesotho, Libya, Namibia, Somalia, Sudan, Swaziland, Uganda and Zimbabwe and cluster 2 including Gabon, Mauritius, Morocco, South Africa, Tunisia and Congo showed a slow and moderate increase in the incidence of breast cancer, respectively. Conclusion Providing health education programs is essential in African countries with rising trend of breast cancer during the last decades.
Collapse
Affiliation(s)
- Mehran Saberian
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran Address: Rahmatieh educational complex, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Kamran Mehrabani
- Department of Biostatistics, Faculty of medicine, Shiraz University of medical sciences, Shiraz, Iran Address: Shiraz University of Medical Sciences, Zand Avenue, Shiraz, Iran.
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| |
Collapse
|
14
|
Agodirin OS, Aremu I, Rahman GA, Olatoke SA, Akande HJ, Oguntola AS, Olasehinde O, Ojulari S, Etonyeaku A, Olaogun J, Romanoff A. Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies. JCO Glob Oncol 2020; 6:731-742. [PMID: 32437263 PMCID: PMC7268898 DOI: 10.1200/jgo.19.00402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The prevalence of themes linked to delay in presentation of breast cancer (BC) and their underlying factors vary considerably throughout Africa. Regional differences and trends are largely unreported. The purpose of this research was to provide summary estimates of the prevalence and distribution of the themes and underlying factors linked to delay in the presentation of BC, regional variation, and trends in an effort to identify targets for intervention. DESIGN We screened articles found through PubMed/Medline, African Journal OnLine, Science Direct, Google/Google Scholar, and ResearchGate. We included patient-reported surveys on the reasons linked to delayed presentation under 6 previously identified themes: symptom misinterpretation, fear, preference for alternative care, social influence, hospital-related factors, and access factors. The meta-analytical procedure in MetaXL used the quality-effect model. RESULTS Twelve of the 236 identified articles were eligible for this review. The overall summary estimate of late presentation (> 90 days) was 54% (95% CI, 23 to 85) and was worst in the eastern and central regions. Symptom misinterpretation was the most common theme (50%; 95% CI, 21 to 56), followed by fear (17%; 95% CI, 3 to 27), hospital-related theme (11%; 95% CI, 1 to 21), preference for alternative care (10%; 95% CI, 0 to 21), social influence (7%; 95% CI, 0 to 14), and access-related theme (6%; 95% CI, 0 to 13). The most common factor underlying symptom misinterpretation was mischaracterizing the breast lesion as benign (60%; 95% CI, 4 to 100) which surpassed lack of awareness in the last decade. Misdiagnosis and failure to refer were the dominant hospital-related factors. CONCLUSION Modifiable factors such as mischaracterizing malignant masses as benign, fear, misdiagnosis, and failure to refer were the prevalent factors contributing to delays throughout Africa. These factors are promising targets for intervention.
Collapse
Affiliation(s)
- Olayide S Agodirin
- Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Isiaka Aremu
- Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Ganiyu A Rahman
- Department of Surgery, University of Cape Coast and Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Samuel A Olatoke
- Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Halimat J Akande
- Department of Radiology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Adetunji S Oguntola
- Department of Surgery, Lautech Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Olalekan Olasehinde
- Department of Surgery, Obafemi Awolowo Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Sheriff Ojulari
- Department of Physiology, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - Amarachukwu Etonyeaku
- Department of Surgery, Obafemi Awolowo Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Julius Olaogun
- Department of Surgery, Ekiti State Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Anya Romanoff
- Breast Surgery, Dubin Breast Center, Icahn School of Medicine, The Mount Sinai Hospital, New York, NY.,Department of Health System Design and Global Health, Icahn School of Medicine, The Mount Sinai Hospital, New York, NY
| |
Collapse
|
15
|
Francies FZ, Hull R, Khanyile R, Dlamini Z. Breast cancer in low-middle income countries: abnormality in splicing and lack of targeted treatment options. Am J Cancer Res 2020; 10:1568-1591. [PMID: 32509398 PMCID: PMC7269781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023] Open
Abstract
Breast cancer is a common malignancy among women worldwide. Regardless of the economic status of a country, breast cancer poses a burden in prevention, diagnosis and treatment. Developed countries such as the U.S. have high incidence and mortality rates of breast cancer. Although low incidence rates are observed in developing countries, the mortality rate is on the rise implying that low- to middle-income countries lack the resources for preventative screening for early detection and adequate treatment resources. The differences in incidence between countries can be attributed to changes in exposure to environmental risk factors, behaviour and lifestyle factors of the different population groups. Genomic modifications are an important factor that significantly alters the risk profile of breast tumourigenesis. The incidence of early-onset breast cancer is increasing and evidence shows that early onset of breast cancer is far more aggressive than late onset of the disease; possibly due to the difference in genetic alterations or tumour biology. Alternative splicing is a pivotal factor in the progressions of breast cancer. It plays a significant role in tumour prognosis, survival and drug resistance; hence, it offers a valuable option as a therapeutic target. In this review, the differences in breast cancer incidence and mortality rates in developed countries will be compared to low- to middle-income countries. The review will also discuss environmental and lifestyle risk factors, and the underlying molecular mechanisms, genetic variations or mutations and alternative splicing that may contribute to the development and novel drug targets for breast cancer.
