scholarly journals Global, Regional, and National Burden of Breast Cancer and Its Attributable Risk Factors Among Women, 1990–2017

2020 ◽  
Author(s):  
Saeid Safiri ◽  
Mohsen Naghavi
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Death Rate ◽  
National Level ◽  
High Body Mass Index ◽  
Attributable Risk ◽  
Death Rates ◽  
Awareness Campaigns ◽  
Life Years ◽  
Increasing Trend

Abstract Introduction: Breast cancer is the most common cancer in women worldwide. However, no comprehensive study has been conducted to compare the incidence, mortality, and disability-adjusted life years (DALYs) for female breast cancer among different countries. The current study examined the level and trends of incidence, death, and DALYs for breast cancer and its attributable risk factors among women in 195 countries from 1990 to 2017 by age, socio-demographic index (SDI; a composite of socio-demographic factors), and healthcare access and quality (HAQ; an indicator of health system performance) index.Methods: Vital registration, verbal autopsy, and cancer registries were used across the globe to generate estimates. Incidence, mortality, and DALYs were estimated. All estimates are presented as counts and age-standardised rates per 100,000 person-years. Results: Between 1990 and 2017 the global incidence of breast cancer increased significantly by 17.1% (95% uncertainty interval [UI]: 7.1–23.6; with 1.9 million incidences in 2017 [95% UI 1.9–2.0]; age-standardised rate of 45.9 [95% UI: 44.2–47.4]). However, over this same period the age-standardised death rate significantly decreased by 10.6% (95% UI: -19.5 to -4.4), with 600.7 thousand deaths in 2017 (95% UI: 578.7–630.0; age-standardised death rate of 14.1 95% UI: 13.6–14.8). Global DALYs also significantly decreased between 1990 and 2017 by 9.3% (95% UI: -19.9 to -1.6) with 17.4 million DALYs reported in 2017 (95% UI: 16.6–18.4; age-standardised rate of 414.7; 95% UI: 395.5– 437.6). Lebanon [138.3 (95% UI: 106.5–170.7)], the Netherlands [109.8 (95% UI: 97.4–122.7)], and the UK [102.6 (95% UI: 99.6–105.8)] had the three highest age-standardised incidence rates in 2017. Meanwhile, Pakistan [34.1 (95% UI: 20.9–71.3)], Tonga [34.0 (95% UI: 26.8–41.9)], and the Bahamas [33.3 (95% UI: 28.9–37.8)] had the three highest age-standardised death rates in 2017. Between 1990 and 2017, Saudi Arabia [232% (95% UI: 93–410)], Mauritius [174% (95% UI: 134–222)], and Taiwan [172% (95% UI: 141–208)] showed an increasing trend for the highest age-standardised incidence rate of breast cancer. Meanwhile, Mauritius [90% (95% UI: 66–117)], Philippines [76% (95% UI: 43–115)], and the Dominican Republic [69% (95% UI: 11–125)] produced the greatest significant increasing trend in age-standardised death rates. An increasing trend between population ageing and age-standardised incidence and death rates were observed globally, peaking among the oldest population grouping [incidence: 535.6 (95% UI: 511.8–560.7); death: 251.4 (95% UI: 242.6–260.9)]. Non-linear associations were observed between age-standardised DALY rates with SDI and HAQ. Alcohol consumption [9.2% (95% UI: 7.7–10.7)], high fasting plasma glucose [6.1% (95% UI: 1.1–13.6)], and high body mass index [4.5% (95% UI: 1.4–8.5)] were the three largest contributors to breast cancer DALYs globally.Conclusions: Remarkable inter-country variation exists in the burden of breast cancer. While there is a global downward trend in breast cancer age-standardised mortality rates, some countries are experiencing increases in age-standardised incidence and death rates from breast cancer. Prevention measures should be tailored to national-level estimates specific for each country and strengthened through early detection and treatment and public policy awareness campaigns aimed to reduce exposure to modifiable risk factors, particularly for countries with high incidence levels and/or increasing trends.

scholarly journals Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease study 2019

2021 ◽  
Vol 6 (11) ◽  
pp. e004128
Author(s):  
Saeid Safiri ◽  
Ali-Asghar Kolahi ◽  
Mohsen Naghavi
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Death Rate ◽  
Attributable Risk ◽  
Mortality Data ◽  
Years Of Life Lost ◽  
Death Rates ◽  
Life Years ◽  
Incident Cases ◽  
Mortality Estimates

