Spatial distribution of breast cancer in Sudan 2010-2016

Abstract

Background: Breast cancer is the most prevalent cancer among females worldwide including Sudan. The aim of this study was to determine the spatial distribution of breast cancer in Sudan.

Materials and methods: A facility based cross-sectional study was implemented in eighteen histopathology laboratories distributed in the three localities of Khartoum State on a sample of 4630 Breast Cancer cases diagnosed during the period 2010-2016. A master database was developed through Epi InfoTM 7.1.5.2 for computerizing the data collected: the facility name, type (public or private), and its geo-location (latitude and longitude). Personal data on patients were extracted from their respective medical records (name, age, marital status, ethnic group, state, locality, administrative unit, permanent address and phone number, histopathology diagnosis). The data was summarized through SPSS to generate frequency tables for estimating prevalence and the geographical information system (ArcGIS 10.3) was used to generate the epidemiological distribution maps. ArcGIS 10.3 spatial analysis features were used to develop risk maps based on the kriging method.

Results: Breast cancer prevalence was 3.9 cases per 100,000 female populations. Of the 4423 cases of breast cancer, invasive breast carcinoma of no special type (NST) was the most frequent (79.5%, 3517/4423) histopathological diagnosis. The spatial analysis indicated as high risk areas for breast cancer in Sudan the States of Nile River, Northern, Red Sea, White Nile, Northern and Southern Kordofan.

Conclusions: The attempt to develop a predictive map of breast cancer in Sudan revealed three levels of risk areas (risk, intermediate and high risk areas); regardless the risk level, appropriate preventive and curative health interventions with full support from decision makers are urgently needed.

Fig 1. Geographical distribution of the histopathology laboratories.

The geographical information system ArcGIS 10.3 for Desktop version 10.3.0.4322 was used to generate “Fig 1”. Sudan administrative divisions were downloaded from http://www.maplibrary.org/library/stacks/Africa/Sudan/index.htm, and uploaded in ARCGIS. All the administrative divisions of Sudan were first displayed as a layer. Then the limits of the layers corresponding to Sudan States were selected and saved. When the map was elaborated, the features of ArcGIS were used to convert the map into the figure. The capacity in geographical information system was introduced from 2015 in the University of Medical Sciences and Technology, Khartoum, Sudan by Dr. Mounkaila Noma [18].

Fig 2. Epidemiological distribution of Breast Cancer in female population in Sudan (n = 1135).

The geographical information system ArcGIS 10.3 for Desktop version 10.3.0.4322 was used to generate “Fig 2”. Sudan administrative divisions were downloaded from http://www.maplibrary.org/library/stacks/Africa/Sudan/index.htm, and uploaded in ARCGIS. All the administrative divisions of Sudan were first displayed as a layer. Then the limits of the layers corresponding to Sudan States were selected and saved. When the map was developed, the features of ArcGIS were used to convert the map into the figure. The capacity of the geographical information system was introduced from 2015 in the University of Medical Sciences and Technology, Khartoum, Sudan by Dr. Mounkaila Noma [18].

Fig 3. Breast Cancer risk map in Sudan (n = 1135).

The geographical information system ArcGIS 10.3 for Desktop version 10.3.0.4322 was used to generate “Fig 3”. Sudan administrative divisions were downloaded from http://www.maplibrary.org/library/stacks/Africa/Sudan/index.htm, and uploaded in ARCGIS. All the administrative divisions of Sudan were first displayed as a layer. Then the limits of the layers corresponding to Sudan States were selected and saved. When the map was elaborated, the features of ArcGIS were used to convert the map into the figure. The capacity of the geographical information system was introduced from 2015 in the University of Medical Sciences and Technology, Khartoum, Sudan by Dr. Mounkaila Noma [18].