Collapse
Affiliation(s)
- Flavia Zita Francies
- SA-MRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences Hatfield, 0028, South Africa
| | - Rodney Hull
- SA-MRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences Hatfield, 0028, South Africa
| | - Richard Khanyile
- SA-MRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences Hatfield, 0028, South Africa
| | - Zodwa Dlamini
- SA-MRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences Hatfield, 0028, South Africa
| |
Collapse
|
16
|
Evidence for an ancient BRCA1 pathogenic variant in inherited breast cancer patients from Senegal. NPJ Genom Med 2020; 5:8. [PMID: 32025337 PMCID: PMC6994613 DOI: 10.1038/s41525-020-0114-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/02/2020] [Indexed: 12/13/2022] Open
Abstract
BRCA1 and BRCA2 are the most incriminated genes in inherited breast/ovarian cancers. Several pathogenic variants of these genes conferring genetic predisposition have been described in different populations but rarely in sub-Saharan Africa. The objectives of this study were to identify pathogenic variants of the BRCA genes involved in hereditary breast cancer in Senegal and to search for a founder effect. We recruited after free informed consent, 27 unrelated index cases diagnosed with breast cancer and each having a family history. Mutation screening of the genes identified a duplication of ten nucleotides c.815_824dupAGCCATGTGG, (p.Thr276Alafs) (NM_007294.3) located in exon 11 of BRCA1 gene, in 15 index cases (allelic frequency 27.7%). The pathogenic variant has been previously reported in African Americans as a founder mutation of West African origin. Haplotypes analysis of seven microsatellites surrounding the BRCA1 gene highlights a shared haplotype encompassing ~400 kb between D17S855 and D17S1325. This haplotype was not detected in none of 15 healthy controls. Estimation of the age of the pathogenic variant suggested that it occurred ~1400 years ago. Our study identified a founder pathogenic variant of BRCA1 predisposing to breast cancer and enabled the establishment of an affordable genetic test as a mean of prevention for Senegalese women at risk.
Collapse
|
17
|
El-Yakub A. Biological characteristics of breast cancers in a teaching hospital in Northwestern Nigeria. SAHEL MEDICAL JOURNAL 2020. [DOI: 10.4103/smj.smj_23_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
18
|
Adedokun B, Zheng Y, Ndom P, Gakwaya A, Makumbi T, Zhou AY, Yoshimatsu TF, Rodriguez A, Madduri RK, Foster IT, Sallam A, Olopade OI, Huo D. Prevalence of Inherited Mutations in Breast Cancer Predisposition Genes among Women in Uganda and Cameroon. Cancer Epidemiol Biomarkers Prev 2019; 29:359-367. [PMID: 31871109 DOI: 10.1158/1055-9965.epi-19-0506] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/23/2019] [Accepted: 12/09/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has a high proportion of premenopausal hormone receptor negative breast cancer. Previous studies reported a strikingly high prevalence of germline mutations in BRCA1 and BRCA2 among Nigerian patients with breast cancer. It is unknown if this exists in other SSA countries. METHODS Breast cancer cases, unselected for age at diagnosis and family history, were recruited from tertiary hospitals in Kampala, Uganda and Yaoundé, Cameroon. Controls were women without breast cancer recruited from the same hospitals and age-matched to cases. A multigene sequencing panel was used to test for germline mutations. RESULTS There were 196 cases and 185 controls with a mean age of 46.2 and 46.6 years for cases and controls, respectively. Among cases, 15.8% carried a pathogenic or likely pathogenic mutation in a breast cancer susceptibility gene: 5.6% in BRCA1, 5.6% in BRCA2, 1.5% in ATM, 1% in PALB2, 0.5% in BARD1, 0.5% in CDH1, and 0.5% in TP53. Among controls, 1.6% carried a mutation in one of these genes. Cases were 11-fold more likely to carry a mutation compared with controls (OR = 11.34; 95% confidence interval, 3.44-59.06; P < 0.001). The mean age of cases with BRCA1 mutations was 38.3 years compared with 46.7 years among other cases without such mutations (P = 0.03). CONCLUSIONS Our findings replicate the earlier report of a high proportion of mutations in BRCA1/2 among patients with symptomatic breast cancer in SSA. IMPACT Given the high burden of inherited breast cancer in SSA countries, genetic risk assessment could be integrated into national cancer control plans.
Collapse
Affiliation(s)
- Babatunde Adedokun
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Yonglan Zheng
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Paul Ndom
- Hôpital Général Yaoundé, Yaoundé, Cameroon
| | | | | | | | - Toshio F Yoshimatsu
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois
| | | | - Ravi K Madduri
- Globus, The University of Chicago, Chicago, Illinois.,Data Science and Learning Division, Argonne National Laboratory, Lemont, Illinois
| | - Ian T Foster
- Globus, The University of Chicago, Chicago, Illinois.,Data Science and Learning Division, Argonne National Laboratory, Lemont, Illinois
| | - Aminah Sallam
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois.,Yale School of Medicine, New Haven, Connecticut
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois.
| | - Dezheng Huo
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, Illinois. .,Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| |
Collapse
|
19
|
Gebremariam A, Addissie A, Worku A, Assefa M, Pace LE, Kantelhardt EJ, Jemal A. Time intervals experienced between first symptom recognition and pathologic diagnosis of breast cancer in Addis Ababa, Ethiopia: a cross-sectional study. BMJ Open 2019; 9:e032228. [PMID: 31719089 PMCID: PMC6858206 DOI: 10.1136/bmjopen-2019-032228] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES This study aimed to estimate the magnitude of patient and diagnostic delays and associated factors among women with breast cancer in Addis Ababa. DESIGN This is a cross-sectional study. SETTINGS AND PARTICIPANTS All women newly diagnosed with breast cancer in seven major healthcare facilities in Addis Ababa (n=441) were included in the study. MAIN OUTCOMES AND MEASURES Patient interval (time from recognition of first symptom to medical consultation) and diagnostic interval (time from first consultation to diagnosis). Patient intervals >90 days and diagnostic intervals >30 days were considered delays, and associated factors were determined using multivariable Poisson regressions with robust variance. RESULTS Thirty-six percent (95% CI [31.1%, 40.3%]) of the patients had patient intervals of >90 days, and 69% (95% CI [64.6%, 73.3%]) of the patients had diagnostic intervals of >30 days. Diagnostic interval exceeded 1 year for 18% of patients. Ninety-five percent of the patients detected the first symptoms of breast cancer by themselves, with breast lump (78.0%) as the most common first symptom. Only 8.0% were concerned about cancer initially, with most attributing their symptoms to other factors. In the multivariable analysis, using traditional medicine before consultation was significantly associated with increased prevalence of patient delay (adjusted prevalence ratio (PR) = 2.13, 95% CI [1.68, 2.71]). First consultation at health centres (adjusted PR = 1.19, 95% CI [1.02, 1.39]) and visiting ≥4 facilities (adjusted PR = 1.24, 95% CI [1.10, 1.40]) were associated with higher prevalence of diagnostic delay. However, progression of symptoms before consultation (adjusted PR = 0.73, 95% CI [0.60, 0.90]) was associated with decreased prevalence of diagnostic delay. CONCLUSIONS Patients with breast cancer in Addis Ababa have prolonged patient and diagnostic intervals. These underscore the need for public health programme to increase knowledge about breast cancer symptoms and the importance of early presentation and early diagnosis among the general public and healthcare providers.