IntroductionThe current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors).MethodsVarious data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population.ResultsGlobally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)).ConclusionsThere was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.

scholarly journals Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the Global Burden of Disease Study 2017

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Na Li ◽  
Yujiao Deng ◽  
Linghui Zhou ◽  
Tian Tian ◽  
Si Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Burden Of Disease ◽  
Attributable Risk ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Cancer Burden ◽  
Cancer Data ◽  
Life Years ◽  
Incident Cases

Abstract Background Statistical data on the incidence, mortality, and burden of breast cancer and the relevant risk factors are valuable for policy-making. We aimed to estimate breast cancer incidence, deaths, and disability-adjusted life years (DALYs) by country, gender, age group, and social-demographic status between 1990 and 2017. Methods We extracted breast cancer data from the 2017 Global Burden of Disease (GBD) study from 1990 through 2017 in 195 countries and territories. Data about the number of breast cancer incident cases, deaths, DALYs, and the age-standardized rates were collected. We also estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study. Results In 2017, the global incidence of breast cancer increased to 1,960,681 cases. The high social-development index (SDI) quintile included the highest number of breast cancer death cases. Between 2007 and 2017, the ASDR of breast cancer declined globally, especially in high SDI and high middle SDI countries. The related DALYs were 17,708,600 in 2017 with high middle SDI quintile as the highest contributor. Of the deaths and DALYs, alcohol use was the greatest contributor in most GBD regions and other contributors included high body mass index (BMI) and high fasting plasma glucose. Conclusion The increasing global breast cancer burden is mainly observed in lower SDI countries; in higher SDI countries, the breast cancer burden tends to be relieving. Therefore, steps against attributable risk factors should be taken to reduce breast cancer burden in lower SDI countries.

scholarly journals The Global, Regional, and National Burden of Nasopharyngeal Carcinoma and Its Attributable Risk Factors in 194 Countries and Territories, 2007–2017

2021 ◽  
Author(s):  
Zhisen Shen ◽  
Yujie Cao ◽  
Lin Luo ◽  
Liyuan Han ◽  
Jun Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nasopharyngeal Carcinoma ◽  
Dominican Republic ◽  
South Asia ◽  
Incidence Rate ◽  
Death Rate ◽  
Attributable Risk ◽  
Uncertainty Interval ◽  
Death Rates ◽  
The Caribbean

Abstract BackgroundSo far, no research about the burden of the incidence rate, Disability-Adjusted Life Years (DALYs), and death rate associated with nasopharyngeal carcinoma (NPC) has been reported on the global, regional, and national levels. In this paper, we provide an overview of the most recent global epidemiology of nasopharyngeal cancer with data obtained from the Global Health Data Exchange (GHDx) repository.MethodsWe utilized the reports of the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study in 2017 to estimate the burden of NPC in 194 countries and territories by age, sex, and Socio-Demographic Index (SDI) from 2007 to 2017. Moreover, we assessed the risk factors of NPC-related DALYs and deaths through the Comparative Risk Assessment Framework.ResultsIn the year 2017, 10.978 million new NPC cases with a 95% uncertainty interval of 10.444 to 11.556 million were recorded globally, whereas the DALYs and deaths were 2.09 million cases with a 95%UI 2 to 2.17 million and 695.5 thousand cases with 95% UI 668.7 to 722.7 thousand, respectively. From 2007 to 2017, the estimated incidence rate of NPC decreased by 2.3% with 95% uncertainty interval -7% to 3.28%, the estimated DALY rate decreased by 4.95% with 95% uncertainty interval from -8.46% to -1.24%, and the estimated death rate decreased by 3.01% with 95% uncertainty interval -6.36% to 0.43%. The age-standardized incidence, DALY, and death rates in 2017 were all the highest among the countries located in the middle-SDI quintiles region. At the GBD regional level, the most severe age-standardized incidence, DALY, and death rates in 2017 occurred in Oceania, followed by Southeast Asia and East Asia. From 2007 to 2017, the Caribbean and South Asia have the most increase in percentage in age-standardized incidence, DALY, and death rates. At the national level, countries like Ukraine, Jamaica, and the Dominican Republic reported the largest percentage increases in the age-standardized incidence, DALY, and death rates in a decade. From 2007 to 2017, DALYs and death rate of NPC increased by 18.99% (95%UI:13.34% - 25.73%) and 23.5% (95%UI:17.76% - 29.84%), respectively. While the estimated age-standardized attributable risk DALY rate and the age-standardized attributable risk mortality rate decreased by 5.55% (95% UI: -9.93% - 0.34%) and 4.25% (95% UI: -8.64% - 0.56%). ConclusionThe middle-SDI quintiles had the highest age-standardized incidence, DALY, and death rates in 2017. The largest increases in age-standardized incidence, DALY, and death rates were reported in the Caribbean and South Asia from 2007 to 2017, especially in countries such as Ukraine, Jamaica, Dominican Republic, and Dominica. In these regions, Alcohol consumption, Smoking, and A diet short of fruits were the primary three risk factors contributing to both DALYs and deaths in 2017.

