Understanding the High Incidence of Premenopausal Breast Cancer in Africa: Genetic, Environmental, and Healthcare Factors.

Understanding the High Incidence of Premenopausal Breast Cancer in Africa: Genetic, Environmental, and Healthcare Factors.

Clement Ogar Elam , Praise Oluwatobi Ogunleke, Sodiq Idowu Abdusalam, Toluwase Oluwajomiloju OGUNDIPE, Ifeoluwatoyosi Abigail Adeniran, Olusegun Franklin Arobo
Department of Medicine and Surgery, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria; College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Ogbomoso, Nigeria; Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria., Ile-Ife, Nigeria; College of Health Sciences, Bowen University, Iwo, Osun state, Nigeria, Ile-Ife, Nigeria

Introduction and Background
Breast cancer poses a critical health burden in Africa, with 45–50% of cases occurring in premenopausal women versus 10–15% in high-income nations. Disparities arise from genetic susceptibility, environmental exposures, and systemic healthcare gaps. Late-stage diagnoses (75–80% at stages III/IV), aggressive subtypes (27% triple-negative), and survival rates of 20–40% underscore urgent needs for tailored interventions.
Aims and Objectives
This narrative review synthesizes 77 studies to explore genetic, environmental, and healthcare factors driving premenopausal breast cancer in Africa, aiming to guide policy and clinical strategies.
Methods
Peer-reviewed articles, registries, and reports (1990–2024) were analyzed. Inclusion criteria focused on genetic risks (e.g., BRCA1/2), environmental/lifestyle factors (diet, pollution), and healthcare barriers (screening access, infrastructure). Data from African populations were prioritized.
Results
Genetic factors: BRCA1/2 mutations accounted for 5–10% of cases; 12–25% of early-onset cancers were hereditary. Familial history doubled risk.
Environmental factors: Urbanization, Westernized diets, obesity, pesticide exposure, and reproductive shifts (early menarche, delayed childbirth) increased risks.
Healthcare factors: Over 60% of African nations lacked organized screening. Limited mammography, low awareness, and socioeconomic delays led to advanced diagnoses. Survival rates lagged 40–60% behind high-income countries.
Conclusions and Recommendations
Multifactorial drivers necessitate integrated solutions: scaling genetic testing, deploying mobile screening (e.g., iBreastExam), and community education to combat stigma. Policymakers must fund cancer registries, train healthcare workers, and ensure therapy access. Aligning with the WHO’s Global Breast Cancer Initiative, international collaborations can reduce mortality by 2.5% annually. Holistic, context-specific strategies addressing Africa’s sociocultural and infrastructural challenges are vital to mitigate disparities.

Keywords: Premenopausal breast cancer, Africa, Genetic predisposition, Triple-negative breast cancer (TNBC), Environmental risk factors, Healthcare disparities, Socioeconomic determinants, Community education, Policy interventions