Collapse
Affiliation(s)
- Alem Gebremariam
- Public Health, Adigrat University College of Medicine and Health Sciences, Adigrat, Ethiopia
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Adamu Addissie
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Radiotherapy Center, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
| | - Lydia E Pace
- Medicine, Brigham and Women's Hospital, Boston, Massachuset, USA
| | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia, USA
| |
Collapse
|
20
|
Wright N, Rida P, Rakha E, Agboola A, Aneja R. Panoptic Overview of Triple-Negative Breast Cancer in Nigeria: Current Challenges and Promising Global Initiatives. J Glob Oncol 2019; 4:1-20. [PMID: 30085829 PMCID: PMC6223531 DOI: 10.1200/jgo.17.00116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose Triple-negative breast cancer (TNBC) is the most deadly form of breast cancer (BC) today. TNBC treatment is fraught with challenges because of the extensive interpatient heterogeneity in clinical behavior and scarcity of stratifying biomarkers and actionable targets. Women of African ancestry face a disproportionate burden resulting from this disease, which affects them earlier and more aggressively and has a higher propensity to spread and resist conventional treatments. A much higher proportion of Nigerian patients with BC have TNBC compared with patients with BC in the United States and Europe. Methods This article spotlights Nigeria as an example of a nation wherein genetic and nongenetic spheres of influence intersect to affect the prevalence of this disease, the scale of its challenge, and its toll. Results Studies have illuminated the inherently different tumor biology of Nigerian TNBCs, which show distinct genetic variants and gene expression patterns compared with European or European-American TNBCs. Parallels are apparent between TNBC phenotypes among African Americans and Nigerians, implicating the common thread of shared genetic ancestry between these populations. Reproductive, lifestyle, socioeconomic, and cultural factors also shape TNBC outcomes in Nigeria, as do resource constraints in Nigerian health care and research sectors. Conclusion Increasing our understanding of how these factors contribute to poorer outcomes among Nigerian women may uncover valuable insights and strategies in alleviating the TNBC burden in many countries of the world and help reduce the racial disparity in BC-related outcomes here in the United States. Importantly, this review also highlights collaborative global and local initiatives that converge expertise and resources to advance research on effective management of TNBC in diverse populations.
Collapse
Affiliation(s)
- Nikita Wright
- Nikita Wright, Padmashree Rida, Emad Rakha, Ayodeji Agboola, and Ritu Aneja, Georgia State University, Atlanta, GA; Emad Rakha, University of Nottingham and Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom; and Ayodeji Agboola, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Padmashree Rida
- Nikita Wright, Padmashree Rida, Emad Rakha, Ayodeji Agboola, and Ritu Aneja, Georgia State University, Atlanta, GA; Emad Rakha, University of Nottingham and Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom; and Ayodeji Agboola, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Emad Rakha
- Nikita Wright, Padmashree Rida, Emad Rakha, Ayodeji Agboola, and Ritu Aneja, Georgia State University, Atlanta, GA; Emad Rakha, University of Nottingham and Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom; and Ayodeji Agboola, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Ayodeji Agboola
- Nikita Wright, Padmashree Rida, Emad Rakha, Ayodeji Agboola, and Ritu Aneja, Georgia State University, Atlanta, GA; Emad Rakha, University of Nottingham and Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom; and Ayodeji Agboola, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Ritu Aneja
- Nikita Wright, Padmashree Rida, Emad Rakha, Ayodeji Agboola, and Ritu Aneja, Georgia State University, Atlanta, GA; Emad Rakha, University of Nottingham and Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom; and Ayodeji Agboola, Olabisi Onabanjo University, Sagamu, Nigeria
| |
Collapse
|
21
|
Wondimagegnehu A, Abebe W, Abraha A, Teferra S. Depression and social support among breast cancer patients in Addis Ababa, Ethiopia. BMC Cancer 2019; 19:836. [PMID: 31455282 PMCID: PMC6712811 DOI: 10.1186/s12885-019-6007-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 07/31/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depression is a common co-morbid, disabling disorder that affects 10-25% of cancer patients. It causes substantial functional impairment and lowers survival rate of breast cancer patients. Therefore, the aim of this study is to determine the magnitude of depression and its association with social support among breast cancer patients in Addis Ababa, Ethiopia. METHODS A cross-sectional study which included 428 breast cancer patients was conducted in seven health facilities in Addis Ababa, Ethiopia. Depression and Social Support were assessed using standard tools Patient Health Questionnaire 9 (PHQ 9) and Multidimensional Scale of Perceived Social Support (MSPSS) respectively. Descriptive statistics were done based on the standard PHQ9 cut off points (0-4, 5-9, 10-14, 15-19 and ≥ 20). Mann-Whitney and Kruskal Wallis tests were employed to compare MSPSS score among depressed and non-depressed patients and across the different levels of depression. Bivariate and multivariate logistic regression was done to identify factors associated with depression. RESULT The prevalence of depression among breast cancer patients was 25% (107/428), andaccording to the PHQ9 score categorization, 70/428 (16.4%), 30/428 (7.01%) and 7/428 (1.64%) of these patients were having moderate, moderately severe and severe depression respectively. Age, occupation, type of health facility treated, severity of pain, hormonal therapy and having problem with employer/ family were significantly associated with depression. The participants' MSPSS total score was overall found to be high (70.35 ± 16.81). Those women who had moderate and severe depression had lower mean MSPSS scores compared to women with none/ minimal depression (P = 0.002). CONCLUSION This study found that one in four breast cancer patients had depression. Depression is associated with poor social support given by family, friends and significant others. Therefore, screening for depression and psychosocial service should be integrated in the routine breast cancer care in Ethiopia.
