Abstract
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.
Highlights
Breast cancer accounts for 25% of diagnosed cancers and 20% of cancer-related mortality in women from sub-Saharan Africa
The likelihood of previous mammography screening increased by a factor of 1.07 for every year older chronologically (OR = 1.07, 95% CI: 1.00–1.14) and decreased by a factor of 1.12 for every year older at menarche (OR = 0.89, 95% CI: 0.80–0.99)
The present findings suggest women of younger menarche age were motivated to request mammograms, presumably in response to the public awareness jingles, it is still necessary for health campaigns to address the patriarchal aspects of Nigerian society, where women are less able to take the initiative for their own health care.[22]
Summary
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. Breast cancer accounts for 25% of diagnosed cancers and 20% of cancer-related mortality amongst women in sub-Saharan Africa.[1] Data from the International Agency for Research on Cancer suggest about 100 000 breast cancer cases are diagnosed annually in the African region, with the largest number of country-specific cases diagnosed in Nigeria (circa 14 000) yearly.[2] While the breast cancer incidence and mortality rates remain highest in fully industrialised nations, rates are rapidly increasing in developing countries. Missing a mammogram can significantly increase the likelihood of being diagnosed with cancer at a later stage.[7] http://www.sajo.org.za
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