scholarly journals Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990–2019

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Hao Zi ◽  
Shao-Hua He ◽  
Xie-Yuan Leng ◽  
Xiao-Feng Xu ◽  
Qiao Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Cancer ◽  
High Body Mass Index ◽  
Attributable Risk ◽  
Global Public Health ◽  
Life Years ◽  
Prostate Cancers ◽  
High Fasting Plasma Glucose ◽  
Incident Cases ◽  
Related Mortality

Abstract Background The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. Methods We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. Results Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = − 0.68 and − 0.83, respectively) and prostate cancer (EAPC = − 0.75 and − 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. Conclusions Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.

Examination of incidence, mortality and disability-adjusted life years and risk factors of breast cancer in 49 Asian countries, 1990–2019: estimates from Global Burden of Disease Study 2019

2021 ◽  
Author(s):  
Rajesh Sharma
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Mortality Rate ◽  
Burden Of Disease ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Asian Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standardized Mortality Rate

Abstract Background This study presents an up-to-date, comprehensive and comparative examination of breast cancer’s temporal patterns in females in Asia in last three decades. Methods The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. Results In Asia, female breast cancer incidence grew from 245 045[226 259–265 260] in 1990 to 914 878[815 789–1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6–22.9] to 35.9/100 000[32.0–40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094–148 380] to 337 822[301 454–375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0–13.1]; 2019: 13.4[12.0–14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95–21.4] in Mongolia to 122.5[92.1–160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2–8.8] in South Korea to 51.9[39.0–69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. Conclusion With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.

scholarly journals The Global, Regional, and National Burden and Trends of Breast Cancer From 1990 to 2019: Results From the Global Burden of Disease Study 2019

2021 ◽  
Vol 11 ◽  
Author(s):  
Shangbo Xu ◽  
Yiyuan Liu ◽  
Taofeng Zhang ◽  
Jiehua Zheng ◽  
Weixun Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Burden Of Disease ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Fasting Plasma ◽  
Life Years ◽  
High Fasting Plasma Glucose

BackgroundThe burden of breast cancer has been increasing globally. The epidemiology burden and trends need to be updated. This study aimed to update the burden and trends of breast cancer incidences, deaths, and disability-adjusted life-years (DALYs) from 1990 to 2019, using the Global Burden of Disease 2019 study.MethodsThe data of incidences, deaths, DALYs, and age-standardized rates were extracted. Estimated annual percentage changes were used to quantify the trends of age-standardized rates. Besides, the population attributable fractions of the risk factors of breast cancer were also estimated.ResultsGlobally, the incidences of breast cancer increased to 2,002,354 in 2019. High social-development index (SDI) quintiles had the highest incidence cases with a declining trend in age-standardized incidence rate. In 2019, the global deaths and DALYs of breast cancer increased to 700,660 and 20,625,313, respectively. From 1990 to 2019, the age-standardized mortality rates and age-standardized DALY rates declined globally, especially in high and high-middle SDI quintiles. Besides, the trends varied from different regions and countries. The proportion of the patients in the 70+ years age group increased globally. Deaths of breast cancer attributable to high fasting plasma glucose and high body mass index increased globally, and high fasting plasma glucose was the greatest contributor to the global breast cancer deaths.ConclusionThe burden of breast cancer in higher SDI quintiles had gone down while the burden was still on the rise in lower SDI quintiles. It is necessary to appeal to the public to decrease the exposure of the risk factors.