Collapse
Affiliation(s)
- Abigiya Wondimagegnehu
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany.
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA.
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Aynalem Abraha
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| |
Collapse
|
22
|
Dibisa TM, Gelano TF, Negesa L, Hawareya TG, Abate D. Breast cancer screening practice and its associated factors among women in Kersa District, Eastern Ethiopia. Pan Afr Med J 2019; 33:144. [PMID: 31565116 PMCID: PMC6756780 DOI: 10.11604/pamj.2019.33.144.18062] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 04/19/2019] [Indexed: 12/27/2022] Open
Abstract
Introduction Breast cancer is one of the most common cancers and cause of death among women globally. Mortality due to breast cancer was higher in lower (LMICs) and middle-income countries than high income countries (HICs) mostly due to lack of timely detection and treatment. There was limited evidence related to breast cancer screening practice among women in Eastern Ethiopia. Therefore, the aim of this study was to assess breast cancer screening practice and its associated factors among women in this area. Methods A community based descriptive cross-sectional study design was conducted among 422 randomly selected women in Kersa district, Eastern Ethiopia using systematic sampling. Data were collected using pretested interviewer administered questionnaire. Logistic regression was used to analyse the association between the dependent and independent variables. Results The overall breast cancer screening practice among women was 6.9%. Women with the age of 26 years and above were 2.3 times more likely to have breast cancer screening practice as compared to women with age of 20-25 years (AOR=2.3; 95% CI: 1.4, 3.7), and women who had good knowledge on breast cancer risk factors were 3.4 times more likely to had breast cancer screening as compared to their counterpart (AOR=3.4; 95% CI: 1.3, 9.4). The women who had ever heard about breast cancer screening were 2.8 times more likely to have breast cancer screening as compared to those who had never heard about breast cancer screening (AOR=2.8; 95% CI: 1.2, 6.5). Conclusion The overall breast cancer screening practice was very low among women in the study area. Age and women's knowledge towards breast cancer risk factors and breast cancer screening information were identified as important factors for breast cancer screening practice.
Collapse
Affiliation(s)
- Teshale Mulatu Dibisa
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilayie Feto Gelano
- Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Negesa
- Department of Clinical Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tewelde Gebre Hawareya
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Degu Abate
- School of Medical Laboratory, Department of Microbiology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
23
|
|
24
|
Novel BRCA2 pathogenic variant c.5219 T > G; p.(Leu1740Ter) in a consanguineous Senegalese family with hereditary breast cancer. BMC MEDICAL GENETICS 2019; 20:73. [PMID: 31060517 PMCID: PMC6501405 DOI: 10.1186/s12881-019-0814-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/24/2019] [Indexed: 01/07/2023]
Abstract
Background Pathogenic variants associated with hereditary breast cancer have been reported for BRCA1 and BRCA2 (BRCA1/2) genes in patients from multiple ethnicities, but limited information is available from sub-Saharan African populations. We report a BRCA2 pathogenic variant in a Senegalese family with hereditary breast cancer. Methods An index case from a consanguineous family and nineteen healthy female relatives were recruited after informed consent. Along with this family, 14 other index cases with family history of breast cancer were also recruited. For the control populations we recruited 48 healthy women with no cancer diagnosis and 48 women diagnosed with sporadic breast cancer without family history. Genomic DNA was extracted from peripheral blood. All BRCA2 exons were amplified by PCR and sequenced. Sequences were compared to the BRCA2 GenBank reference sequence (NM_000059.3) using Alamut Software. Results We identified a novel nonsense pathogenic variant c.5219 T > G; p.(Leu1740Ter) in exon 11 of BRCA2 in the index case. The pathogenic variant was also identified in three sisters and one daughter, but was absent in the controls and unrelated cases. Conclusions This is the first report of a novel BRCA2 pathogenic variant in a Senegalese family with hereditary breast cancer. This result confirms the diversity of hereditary breast cancer pathogenic variants across populations and extends our knowledge of genetic susceptibility to breast cancer in Africa. Electronic supplementary material The online version of this article (10.1186/s12881-019-0814-y) contains supplementary material, which is available to authorized users.
Collapse
|
25
|
Gebremariam A, Addissie A, Worku A, Hirpa S, Assefa M, Pace LE, Kantelhardt EJ, Jemal A. Breast and cervical cancer patients' experience in Addis Ababa city, Ethiopia: a follow-up study protocol. BMJ Open 2019; 9:e027034. [PMID: 30967409 PMCID: PMC6500298 DOI: 10.1136/bmjopen-2018-027034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Cancer is an emerging public health problem in Ethiopia, with breast and cervical cancers accounting for over half of all newly diagnosed cancers in women. The majority of women with breast and cervical cancer are diagnosed at late stage of the disease and most patients do not receive care consistent with global standards. However, little is known about the health-seeking behaviours, barriers to early detection and treatment, patient-reported outcomes, financial burden and survival of women with breast and cervical cancer in the country. Therefore, this study aims to document the experience of women with breast and cervical cancer from recognition of symptoms to diagnosis, treatment and survivorship/mortality in Addis Ababa city, Ethiopia. METHODS AND ANALYSIS A prospective follow-up study using mixed methods (both quantitative and qualitative) will be employed. All women newly diagnosed with breast and cervical cancer from 1 January, 2017 to 30 June 2018 in Addis Ababa will be included in the study. Interviewer-administered questionnaires will be used to collect information about medical consultations after recognition of symptoms, health-seeking behaviours, treatment received, barriers to early detection and treatment, and survivorship care. In-depth interview will be conducted on purposefully selected women with breast and cervical cancer. The primary outcomes of the study are time intervals (patient and diagnostic waiting times), stage at diagnosis and survival. Multivariable analysis will be employed to determine the contributions of independent variables on the outcomes of interest. HRs with 95% CIs will be calculated for time-to-event outcomes. Qualitative data will be analysed using thematic analysis. ETHICS AND DISSEMINATION This protocol is ethically approved by Institutional Review Board of Addis Ababa University. Verbal informed consent will be obtained from study participants. Results will be disseminated in international peer-reviewed journals and presented in relevant conferences.
