In a groundbreaking study published in BMC Cancer, researchers have illuminated a concerning trend in the prevalence of breast cancer in Sierra Leone, shedding light on the persistent and widening disparities between sexes over the past two decades. Despite breast cancer being widely recognized as a predominantly female disease worldwide, especially in high-income regions, the landscape is considerably complex in low- and middle-income countries such as Sierra Leone. The study meticulously dissects sex-disaggregated data spanning from 2000 to 2019, revealing crucial nuances that could shape future health interventions and policy reform.

Breast cancer holds the unfortunate distinction of being the most frequently diagnosed cancer among women globally, yet the burden of this disease is increasingly felt in sub-Saharan Africa, where healthcare infrastructure often lags behind the escalating needs. The research led by Osborne focuses on Sierra Leone, a country where epidemiological data on cancer have traditionally been sparse or aggregated, obscuring sex-specific prevalence patterns and the extent of inequality. This analysis breaks new ground by utilizing reliable, age-standardized datasets from the World Health Organization to provide a precise and comparative view of breast cancer trends disaggregated by sex.

Between 2000 and 2019, the age-standardized prevalence of breast cancer in Sierra Leone escalated notably from 52.4 to 78.3 cases per 100,000 population. These figures highlight a gradual yet significant upward trajectory in breast cancer diagnoses, underlining growing public health challenges in managing this cancer. Notably, while female breast cancer prevalence showed a marked increase, male breast cancer rates remained persistently low, though not negligible, suggesting divergent epidemiological patterns and potential under-recognition or underreporting in males.

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Females in Sierra Leone experienced an alarming rise in breast cancer prevalence—from 102.7 cases per 100,000 in 2000, with confidence intervals indicating robust data reliability, to 157.9 cases per 100,000 in 2019. This sharp increase of over 50% within two decades mandates urgent attention to screening capabilities, diagnostic accuracy, and treatment accessibility. These findings expose critical gaps in healthcare delivery, where delayed diagnosis and limited therapeutic options may exacerbate survival outcomes for many women.

In contrast, males exhibited stable prevalence figures across the years, with rates fluctuating minimally around 0.7 to 0.8 cases per 100,000 population. Although the prevalence in males is comparatively low, the study’s focused approach underscores the importance of not overlooking male breast cancer, which, despite being rare, carries significant clinical and psychosocial impacts. Moreover, the data firm up a foundation for understanding sex disparities in the Sierra Leonean context, which are more pronounced than previously realized.

Quantifying disparities between sexes, the researchers applied several rigorous inequality measures. The absolute difference in breast cancer prevalence between females and males widened from 102.0 per 100,000 in 2000 to 157.1 per 100,000 in 2019. This metric starkly illustrates the gender gap in disease burden and signals how the female population bears a disproportionate health strain, necessitating targeted interventions tailored to women’s unique risk profiles and healthcare needs.

Moreover, the study reported an increase in the prevalence ratio of females to males from 143.5 to 198.1 over the study period. This nearly twofold female predominance cements the understanding that breast cancer remains a predominantly female disease in Sierra Leone but also emphasizes how the relative risk for women is escalating compared to men. This ratio offers actionable insight for healthcare planners aiming to design equitable resource allocation frameworks.

The implications of these findings extend beyond mere epidemiological documentation. They call for urgent reinforcement and expansion of national cancer registries, which are pivotal for accurate surveillance, timely detection, and evidence-based policy formulation. Currently, data limitations and infrastructural weaknesses hinder comprehensive cancer control strategies in Sierra Leone, leaving many patients undiagnosed or inadequately treated.

Additionally, the study highlights the pressing need to improve access to early detection services for breast cancer. Early-stage diagnosis is critical in improving survival rates but remains hampered by infrastructural deficits, socioeconomic barriers, and low public awareness. Expanding screening programs, especially in rural and underserved areas, alongside educational campaigns, could substantially shift disease trajectories toward better outcomes.

The hurdles to equitable healthcare exist at multiple levels, from systemic deficiencies such as scarce oncology specialists and limited diagnostic imaging, to cultural factors that may delay the seeking of care, particularly among women. Addressing these structural barriers must be integral to breast cancer control efforts, ensuring that health systems are responsive, resilient, and accessible regardless of gender or socioeconomic status.

This comprehensive analysis does not only uncover the growing breast cancer burden among women in Sierra Leone but also advocates for an inclusive, gender-sensitive lens in future research and management approaches. Such an approach recognizes that while men are less frequently affected, their experiences and needs warrant recognition in the healthcare ecosystem.

Future investigations should build upon this foundational study by incorporating risk factor analysis, including genetic, environmental, and lifestyle components, to further elucidate drivers behind the observed trends. Investigative efforts into healthcare-seeking behaviors and treatment adherence could also provide valuable data to inform culturally-appropriate interventions.

At an international level, this work adds to the growing body of evidence emphasizing the urgent need to bolster non-communicable disease frameworks within the global health agenda, especially in sub-Saharan Africa. Investments aimed at capacity building, infrastructure development, and collaborative research partnerships will be pivotal in bridging the gaps unveiled by this study.

In summary, the sex-disaggregated analysis of breast cancer prevalence in Sierra Leone from 2000 to 2019 reveals an increasing disease burden predominantly affecting women, with disparities between sexes widening over time. This trend underscores the critical need for enhanced cancer registries, early detection programs, improved treatment access, and removal of systemic barriers to healthcare. The findings serve as a clarion call for policymakers, healthcare providers, and researchers to unite in combating the rising tide of breast cancer through tailored, equitable, and sustainable approaches.

Ensuring that breast cancer control strategies are informed by robust, sex-specific data is paramount to safeguarding the health of populations in Sierra Leone and beyond. As this study poignantly illustrates, the future of cancer care lies in meticulous surveillance, gender-informed policies, and relentless advocacy for health equity.

Subject of Research: Breast cancer prevalence and sex-based disparities in Sierra Leone

Article Title: Sex-disaggregated analysis of breast cancer prevalence in Sierra Leone

Article References:
Osborne, A. Sex-disaggregated analysis of breast cancer prevalence in Sierra Leone.
BMC Cancer 25, 1022 (2025). https://doi.org/10.1186/s12885-025-14403-6

Image Credits: Scienmag.com

DOI: https://doi.org/10.1186/s12885-025-14403-6

Tags: addressing healthcare inequalitiesbreast cancer prevalence Sierra Leonebreast cancer trends 2000-2019cancer epidemiology in sub-Saharan Africaepidemiological data on breast cancerhealth disparities in cancerlow-income country health challengespublic health policy reformsex differences in breast cancersex-disaggregated cancer datawomen’s health in Sierra LeoneWorld Health Organization cancer statistics