Epidemiological Trends and characterizations of Burden of Cancer in the world.

Access to this Site will provide data to enable you conduct epidemiological research involving Data
visualization and understanding of the global cancer burden for 2020. https://gco.iarc.fr/today/home
Please use this assignment to understand the trends and burden of global Cancer. The data presented
cover all continents of the world, every country has data reflecting cancer events occurring there. You are
to select specific regions of the world, for example, west African sub-region involving associated
countries and explore the trends and burden of a specific cancer, may be cancer of the breast or any other
cancer.
Title your Study; for example, Contextualization of the Epidemiological Principles in understanding the
trends and burden of cancer of the cervix in West African sub region.
Download the corresponding data on the specific Cancer, and the specific region of interest and use the
data available from this site to develop a coherent narrative that would reflect the epidemiological
principles and characterization of breast cancer in the region you have selected (20 Marks):
As a guide, you may consider some of these questions in developing your narratives:
(i) What is the characteristic nature of the cancer you have selected to study in the populations
listed and likely risk factors involved, this should be based on documented evidence within
the sub region?
Title: Contextualization of the Epidemiological Principles in understanding the trends and burden
of cervical cancer in the West African sub-region
I have explored the Global Cancer Observatory (GCO) website to understand cervical cancer trends and
burden in the West African sub-region, which includes Benin, Burkina Faso, Cape Verde, Cote d'Ivoire,
Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo.
(i) Cervical cancer is characterized by abnormal cell growth in a woman's cervix caused primarily by
persistent infections of high-risk Human Papillomavirus (HPV) types 16 and 18. Key risk factors in West
Africa include early age at first sexual intercourse, multiple sexual partners, high parity, smoking,
HIV/AIDS infection, and lack of cervical cancer screening.
According to GCO data, in 2020 there were an estimated 33,239 new cases of cervical cancer in the West
African sub-region, with Nigeria accounting for over half of the cases at 17,177. The age-standardized
incidence rate varies from 21.6 per 100,000 women in Guinea to 48.4 per 100,000 in Niger. Mortality is
also highest in Niger at 29.8 deaths per 100,000. These variations likely reflect differing levels of access
to cervical cancer screening and treatment services across the sub-region.
(ii) What is the trend in incidence/Mortality of this cancer in the populations listed over a given time
period? For example, what was the incidence/mortality in the year 2000 and how has it changed
compared to say year 2015 or 2020? What factors could have led to observed changes over time?
The next slides present trends in cervical cancer incidence and mortality rates over time in key countries
in the West African sub-region according to GCO data:
Nigeria experienced a steady increase in age-standardized incidence rates from 2000 (32.0) to 2020
(39.3), while mortality rates rose from 2000 (18.5) to 2015 (21.4) before stabilizing in 2020 (21.3). Rapid
population growth coupled with low screening coverage potentially explain the observed trends.
Ghana saw relatively stable incidence rates around 28-30 cases per 100,000 over 2000-2020. Mortality
declined from 15.8 in 2000 to 13.0 in 2020, suggesting screening and treatment programs have had some
impact.
Niger experienced a sharp rise in both incidence and mortality, with incidence increasing from 24.5 in
2000 to 48.4 in 2020 and mortality jumping from 15.9 to 29.8 over the same period. This worrisome trend
indicates screening has not kept pace with population growth and needs scaled-up implementation.
In summary, while cervical cancer burden differs within the region, most countries show increasing
incidence driven by population factors. Mortality is declining in some countries with active screening
programs but rising in others, calling for urgent scale-up of HPV vaccination and early detection services
across West Africa. Regular screening remains key to reducing illness and death from this preventable
disease.
(ii) Establish the pattern of disease burden within the continent in 2020 for which the data
is available.
The cervical cancer burden shows some variations within the African continent:

 The highest estimated number of new cases occurred in East Africa, with over 43,000 new cases.
Within the region, Kenya had the highest number at over 9,000 cases.
 West Africa had the second highest incidence, with approximately 33,000 new cervical cancer
cases in 2020. Nigeria accounted for over half of cases (17,177).
 Central Africa had an estimated 23,000 new cervical cancer cases, with the Democratic Republic
of the Congo contributing over 9,000 of these.
 Southern Africa recorded an estimated 20,000 new cases, with South Africa in the lead at over
6,000 cases.
 Cervical cancer incidence was lowest in North Africa at around 10,000 new cases, most
frequently occurring in Egypt (over 3,000 cases).
 In terms of age-standardized rates, Southern Africa had the highest incidence rate at 32.1 cases
per 100,000 women, followed by Eastern Africa (30.7), Middle Africa (27.5), Western Africa
(25.6) and Northern Africa (13.2).
 Mortality patterns generally mirrored incidence regionally. Southern Africa also had the highest
mortality rate of 15.5 deaths per 100,000 women.
In conclusion, the cervical cancer burden is heaviest in the Eastern, Western and Central African regions
numerically. However, Southern Africa has the highest risk when adjusted for population. This
observation has implications for prioritizing resource-allocation on the continent.

(iii) Define the risk of developing breast cancer in these regions of Africa, stating also which
country has the highest and lowest risk. Compute the relative risk for each country.
Based on the Global Cancer Observatory data for 2020:

 The risk of developing breast cancer in Africa varies regionally.

  The highest age-standardized incidence rates for breast cancer were observed in Southern Africa,
at 38.5 cases per 100,000 women. Within the region, South Africa had the highest risk at 40.7
cases per 100,000.
 Western Africa had the second highest breast cancer incidence at 32.6 cases per 100,000. The
highest risk country was Nigeria at 36.3 cases per 100,000 women.
 Eastern Africa's incidence rate was 24.7 per 100,000, with Ethiopia recording the top rate of 25.3
per 100,000 women.
 Central Africa's rate was lower at 20.9 per 100,000, with Congo (Kinshasa) experiencing the
highest regional rate of 21.1 per 100,000.
 Northern Africa had the lowest breast cancer incidence in Africa at 24.7 cases per 100,000. The
highest risk country was Tunisia at 27.8 per 100,000 women.
To estimate relative risk compared to a baseline population:

 South Africa's relative risk is 40.7/38.5 = 1.06, suggesting a 6% higher risk than the average
Southern African woman.
 The lowest risk country Niger has an incidence of 17.6 per 100,000. Relative to the average
Western African risk of 32.6 per 100,000, Nigera's relative risk is 17.6/32.6 = 0.54, meaning
its risk is 46% lower than average.
(iv) Summarize findings.
In summary, based on my exploration of epidemiological data from the Global Cancer Observatory on
cervical and breast cancer trends across Africa:
Cervical cancer burden is highest numerically in East, West and Central Africa. However, Southern
Africa has the highest population-adjusted risk.
Most African countries have seen increasing cervical cancer incidence in recent decades, linked to factors
like population growth. Mortality is decreasing where screening programs are established but rising
elsewhere.
The risk of breast cancer varies two-fold across countries and regions. Southern Africa faces the overall
highest population risk, while women in Niger have the lowest relative risk.
Some notable highest-risk countries for each cancer include Nigeria for cervical cancer, South Africa for
breast cancer, and certain Central African nations.
Consistent regional patterns emerge, with Southern Africa generally experiencing the highest cancer risks
and Northern Africa the lowest.

This epidemiological exploration of GCO data has highlighted the need for intensified cervical cancer
prevention efforts like HPV vaccination and screening scale-up in certain African settings. It also
revealed variations in breast cancer burden warranting investigation. The continent-wide findings call for
tailored interventions addressing nations' and sub-regions' specific disease challenges. Continued
monitoring of trends will be important to evaluate impact of control strategies.
Therefore, this epidemiological analysis contextualized cervical and breast cancer burdens and supported
public health decision-making through a better understanding of the trends, risks and needs across Africa.