Collapse
Affiliation(s)
- Alem Gebremariam
- Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Tigray, Ethiopia
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Adamu Addissie
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Selamawit Hirpa
- Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Oncology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
| | - Lydia E Pace
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia, USA
| |
Collapse
|
26
|
Sowunmi A, Olatunji T, Ketiku K, Campbell O. Sociodemographic correlates and management of breast cancer in Radiotherapy Department, Lagos University Teaching Hospital: A 10-year review. JOURNAL OF CLINICAL SCIENCES 2019. [DOI: 10.4103/jcls.jcls_82_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
27
|
Weiner CM, Mathewos A, Addissie A, Ayele W, Aynalem A, Wondemagegnehu T, Wienke A, Jemal A, Zerche P, Thomssen C, Seidler A, Kantelhardt EJ. Characteristics and follow-up of metastatic breast cancer in Ethiopia: A cohort study of 573 women. Breast 2018; 42:23-30. [PMID: 30149234 DOI: 10.1016/j.breast.2018.08.095] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/27/2018] [Accepted: 08/06/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES There is little information on characteristics, treatment and outcome of metastatic breast cancer (mBC) patients in low-income countries. This study aims to describe mBC in the setting of Ethiopia. MATERIALS AND METHODS A retrospective cohort study was conducted among all female mBC patients from the only oncologic hospital in Addis Ababa 01/2006 to 12/2010. Time between first metastasis and known death or loss to follow-up for more than six months as surrogate for death were used for Cox proportional hazards model. RESULTS A total of 573 patients were included; 188 (32.8%) women with de novo mBC (dnmBC) and 385 women with recurrent mBC (rmBC). The average age at time of first metastasis was 43.7 (standard deviation 11.9) years with an average survival probability of twelve months. Negative hormone receptor status, only present in 29% (Hazard ratio HR = 2.28 [95% confidence interval CI 1.56-3.32] p < 0.001), and grade 3 (HR = 1.72 [95% CI 1.15-2.55] p = 0.008) had significant influence on survival. Patients with initial bone metastasis (HR = 0.63 [95% CI 0.48-0.83] p = 0.001) had best chances of survival compared to more common initial visceral metastasis. About 35% of the patients received chemotherapy and 30.5% were on endocrine therapy. CONCLUSION The lower survival for mBC in Addis Ababa compared to that from Western countries is presumably due to the later presentation at the hospital and lack of standard therapy. An unexpected high proportion of patients with hormone receptor positive mBC encourage consequent utilization of endocrine therapy to improve the quality of palliative care in this cohort.
Collapse
Affiliation(s)
| | - Assefa Mathewos
- Radiotherapy Centre, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondimu Ayele
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abraha Aynalem
- Radiotherapy Centre, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, USA
| | - Peter Zerche
- Department of Surgery, Hospital Martha-Maria Halle-Dölau, Halle, Saale, Germany
| | - Christoph Thomssen
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany; Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| |
Collapse
|
28
|
Kisiangani J, Baliddawa J, Marinda P, Mabeya H, Choge JK, Adino EO, Khayeka-Wandabwa C. Determinants of breast cancer early detection for cues to expanded control and care: the lived experiences among women from Western Kenya. BMC WOMENS HEALTH 2018; 18:81. [PMID: 29859095 PMCID: PMC5984781 DOI: 10.1186/s12905-018-0571-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 05/18/2018] [Indexed: 01/24/2023]
Abstract
Background Estimately, 70–80% of cancer cases are diagnosed in late stages in Kenya with breast cancer being a common cause of mortality among women where late diagnosis is the major ubiquitous concern. Numerous studies have focused on epidemiological and health policy dynamics essentially underestimating the determining factors that shape people’s choices and cues to health care service uptake. The study sought to evaluate the knowledge, attitude and health seeking behavior towards breast cancer and its screening in a quest to explain why women present for prognosis and treatment when symptomatic pointers are in advanced stages, impeding primary prevention strategies. Methods Eight focus groups (6–10 members per group) and four key informant interviews were conducted among adult participants from rural and urban settings. Sessions were audio-recorded and transcribed. A thematic analysis of the data was based on the concepts of the health belief model. Data analysis was conducted using NVIVO10. Results Most women perceived breast cancer as a fatal disease and conveyed fear of having early screening. Rural women preferred self-prescribed medications and the use of alternative medicine for long periods before presenting for professional care on suspicion that the lump is cancerous. Accessibility to equipped health facilities, lack of information to establish effective follow-up treatment and low-income status were underscored as their major health seeking behavior barriers whereas, urban women identified marital status as their main barrier. Key informant interviews revealed that health communication programs emphasized more on communicable diseases. This could in part explain why there is a high rate of misconception and suspicion about breast cancer among rural and urban women in the study setting. Conclusions Creating breast cancer awareness alongside clear guidelines on accessing screening and treatment infrastructure is critical. It was evident, a diagnosis of breast cancer or lump brings unexpected confrontation with mortality; fear, pain, cultural barriers, emotional and financial distress. Without clear referral channels to enable those with suspicious lumps or early stage disease to get prompt diagnosis and treatment, then well-meaning awareness will not necessarily contribute to reducing morbidity and mortality. Electronic supplementary material The online version of this article (10.1186/s12905-018-0571-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Joyce Kisiangani
- The Aquaya Institute, Nairobi, 00505, Kenya.,School of Public Health, Department of Epidemiology and disease control, Moi University, P.O. Box 3900, Eldoret, Kenya
| | - Joyce Baliddawa
- School of Public Health, Department of Epidemiology and disease control, Moi University, P.O. Box 3900, Eldoret, Kenya
| | - Pamela Marinda
- Department of Food Science and Nutrition, School of Agricultural Sciences, The University of Zambia, Lusaka, Zambia
| | - Hillary Mabeya
- Gynocare Fistula Centre, Eldoret Hospital Lane, P.O. BOX 2326-30100, Eldoret, Kenya
| | - Joseph K Choge
- University of Kabianga, P.O. Box 2030-20200, Kericho, Kenya
| | | | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, 92 Weijin road, Nankai District, Tianjin, 300072, People's Republic of China. .,African Population and Health Research Center (APHRC), P .O. Box 10787-00100, Nairobi, Kenya.
