St. George’s University has called for a risk-informed and equitable approach to breast cancer screening across Africa, urging healthcare providers to consider individual risk factors, improve early diagnosis and expand access to diagnostic services.
The university said breast cancer remains the most diagnosed cancer among women across the continent and the leading cause of cancer-related deaths among women, highlighting the need for greater awareness, timely assessment and improved access to treatment.
According to estimates from the International Agency for Research on Cancer’s GLOBOCAN database, published in 2026, Africa recorded 225,643 new breast cancer cases and an estimated 100,070 deaths in 2024.
The figures underscore the importance of recognising symptoms early and ensuring that women can access appropriate clinical assessment and treatment without avoidable delays.
St. George’s University said breast cancer detection strategies should take into account differences in individual risk, the age at which women develop the disease and the availability of healthcare services across different communities.
Dr Tonia Frame, an assistant professor and director of the Global Health Unit in the Department of Public Health and Preventive Medicine at St. George’s University in Grenada, West Indies, said age alone should not determine how women are assessed for breast cancer risk.
“Breast cancer risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles,” Frame said.
She urged women to become familiar with the usual appearance and feel of their breasts and seek prompt medical assessment when they notice unexplained changes.
Younger Women Also Face Breast Cancer Risk
The university cited a 2025 study involving women diagnosed with breast cancer across five sub-Saharan African countries, which found that 21.9 per cent of participants were diagnosed before the age of 40.
The findings highlight the importance of breast awareness, timely evaluation of symptoms, clinical examination and individual risk assessment.
Frame said discussions about early detection in Africa should extend beyond age, particularly because breast cancer can occur in younger women and access to high-quality diagnostic imaging remains uneven.
She identified family history, inherited susceptibility, previous breast findings and other recognised risk factors as important considerations when determining whether a woman may benefit from earlier assessment, specialist referral or additional imaging.
A risk-informed approach, according to the university, should also consider factors such as breast density and genetic predisposition where relevant.
The approach does not mean that every woman should undergo more frequent screening or additional tests. Instead, it seeks to identify those who may benefit from earlier or more specialised assessment while avoiding unnecessary procedures among women unlikely to benefit.
The World Health Organisation recommends early diagnosis and timely evaluation of women with symptoms of breast cancer. Screening strategies, however, should take account of individual risk and available resources.
This distinction is particularly relevant in settings where diagnostic services are limited and healthcare systems must ensure that women with concerning symptoms receive appropriate investigations.
Unequal Access to Diagnostic Services Remains a Challenge
St. George’s University identified unequal access to breast assessment, imaging and specialist interpretation as major challenges across sub-Saharan Africa.
A 2026 systematic review and meta-analysis cited by the university found that only 13 per cent of women had ever undergone a clinical breast examination.
The review also found that uptake varied according to educational attainment, household wealth, health insurance coverage and contact with healthcare services.
The university said the region continued to face substantial gaps in diagnostic capacity, limiting the ability of healthcare systems to assess suspicious breast changes and confirm diagnoses promptly.
According to the World Health Organisation Regional Office for Africa, limited diagnostic infrastructure and shortages of specialised healthcare personnel contribute to late diagnosis and poor outcomes.
These challenges point to the need for investments that extend beyond public awareness campaigns to strengthen the services required to diagnose and treat breast cancer.
The university identified several priorities, including expanding clinical breast examinations and referral pathways, training frontline health workers, improving access to diagnostic imaging and pathology services, and ensuring timely follow-up after abnormal findings.
It also stressed the importance of monitoring outcomes across socioeconomic groups and geographical areas to identify persistent inequalities in access to care.
Such measures could help address barriers faced by women in underserved communities, where financial constraints, distance from healthcare facilities and limited specialist services may delay assessment.
AI Could Support Detection and Referral
The university also highlighted artificial intelligence as a potential tool for supporting breast cancer detection in settings where imaging capacity and specialist availability are limited.
Depending on the technology and clinical context, AI systems may assist with triage, image interpretation, prioritising clinical workloads or estimating risk.
However, the university cautioned that the usefulness of these technologies depends on appropriate validation, reliable referral pathways, diagnostic confirmation, quality assurance and continuous monitoring to identify differences in performance across population groups.
Frame said digital tools could help extend access to assessment when integrated into functioning primary healthcare systems.
“Integrating community health workers, portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic, financial or health-system barriers,” she said.
She added that technology alone would not address the full range of challenges associated with breast cancer detection.
“The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging,” Frame said.
Her comments highlight the need to ensure that women identified as potentially at risk can proceed through the healthcare system to receive the necessary investigations and treatment.
Without adequate referral arrangements and diagnostic capacity, identifying a potential abnormality may not lead to timely medical intervention.
University Urges Equitable Early Detection Pathways
St. George’s University said a more personalised approach to breast cancer assessment should focus on matching the type and timing of evaluation to individual risk rather than increasing testing for every woman.
The approach would involve identifying women who may benefit from earlier, more frequent or different forms of assessment while reducing unnecessary imaging and procedures among those unlikely to benefit.
The university called for stronger healthcare pathways connecting risk assessment, early detection, diagnostic confirmation and timely treatment.
It said Breast Cancer Awareness Month provides an opportunity to advocate for equitable access to these services and highlight the importance of addressing the barriers that prevent women from receiving appropriate care.
Across Africa, the challenge extends beyond encouraging women to recognise symptoms. Healthcare systems must also ensure that those who seek help can access clinical assessment, diagnostic services and treatment without avoidable delays.
The university said improving outcomes would require coordinated action to strengthen healthcare infrastructure, train frontline personnel, expand diagnostic capacity and ensure that technological innovations support rather than replace clinical judgement.
It emphasised that every woman with a concerning symptom or abnormal finding should be able to obtain appropriate assessment, diagnostic confirmation and treatment, regardless of her income or geographical location.
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