Breast cancer and its determinants in Ethiopia: a systematic review and meta-analysis

Abstract

Objectives: Breast cancer is the leading cause of cancer morbidity and mortality among women. Still, there is a paucity of studies to know the magnitude of the problem in Ethiopia. Hence, this review was intended to pool the prevalence and identify the determinants of breast cancer in Ethiopia.

Design: A systematic review and meta-analysis was conducted.

Data sources: Databases like PubMed/MEDLINE, HINARI, Science Direct, and Google Scholar, as well as websites of organisationsI organizations,rewere searched between 25 February and 6 March 2023.

Eligibility criteria: All observational studies in Ethiopia that reported either the magnitude and/or determinants of breast cancer regardless of publication status were included.

Data extraction and synthesis: Two authors independently assessed and extracted the data. The Joanna Briggs Institute meta-analysis of statistics assessment and review instrument quality appraisal tool was used to assess the quality of the articles. Effect estimates were done by using the random-effects model. The meta-analysis results were displayed by using forest plots.

Results: Seventeen articles were reviewed with 24 435 total participants. The pooled proportion of breast cancer morbidity among patients with cancer was 20. 58% (95% CI 17.25%, 23.90%) in Ethiopia. Consuming packed foods (POR=2.12, 95% CI 1.41, 3.17), presence of high cholesterol (POR=4.08; 95% CI 2.75, 6.07), physical inactivity (POR=3.27; 95% CI 1.80, 5.94), high body mass index (BMI) (POR=2.27; 95% CI 0.85, 6.03), postmenopause (POR=2.25; 95% CI 1.63, 3.10), family history of cancer (POR=3.65; 95% CI 0.85, 15.71) and lack of breastfeeding (POR=2.76; 95% CI 0.90, 7.92) were the determinants of breast cancer.

Conclusions: One of five patients with cancer is diagnosed with breast cancer in Ethiopia. Furthermore, more than a quarter of women with cancer suffer from breast cancer. Processed food consumption, high cholesterol in the body, lack of physical activity, high BMI, postmenopause, family history of cancer and lack of breastfeeding were the risk factors for breast cancer. The use of healthy food sources such as fruits and vegetables, and homegrown varieties of crops rather than seeking processed foods would help.

Prospero registration number: CRD42023417733.

Keywords: Chronic Disease; PUBLIC HEALTH; Primary Health Care; Risk Factors.

Figure 1. Flow chart of the selection of studies for the systematic review and meta-analysis of breast cancer and its determinants in Ethiopia.

Figure 2. Forest plot of the pooled proportion of breast cancer among patients with cancer in Ethiopia. Note: Weights are from the ramdom-effects model.

Figure 3. The pooled OR showing the association between menopausal status and breast cancer in Ethiopia.