| |
Collapse
|
29
|
Ströbele L, Kantelhardt EJ, Traoré Millogo TFD, Sarigda M, Wacker J, Grosse Frie K. Prevalence of breast-related symptoms, health care seeking behaviour and diagnostic needs among women in Burkina Faso. BMC Public Health 2018; 18:447. [PMID: 29615015 PMCID: PMC5883529 DOI: 10.1186/s12889-018-5360-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/22/2018] [Indexed: 11/29/2022] Open
Abstract
Background The prevalence of breast cancer has been increasing in sub-Saharan Africa over the last few years. Patients often present with late stage disease, resulting in a high mortality rate. This study aims to estimate the prevalence of breast -related symptoms in the female population of Burkina Faso. The findings can be used to advise on adequate diagnostic health services for breast symptoms to ensure early detection and down-staging of breast cancer. Methods A cross-sectional, population based study of 996 women was conducted to investigate the proportion of women with breast-related symptoms. A semi-structured questionnaire was used to collect sociodemographic data, information about breast cancer knowledge and details about breast-related symptoms, health care seeking and medical care. Breast-related symptoms were categorised as currently present/not currently present to estimate the current prevalence of women requiring a diagnostic service. Results Among the 996 women, 120 reported having had a breast-related symptom in their life. Only 36 women sought medical advice and eight women had diagnostic confirmation by histological or imaging techniques. Current breast-related symptoms were reported by 33 women (3.3% of the sample). An extrapolation to Burkina Faso’s female population suggests that 184,562 women are in current need of diagnostic services due to any breast-related symptoms. Conclusions Imaging techniques at the community and referral level are needed in order to triage women with breast-related symptoms. Specialised services need to be strengthened to ensure appropriate diagnosis and treatment of breast diseases. Education campaigns among the general population and among health care professionals are required to increase awareness of breast cancer and improve prompt health care seeking and referral.
Collapse
Affiliation(s)
- Leonie Ströbele
- Martin-Luther-University Halle-Wittenberg, Institute for Medical Epidemiology, Biostatistics and Informatics, Magdeburger Straße 8, 06112, Halle, Germany
| | - Eva Johanna Kantelhardt
- Martin-Luther-University Halle-Wittenberg, Institute for Medical Epidemiology, Biostatistics and Informatics, Magdeburger Straße 8, 06112, Halle, Germany.,Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06097, Halle, Germany
| | | | - Maurice Sarigda
- Unité de Formation en Sciences de la Santé, Université Ouaga 1 Professeur Joseph Ki Zerbo 03 B.P. 7021, Ouagadougou, 03, Burkina Faso
| | - Jürgen Wacker
- Fürst-Stirum-Klinik Bruchsal, Gutleutstraße 1-14, 76646, Bruchsal, Germany
| | - Kirstin Grosse Frie
- Martin-Luther-University Halle-Wittenberg, Institute for Medical Epidemiology, Biostatistics and Informatics, Magdeburger Straße 8, 06112, Halle, Germany.
| |
Collapse
|
30
|
Grosse Frie K, Samoura H, Diop S, Kamate B, Traore CB, Malle B, Coulibaly B, Kantelhardt EJ. Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa? Perspectives from Women and Patients in Bamako, Mali. Breast Care (Basel) 2018; 13:39-43. [PMID: 29950966 PMCID: PMC6016059 DOI: 10.1159/000481087] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Breast cancer, the most common cancer among women worldwide, has a high mortality rate in low-income countries. In sub-Saharan Africa, most breast cancer patients are diagnosed with advanced disease. Some studies have quantified the time delay to diagnosis in sub-Saharan Africa, but very few have used qualitative methods to understand barriers leading to delay. This study analyses barriers throughout a breast cancer patient's pathway from symptom recognition to treatment in Mali. METHOD Three focus group discussions were conducted. The model of pathways to treatment was used to structure the results into 4 time intervals: appraisal, help-seeking, diagnosis, and treatment, with a focus on barriers during each interval. RESULTS The main barriers during the appraisal interval were a low level of breast cancer knowledge among women, their families, and medical professionals, and during the help-seeking interval, mistrust in the community health care centers and economic hardship. Barriers during the diagnosis interval were low quality of health care services and lack of social support, and during the pretreatment interval high costs and lack of specialized services. CONCLUSION Multilevel interventions are needed to ensure access, availability, and affordability of a minimum standard of care for breast cancer patients in sub-Saharan Africa.
Collapse
Affiliation(s)
- Kirstin Grosse Frie
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Hatouma Samoura
- Institute of Public Health, University of Bamako, Bamako, Mali
| | - Samba Diop
- Institute of Public Health, University of Bamako, Bamako, Mali
| | - Bakarou Kamate
- Institute of Pathology, University Hospital Point G, Bamako, Mali
| | | | - Brahima Malle
- Institute of Pathology, University Hospital Point G, Bamako, Mali
| | | | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Gynecology, University Hospital Halle (Saale), Halle (Saale), Germany
| |
Collapse
|
31
|
Min W, Liu X, Lu Y, Gong Z, Wang M, Lin S, Kang H, Jin T, Wang X, Ma X, Liu K, Dai C, Zheng Y, Li S, Ma Q, Dai Z. Association of transcription factor 7-like 2 gene polymorphisms with breast cancer risk in northwest Chinese women. Oncotarget 2018; 7:77175-77182. [PMID: 27738320 PMCID: PMC5363578 DOI: 10.18632/oncotarget.12591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/29/2016] [Indexed: 01/08/2023] Open
Abstract
Genetic variations in transcription factor 7-like 2 (TCF7L2) are associated with cancer risk. This study was conducted to establish the relationship between TCF7L2 polymorphisms (rs1225404, rs7003146, and rs7903146) and clinical features and risk of breast cancer in Northwest Chinese Han women. In this study, three polymorphisms of TCF7L2 (rs1225404, rs7003146, and rs7903146) were genotyped in 458 patients with breast cancer and 500 healthy controls using the Sequenom MassARRAY-iPLEX system. We evaluated the associations between the polymorphisms and breast cancer using odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs). The C allele of rs1225404 was associated with increased breast cancer risk (OR = 1.58, P = 0.0004, PC= 0.0012), whereas the G allele of rs7003146 was associated with decreased breast cancer risk (OR = 0.71, P = 0.01, PC= 0.03). Furthermore, the rs1225404 polymorphism positively correlated with negative progesterone receptor status. A positive correlation with positive estrogen receptor (ER) status was observed for the rs7003146 polymorphism. Our results suggest that TCF7L2 polymorphisms rs1225404 and rs7003146, but not rs7903146, may affect breast cancer risk in Northwest Chinese women. Additionally, the tag polymorphisms in TCF7L2 are associated with the clinical features of breast cancer, which may provide us novel insight into the pathogenesis of breast cancer.