Global Burden and Attributable Risk Factors of Acute Lymphoblastic Leukemia in 204 Countries and Territories from 1990-2019: Estimation Based on Global Burden of Disease Study 2019

2021 ◽  
Author(s):  
Yuefen Hu ◽  
Xiuping Zhang ◽  
Aijun Zhang ◽  
Yu Hou ◽  
Yang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Acute Lymphoblastic Leukemia ◽  
Body Mass ◽  
Burden Of Disease ◽  
Lymphoblastic Leukemia ◽  
High Body Mass Index ◽  
Attributable Risk ◽  
Global Burden ◽  
Disease Study

Abstract Purpose: To provide a foundational guideline for policy-makers to efficiently allocate medical resources in the context of population aging and growth, a latest spatial distribution and temporal trend of acute lymphoblastic leukemia (ALL) along with attributable risk factors by sex and age were mapped.Methods: Based on the Global Burden of Disease Study 2019, we calculated the estimated annual percentage change (EAPC) values to quantify temporal trends in morbidity and mortality of ALL. We used applied Spearman rank correlation to estimate the relationship between the EAPC and potential influence factors. The population attributable fraction of potential risk factors for ALL-related disability-adjusted life years (DALYs) were estimated by the comparative risk assessment framework. Results: We found that new ALL cases increased significantly by 129% worldwide, and the age-standardized incidence rate (ASIR) increased by 1.61 percent per year. The proportion of elder patients sharply increased, especially within the higher socio-demographic index (SDI) region. Smoking and high body mass index remained the predominant risk factors for ALL-related mortality. Notably, the contribution of high body mass index presented an increasing trend. Conclusion: The global burden of ALL has steadily increased, especially in middle SDI region. Health measures should be taken into consideration to improve the treatment of elders with ALL due to a great proportion in the higher SDI region. Attention should be paid to the environmental problems caused by industrial development in low SDI areas.

scholarly journals Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017

BMJ ◽  
2020 ◽  
pp. m234 ◽  
Author(s):  
Xiaochen Li ◽  
Xiaopei Cao ◽  
Mingzhou Guo ◽  
Min Xie ◽  
Xiansheng Liu
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Burden Of Disease ◽  
Respiratory Diseases ◽  
High Body Mass Index ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Chronic Respiratory Diseases ◽  
Life Years ◽  
Disease Study

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.

scholarly journals Mammogram history in Nigerian women: Age-related risk factors for breast cancer and educational implications

2018 ◽  
Vol 2 ◽  
Author(s):  
Eric O. Umeh ◽  
Kanayo F. Umeh ◽  
Uzoamaka R. Ebubedike ◽  
Chiamaka F. Ezeugbor ◽  
Chukwuziem N. Anene
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Mammography Screening ◽  
Public Awareness ◽  
Sub Saharan Africa ◽  
Chronological Age ◽  
Nigerian Women ◽  
Awareness Campaigns ◽  
Age Related ◽  
Related Risk

Background: Breast cancer accounts for 25% of diagnosed cancers and 20% of cancer-related mortality in women from sub-Saharan Africa. Given the early onset of breast cancer in African women, there is a need to better understand how age-related risk factors contribute to mammography uptake in this population.Aim: To identify age-related risk factors for breast cancer associated with previous uptake of mammograms in asymptomatic Nigerian women and consider implications for health education campaigns.Method: Participants comprised 544 asymptomatic Nigerian women (aged 28–75 years) responding to breast cancer public awareness campaigns, by presenting for baseline or screening mammography at a local hospital. Information about mammography history and age-related risk factors (menarche, menopausal and chronological age) were obtained by interviewing the participants face-to-face, before proceeding with mammography. Hierarchical logistic regression was used to estimate the odds of previous mammograms based on the age-related risk factors.Results: The likelihood of previous mammography screening increased by a factor of 1.07 (95% confidence interval [CI]: 1.00–1.14) for every year older chronologically and decreased by a factor of 1.12 (95% CI: 1.24–1.01) for every year older at menarche. Age at menarche partly mediated the relationship between chronological age and mammography history (effect = –0.01, 95% CI: –0.01, –0.00). Women with a history of breast cancer were 6.11 times more likely to have previously undertaken mammography screening (95% CI: 2.49–14.97). Age at menopause and age at first confinement were unrelated to mammography history.Conclusions: Nigerian women may recognise the need for mammograms because of adverse age-related risk factors for breast cancer, notably menarche and chronological age. However, awareness of menopausal age as a risk factor and basis for mammography screening may be deficient. It is therefore recommended that public awareness campaigns should emphasise the importance of older menopausal age in breast cancer risk and as a basis for requesting mammograms.

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