70 percent will be from developing countries where there is least control and preparedness to harness the growing cancer burden. On May 10 – 11, 2007, cancer specialists, meeting in London, drafted the "London Declaration on Cancer Control in Africa" as a means to emphasise the need for a re-focus on cancer control in Africa, which has been redundant as a result of emphasis on infectious diseases.
Among all cancers, breast cancer is a bigger concern because of its prevalence as a leading cause of cancer death in women. Its risk factors are not well understood. Previous breast cancer studies point to many risk factors, rather than one dominant controllable cause. Such factors include geographical location (country of residence with associated lifestyle), gender (women are at a higher risk), family history of breast cancer (genetic risk), smoking at early age, and many others.
The only established risk factor is genetic predisposition (familial risk). However, only 5 percent of the breast cancer burden at the population level is attributed to familial risk. Thus, 95 percent of breast cancer cases are due to other risk factors.
Despite more than a decade-long research on breast cancer, 70 percent of women diagnosed with the disease have none of the risk factors with exception of advancing age. In other words, knowing that you have no risk factors could induce a false sense of invincibility while knowledge of exposure to several risks can create undue cancer phobia. Cameroon, like other African countries, has no national cancer registry to harness statistics of breast cancer.
However, the government, in an effort to curb its rising prevalence, has put in place "The National Committee for the Fight against Cancer" which carries out yearly campaigns against gynaecological (ovarian and breast) cancers in Douala and Yaoundé. Data from such campaigns have revealed that breast cancer is a leading cancer among women.
Similar to other cancers, it has a long latency period (The interval between exposure to a carcinogen and the clinical appearance of disease).
This has led to numerous delayed case diagnoses, resulting in low survival rates. Early detection therefore, has been prescribed as the "best protection" due to the fact that a woman who detects breast abnormality and promptly consults a physician is more likely to gain from early treatment, consequently increasing her chances of survival.
In Cameroon, where screening methods such as regular mammography, ultra-sonography and magnetic resonance imaging are scarce or relatively expensive when available, regular breast self-examination may be the best option. Women should be encouraged to do regular breast self-examination by massaging, to detect lumps and any abnormalities.
Pre-menopausal women and particularly pregnant women tend to have higher breast density, which may obscure any small tumour growths. Breast self-examination is highly recommended for post-menopausal women whose increased age puts them at a higher risk of breast cancer development.
Examination of the breast is reportedly more effectively executed through illustrations and trainings by a physician or other trained health practitioners. However, at a community level, concerted efforts by the media and local health departments (NGOs) may be a better educational tool to reach women.
It is worthy to note that not every growth (lump) in the breast will result into cancer. This notwithstanding, women are encouraged to carry out breast self-examination on a monthly basis and promptly report any abnormality to a physician.
PhD student (Cancer Epidemiology)
Tampere School of Public Health
University of Tampere, Finland