Collapse
Affiliation(s)
- Weili Min
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Xinghan Liu
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Ye Lu
- Department of Student Affairs, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Zhuoqing Gong
- Department of Health Science Center, Xi'an Jiaotong University, Xi'an 710061, China
| | - Meng Wang
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Shuai Lin
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Huafeng Kang
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Tianbo Jin
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Xijing Wang
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Xiaobin Ma
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Kang Liu
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Cong Dai
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Yi Zheng
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Shanli Li
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Qingyong Ma
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Zhijun Dai
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| |
Collapse
|
32
|
Lukong KE, Ogunbolude Y, Kamdem JP. Breast cancer in Africa: prevalence, treatment options, herbal medicines, and socioeconomic determinants. Breast Cancer Res Treat 2017; 166:351-365. [PMID: 28776284 DOI: 10.1007/s10549-017-4408-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/17/2017] [Indexed: 12/11/2022]
Abstract
Breast cancer is the leading cause of cancer-related deaths in women worldwide. GLOBOCAN estimated about 1.7 million new cases of breast cancer diagnoses worldwide and about 522,000 deaths in 2012. The burden of breast cancer mortality lies in the developing low-income and middle-income countries, where about 70% of such deaths occur. The incidence of breast cancer is also rising in low-income and middle-income countries in Africa as trend towards urbanization, and adoption of Western lifestyles increases. In general, the triple-negative breast cancer (TNBC) subtype tends to be frequent in women of African ancestry. What are the factors contributing to this prevalence? Are there genetic predispositions to TNBC in African women? This review addresses these questions and provides an update on the incidence, survival, and mortality of breast cancer in Africans, with a focus on sub-Saharan Africans. We have also addressed factors that could account for ethical disparities in incidence and mortality. Further, we have highlighted challenges associated with access to essential drug and to healthcare treatment in some African countries and outlined alternative/herbal treatment methods that are increasingly implemented in Africa and other developing nations.
Collapse
Affiliation(s)
- Kiven Erique Lukong
- Department of Biochemistry, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
| | - Yetunde Ogunbolude
- Department of Biochemistry, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Jean Paul Kamdem
- Department of Biological Sciences, Regional University of Cariri, Campus Pimenta, Crato, Ceará, CEP: 63105-000, Brazil
| |
Collapse
|
33
|
Masamba LPL, Mtonga PE, Kalilani Phiri L, Bychkovsky BL. Cancer Pathology Turnaround Time at Queen Elizabeth Central Hospital, the Largest Referral Center in Malawi for Oncology Patients. J Glob Oncol 2017; 3:734-739. [PMID: 29244984 PMCID: PMC5735957 DOI: 10.1200/jgo.2015.000257] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose In all settings, a need exists for expedited pathology processing for patients with a suspected cancer diagnosis. In low- and middle-income countries (LMICs) with limited resources, processing pathology samples is particularly challenging, so the measurement of turnaround times (TATs) for pathology results is an important quality metric. We explored the pathology TAT for suspected cancer patients at Queen Elizabeth Central Hospital in Malawi to determine whether a difference exists when patients paid an out-of-pocket fee (paid for [PF] v nonpaid for [NPF]) to facilitate sample processing. Methods and Population This retrospective descriptive study included all patients with suspected cancer (N = 544) who underwent incisional and excisional biopsy in 2010 at Queen Elizabeth Central Hospital, a teaching hospital in Malawi. Data were abstracted from patient charts and administrative forms to build a database and determine the TAT for PF and NPF samples. Results The median TAT for the 544 patients was 71 days (interquartile range [IQR], 31 to 118 days). The median pathology processing time was 31 days (IQR, 15 to 52 days) and was shorter for PF versus NPF samples. The median TAT was 43 days for PF samples (IQR, 27 to 69 days) versus 101 days for NPF samples (IQR, 31 to 118 days), which was significantly different by the Wilcoxon rank sum test (P < .01). Conclusion The TAT for pathology samples among patients with suspected cancer was longer than reported for other African countries during the study period, was longer than considered acceptable in high-income countries, and differed between PF and NPF samples.
Collapse
Affiliation(s)
- Leo P L Masamba
- Leo P.L. Masamba and Petani E. Mtonga, Queen Elizabeth Central Hospital; Linda Kalilani Phiri, University of Malawi College of Medicine, Blantyre, Malawi; Brittany L. Bychkovsky, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Petani E Mtonga
- Leo P.L. Masamba and Petani E. Mtonga, Queen Elizabeth Central Hospital; Linda Kalilani Phiri, University of Malawi College of Medicine, Blantyre, Malawi; Brittany L. Bychkovsky, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Linda Kalilani Phiri
- Leo P.L. Masamba and Petani E. Mtonga, Queen Elizabeth Central Hospital; Linda Kalilani Phiri, University of Malawi College of Medicine, Blantyre, Malawi; Brittany L. Bychkovsky, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Brittany L Bychkovsky
- Leo P.L. Masamba and Petani E. Mtonga, Queen Elizabeth Central Hospital; Linda Kalilani Phiri, University of Malawi College of Medicine, Blantyre, Malawi; Brittany L. Bychkovsky, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| |
Collapse
|
34
|
Vanderpuye V, Grover S, Hammad N, PoojaPrabhakar, Simonds H, Olopade F, Stefan DC. An update on the management of breast cancer in Africa. Infect Agent Cancer 2017; 12:13. [PMID: 28228841 PMCID: PMC5307840 DOI: 10.1186/s13027-017-0124-y] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/03/2017] [Indexed: 01/04/2023] Open
Abstract
Background There is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities. Methods A search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms “breast cancer in Africa and developing countries”. One hundred ninety were deemed appropriate. Results Breast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities. Conclusion This review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.
