Five-Year Survival Outcomes for Breast Cancer Patients Across Continental Africa: A Contemporary Review of Literature with Meta Analysis
Abstract
Background
Breast cancer associated mortality in Africa remains high due to poor survival rates, varying widely across countries. Despite medical advancements, barriers like limited access to early detection and treatment persist. This meta-analysis offers a crucial update on 5-year survival trends and influencing factors across continental Africa.
Methods
A systematic search of four biomedical databases and citation searching identified 79 articles from 22 African countries, analyzing 27,559 patients (97% female). A random-effects model was used to estimate the 5-year survival rate with subgroup analyses. Publication bias was assessed using Egger’s test and funnel plots.
Results
Pooled overall 5-year breast cancer survival in Africa averaged 48% (95% CI: 43-53%) with high statistical heterogeneity (I² = 98%). Survival was highest in Northern Africa (64%; 95% CI: 59-69%) and lowest in Western Africa (32%; 95% CI: 23-42%). Males (51%; 95% CI: 36-65%) had marginally higher survival than females (48%; 95% CI: 42-54%). Socioeconomic indices were positively associated with better outcomes. Publication bias, adjusted by the trim-and-fill method, raised survival to 62% (95% CI: 55-67%). A country-wise comparison with 2018 estimates suggests a declining survival tendency, with WHO AFRO countries reporting the poorest estimates among other WHO regions. Despite regional differences, survival trends seem to have plateaued near 48-49% level continent-wide since the early 2010s.
Conclusions
Our findings reveal marked regional disparities in survival rates across Africa, underscoring the urgent need for targeted healthcare interventions. Strengthening healthcare systems, ensuring universal access, and driving socioeconomic progress are vital to improving survival outcomes.
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