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撒哈拉以南非洲的乳腺癌:现状与不确定的未来。

Breast cancer in sub-Saharan Africa: The current state and uncertain future.

机构信息

Department of Biochemistry, Cell and Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens, 58835University of Ghana, Accra, GH 00233, Ghana.

出版信息

Exp Biol Med (Maywood). 2021 Jun;246(12):1377-1387. doi: 10.1177/15353702211006047. Epub 2021 Apr 29.

Abstract

Breast cancer is the commonest cause of global cancer-related deaths in women and a public health burden in sub-Saharan Africa (SSA). Although the disease incidence in SSA seems lower, mortality rates are disproportionately high in comparison to high-income countries. The global disease burden is growing, with SSA reporting the majority of cases; however, the dearth of information results in insufficient data which is barely representative of the actual disease burden in this population. Future incidence predictions assign the subregion with a majority of the cases and associated deaths. Breast cancer presents with racial and ethnic variations, and available evidence suggests geographical diversity and persistent risk factors that have barely been explored in SSA. Breast cancer is a complex genetic disease, but the genetic risk factors in the extant African population, which is the most genetically diverse population, is scant and of low quality. This review focuses on the burden, prevalence, detection, treatment, survival, biology, as well as risk factors, and reinforces the need for breast cancer-associated risk factor investigation and population-specific studies in SSA.

摘要

乳腺癌是全球女性癌症相关死亡的最常见原因,也是撒哈拉以南非洲(SSA)的公共卫生负担。尽管 SSA 的疾病发病率似乎较低,但与高收入国家相比,死亡率不成比例地高。全球疾病负担正在增加,SSA 报告了大多数病例;然而,信息的缺乏导致数据不足,几乎无法代表该人群的实际疾病负担。未来的发病预测将该亚区域指定为大多数病例和相关死亡的来源。乳腺癌存在种族和民族差异,现有证据表明存在地理多样性和持续存在的风险因素,但在 SSA 几乎没有得到探索。乳腺癌是一种复杂的遗传疾病,但在现存的非洲人群中,遗传风险因素很少且质量低,而非洲人群是遗传多样性最丰富的人群。本综述重点关注负担、流行率、检测、治疗、生存、生物学以及风险因素,并强调需要在 SSA 进行乳腺癌相关风险因素调查和针对特定人群的研究。

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