Collapse
Affiliation(s)
- V Vanderpuye
- National center for Radiotherapy and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, Ghana
| | - S Grover
- Hospital of University of Pennsylvania, Department of Radiation Oncology, (Botswana-UPENN program), 3400 Civic Center Blvd., Philadelphia, PA 19104 USA
| | - N Hammad
- Cancer Centre of Southeastern Ontario, Burr 2, Kingston General Hospital, 25 King Street W, Kingston, ON K7L 5P9 Canada
| | - PoojaPrabhakar
- University of Texas Southwestern Medical Center, Dallas, TX USA
| | - H Simonds
- Division of Radiation Oncology, Tygerberg Hospital/University of Stellenbosch, Tygerberg, South Africa
| | - F Olopade
- The University of Chicago, 5841 S Maryland Avenue, MC 2115, Chicago, IL 60637 USA
| | - D C Stefan
- Walter Sisulu University Nelson Mandela Dr, Nelson Mandela Drive, Mthatha, 5100 Eastern Cape South Africa
| |
Collapse
|
35
|
Islami F, Torre LA, Drope JM, Ward EM, Jemal A. Global Cancer in Women: Cancer Control Priorities. Cancer Epidemiol Biomarkers Prev 2017; 26:458-470. [PMID: 28183824 DOI: 10.1158/1055-9965.epi-16-0871] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022] Open
Abstract
This review is an abbreviated version of a report prepared for the American Cancer Society Global Health department and EMD Serono, Inc., a subsidiary of Merck KGaA, Darmstadt, Germany, which was released at the Union for International Cancer Control World Cancer Congress in Paris in November 2016. The original report can be found at https://www.cancer.org/health-care-professionals/our-global-health-work/global-cancer-burden/global-burden-of-cancer-in-women.html. Staff in the Intramural Research Department of the American Cancer Society designed and conducted the study, including analysis, interpretation, and presentation of the review. The funding sources had no involvement in the study design, data analysis and interpretation, or preparation of the reviewThe global burden of cancer in women has recently received much attention, but there are few comprehensive reviews of the burden and policy approaches to reduce it. This article, second in series of two, summarizes the most important cancer control priorities with specific examples of proven interventions, with a particular focus on primary prevention in low- and middle-income countries (LMIC). There are a number of effective cancer control measures available to countries of all resource levels. Many of these measures are extremely cost-effective, especially in the case of tobacco control and vaccination. Countries must prioritize efforts to reduce known cancer risk factors and make prevention accessible to all. Effective treatments and palliative care are also needed for those who develop cancer. Given scarce resources, this may seem infeasible in many LMICs, but past experience with other diseases like HIV, tuberculosis, and malaria have shown that it is possible to make affordable care accessible to all. Expansion of population-based cancer registries and research in LMICs are needed for setting cancer control priorities and for determining the most effective interventions. For LMICs, all of these activities require support and commitment from the global community. Cancer Epidemiol Biomarkers Prev; 26(4); 458-70. ©2017 AACRSee related article by Torre et al. in this CEBP Focus section, "Global Cancer in Women."
Collapse
Affiliation(s)
- Farhad Islami
- Intramural Research, American Cancer Society, Atlanta, Georgia.
| | - Lindsey A Torre
- Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Jeffrey M Drope
- Intramural Research, American Cancer Society, Atlanta, Georgia
| | | | - Ahmedin Jemal
- Intramural Research, American Cancer Society, Atlanta, Georgia
| |
Collapse
|
36
|
Zouré AA, Bambara AH, Sawadogo AY, Ouattara AK, Ouédraogo M, Traoré SS, Bakri Y, Simporé J. Multiparity and Breast Cancer Risk Factor among Women in Burkina Faso. Asian Pac J Cancer Prev 2016; 17:5095-5099. [PMID: 28122440 PMCID: PMC5454642 DOI: 10.22034/apjcp.2016.17.12.5095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The relative lack of information on breast cancer etiology in Burkina Faso led us to undertake the present work to highlight risk factors. This prospective study was conducted using a questionnaire between January 2015 and February 2016 on women admitted to Yalgado OUEDRAOGO hospital, for consultation or supervision. The characteristics of multiparous breast cancer patients (n = 44) were compared with their non-multiparous counterparts (n = 36). The study found that increased risk of breast cancer among non-multiparous cases was related to body mass index (BMI) (p <0.001), age at menopause (p <0.004) and use of oral contraception (p <0.021) while abortion (p <0.002) was a risk factor among multiparous cases. These results suggest that even if multiparity is associated with a decreased risk in some women, avoidance of abortion during reproductive life should be recommended. The results provide preliminary information, which now need to be supplemented by survey of a larger sample in the national territory.
Collapse
Affiliation(s)
- Abdou Azaque Zouré
- Biomolecular Research Center Pietro Annigoni (CERBA)/LABIOGENE, University of Ouaga1 Pr Joseph KI ZERBO, UFR/SVT, Burkina Faso.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Harbeck N, Gnant M, Thomssen C. Breast Cancer Is Our Global Responsibility. Breast Care (Basel) 2015; 10:360. [PMID: 26989353 PMCID: PMC4789920 DOI: 10.1159/000443159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology, University of Munich, Germany
| | - Michael Gnant
- Department of Surgery and Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Christoph Thomssen
- Department of Gynecology, Martin-Luther-University, Halle an der Saale, Germany
| |
Collapse
|