The Landscape of Randomised Controlled Trials of Therapies in Breast Cancer in Low and Middle Income Countries

Abstract

Objectives. The objectives of this study were to identify the randomised controlled trials in breast cancer occurring in low and middle income countries (LMICs) generally and within Sub-Saharan Africa specifically, to describe the current status and identify opportunities for further research in these areas. Materials and Methods. Data for this study were obtained from ClinicalTrials.gov. The search term "Breast Cancer Research" was used, and relevant information extracted and analysed. Results. 2414 trials were identified, of which 1099 were eligible for inclusion. 69 of these trials occurred in LMICs. Of the 52 LMICs globally, 30% were participating in breast cancer research. Of the 17 LMICs in Africa, 77% are situated in Sub-Saharan Africa; 23% were participating in breast cancer research, which accounted for 9% of total Sub-Saharan African studies. Conclusion. This study provides current evidence for the need for breast cancer research in LMICs globally and within Sub-Saharan Africa. Within LMIC regions where research is active, the type and numbers of studies are unevenly distributed. High quality research within such areas should be encouraged as the results may have both local and global applications, particularly in the provision of affordable health care.

Figure 1

Global breast cancer incidence and mortality in women in 2012. Estimated age-standardised rates for breast cancer incidence (blue bar) and mortality (red bar) in females are shown for global regions, high income regions, low income regions, and the world. Reproduced with permission from Abenaa M Brewster, Mariana Chavez-MacGregor, and Powel Brown. ∗ includes all regions of Europe, Northern America, Australia, New Zealand, and Japan. † includes all regions of Africa, Asia (excluding Japan), Latin America, the Caribbean, and Federated States of Micronesia.

Figure 2

Global cancer statistics regarding the estimated percentage of patients with access to radiotherapy, 2012. Reproduced with permission from Volume 65, Issue 2, pages 87–108, 4 FEB 2015. ∗ refers to countries where 100% of the population can access radiotherapy or countries where radiotherapy is greater in supply than demand, despite possible regional differences in access to radiotherapy within the country. Source: The Cancer Atlas, second edition, as obtained from the International Atomic Energy Agency.