St. George’s University has called for a risk-informed equitable approach to breast cancer screening in Africa.
In a statement it says across Africa breast cancer is the most diagnosed cancer among women and the leading cause of cancer-related deaths.
According to the International Agency for Research on Cancer’s GLOBACAN 2024 estimates published in 2026 Africa recorded 225643 new breast cancer cases and an estimated 100070 deaths in 2024. These figures underscore the importance of raising awareness recognising symptoms early and improving access to timely diagnosis and treatment.
The median age of diagnosis among African women with breast cancer varies across countries and populations. A 2025 study of women diagnosed with breast cancer across five sub-Saharan African countries found that 21.9 per cent of participants were diagnosed before age 40.
These findings underscore the importance of breast awareness timely symptom evaluation clinical examination and individual risk assessment.
The World Health Organisation(WHO) recommends early diagnosis and timely evaluation of women with breast cancer symptoms while screening recommendations should consider individual risk and available resources. ‘Breast cancer risk does not suddenly begin at a particular birthday and two women of the same age may have very different risk profiles’ said Dr. Tonia Frame the Assistant Professor and Director Global Health Unit Department of Public Health and Preventive Medicine at St. George’s University Grenada West Indies.
‘Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes. In Africa where breast cancer often presents at a comparatively younger age and access to high-quality imaging is uneven discussions about early detection should extend beyond age alone. Family history inherited susceptibility previous breast findings and other recognized risk factors can help determine whether a woman may benefit from earlier assessment specialist referral or additional imaging.’
Why individual risk matters is that a risk-informed approach should consider several factors such as family history genetic factors breast density and previous breats findings.
Access to breast assessment imaging and specialist interpretation remains highly unequal across sub-Saharan Africa. A 2026 systematic review and meta-analysis found that only 13% of women had ever undergone a clinical breast examination with uptake varying according to education household wealth health insurance coverage and contact with healthcare services. The region also faces significant gaps in diagnostic capacity.
According to the WHO Regional Office for Africa limited diagnostic infrastructure and shortages of specialized healthcare personnel contribute to late diagnosis and poor outcomes. These challenges reinforce the need to expand access to breast assessment diagnostic imaging pathology services and trained specialists particularly in underserved communities.
Addressing these inequalities requires more than awareness campaigns. Priorities include strengthening clinical breast examination and referral pathways training frontline health workers expanding access to diagnostic imaging and pathology ensuring timely follow-up after abnormal findings and monitoring outcomes across socioeconomic and geographic groups.
Artificial intelligence (AI) is being evaluated as a potential support for breast cancer detection in settings where imaging capacity and specialist availability are limited. Depending on the technology and clinical context AI may assist with triage image interpretation workflow prioritization or risk estimation. Its clinical value depends on appropriate validation reliable referral pathways diagnostic confirmation quality assurance and ongoing monitoring for unequal performance across population groups.
‘Integrating community health workers portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic financial or health-system barriers’ said Dr. Tonia Frame. ‘The most important feature is not the algorithm alone but the complete pathway linking awareness initial assessment referral diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history risk factors examination findings and appropriate diagnostic imaging.’
For women a more personalized approach does not mean performing more tests in every case. It means identifying those who may benefit from earlier more frequent or different forms of assessment while avoiding unnecessary imaging and procedures among women unlikely to benefit.
Breast Cancer Awareness Month is an opportunity to advocate for equitable care pathways from risk assessment and early detection to diagnosis and timely treatment. Across Africa a key challenge is ensuring every woman with a concerning symptom or abnormal finding receives appropriate assessment diagnostic confirmation and treatment without avoidable delays.
Preparing future physicians for evolving healthcare needs is central to medical and public health education at St. George’s University School of Medicine. Through a diverse international learning environment and clinical exposure students develop the medical knowledge clinical skills and professional competencies needed to care for diverse patient populations.