Nigeria's 6-year (2018-2023) stage distribution of breast cancer at diagnosis: a systematic review and meta-analysis.

BACKGROUND

Nigeria has implemented various interventions to reduce late-stage breast cancer (BC) diagnosis in recent decades. This meta-analysis assessed the impact of these efforts by examining recent BC stage distribution data.

METHODS

A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines was conducted. PubMed was searched for studies on BC in Nigeria from 2018 to 2023 and additional articles were identified through hand searching and snowballing in African Journal Online, Google Scholar and ResearchGate. Data on patient demographics, time to diagnosis at tertiary center and stage distribution were extracted and meta-analyzed using a random-effects model. A simple comparison with historical data of 2000-2018 was conducted.

RESULTS

Eleven articles reported the stage distribution of 1,647 BC patients. Overall analysis of the recent stage distribution showed a slight decrease in stages I, II and IV and an increase in stage III. However, these changes were accompanied by wider confidence intervals: 6% 95% confidence intervals (95% CI 0-15), 17% (6%-29%), 56 (95% CI 38-68) and 21 (9-34) were stages I-IV, respectively, compared to 8% (95% CI 3-13), 21% (14%-28%), 44 (95% CI 33-51) and 29 (21-37) in the historical data. The sensitivity analysis, using a two-stage classification as ('early' or 'late' disease), strongly indicated a trend towards more advanced-stage (82% CI 79-85) disease in the recent analysis.

CONCLUSION

Advanced-stage BC remains prevalent in Nigeria. A comprehensive evaluation of current BC control strategies is needed to identify barriers and develop effective interventions for early diagnosis and treatment.