Breast Cancer: SGU advocates risk-based screening as Africa records 100,000 deaths

Dr. Tonia Frame

By Admin

As breast cancer continues to claim thousands of lives across Africa, St. George’s University (SGU), Grenada, has called for a more equitable and risk-informed approach to screening, warning that age alone may not be enough to identify women who need early assessment.

The university said improving breast cancer outcomes across the continent would require more than awareness campaigns, stressing the need for earlier diagnosis, personalised risk assessment, accessible diagnostic services and timely treatment.

The call comes as estimates from the International Agency for Research on Cancer show that Africa recorded approximately 225,643 new breast cancer cases and 100,070 deaths in 2024, making the disease the most commonly diagnosed cancer among women and the leading cause of cancer-related deaths in the region.

SGU said the figures highlight the urgent need to improve awareness of breast cancer symptoms and ensure women can access appropriate medical assessment without avoidable delays.

Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at SGU, said breast cancer risk varies considerably among women, making individual assessment an important part of early detection.

“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 normal appearance and feel of their breasts and seek prompt medical evaluation for unexplained changes.

Frame noted that breast cancer often presents at a comparatively younger age among African women, while access to high-quality imaging and specialist services remains uneven across the continent.

She said screening discussions should therefore consider family history, inherited genetic susceptibility, previous breast abnormalities and other recognised risk factors to determine whether a woman needs earlier assessment, specialist referral or additional imaging.

A 2025 study involving women diagnosed with breast cancer across five sub-Saharan African countries found that 21.9 per cent of participants were diagnosed before the age of 40, underscoring the importance of recognising symptoms and seeking timely evaluation.

The World Health Organisation recommends early diagnosis and prompt evaluation of women with suspected breast cancer symptoms, while screening decisions should reflect individual risk and available resources.

Risk factors that should not be ignored

According to SGU, women with a family history of breast or ovarian cancer, particularly cases diagnosed at younger ages or involving multiple close relatives, may require formal risk assessment to determine whether they need earlier screening.

Women with inherited BRCA1 or BRCA2 gene variants may also require screening before the age recommended for women at average risk.

The university identified breast density as another important consideration, explaining that dense breast tissue can make abnormalities harder to detect through mammography and is independently associated with increased breast cancer risk.

Depending on a woman's overall risk, supplementary imaging, including magnetic resonance imaging, may be considered. However, such decisions should account for the potential benefits and risks, including false-positive results and unnecessary biopsies.

Previous high-risk breast lesions, atypical biopsy results and suspicious imaging findings may also require a more individualised follow-up plan developed with a physician.

Frame said a personalised approach should not mean subjecting every woman to more tests, but identifying those most likely to benefit from earlier or more intensive assessment.

Unequal access threatens early detection

Despite growing awareness of breast cancer, access to clinical examination, diagnostic imaging, pathology services and specialist care remains a major challenge across sub-Saharan Africa.

A 2026 systematic review and meta-analysis found that only 13 per cent of women in the region had ever undergone a clinical breast examination. Uptake also varied according to education, household wealth, health insurance coverage and contact with healthcare services.

The World Health Organisation's Regional Office for Africa has similarly identified gaps in diagnostic infrastructure and shortages of specialised health personnel as barriers to effective breast cancer control.

SGU said addressing these inequalities would require stronger referral systems, better training for frontline health workers, expanded access to diagnostic imaging and pathology, and reliable follow-up for women with abnormal findings.

It also called for greater attention to disparities across socioeconomic groups and geographical locations to ensure that women in underserved communities are not left behind.

 AI offers promise, but cannot replace diagnosis

The university also highlighted the potential role of artificial intelligence in supporting breast cancer detection, particularly in settings where imaging services and specialist personnel are limited.

Depending on the technology and clinical setting, AI could assist with triage, image interpretation, prioritisation of cases and risk estimation.

However, Frame cautioned that the technology's usefulness depends on proper validation, quality assurance, diagnostic confirmation and effective referral pathways.

“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.

“The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment.”

She stressed that AI-generated results should not be treated as a diagnosis, but interpreted alongside a woman's medical history, risk factors, clinical examination and appropriate imaging.

Women urged to take an active role

As Breast Cancer Awareness Month continues, SGU encouraged women to discuss their personal risk factors with healthcare professionals and ask when screening should begin, whether their family history warrants further assessment and whether previous breast symptoms or biopsy results require closer monitoring.

Women with dense breasts may also need to discuss how breast density affects mammography and whether additional assessment is appropriate.

The university said informed decisions should balance the benefits of early detection against unnecessary investigations, with screening plans tailored to individual risk and the services available.

It added that effective breast cancer control must extend beyond identifying possible abnormalities to ensuring that women receive timely diagnostic confirmation and treatment.

Preparing future physicians to respond to evolving healthcare needs, SGU said, remains central to its medical and public health education through international learning opportunities and clinical exposure designed to equip students to care for diverse patient populations.

The university's message is that improving breast cancer survival in Africa will depend not only on encouraging women to seek care, but also on building health systems capable of providing the right assessment, diagnosis and treatment when they do.

Nigeria could declare Ebola outbreak over by Dec 7 – Pate

By Admin

Nigeria could declare the Ebola outbreak over as early as December 7, 2026, if no further confirmed or probable cases are detected following the medical evacuation of the country’s imported index patient.

The Coordinating Minister of Health and Social Welfare, Professor Mohammed Ali Pate disclosed the provisional date on Monday as health authorities intensified contact tracing, investigated suspected cases and strengthened preparedness across health facilities to prevent further spread of the Bundibugyo virus disease.

Writing on his X handle, Pate said the 42-day countdown towards declaring the outbreak over would be subject to validation by the Nigeria Centre for Disease Control and Prevention (NCDC) and the World Health Organisation (WHO), in line with established outbreak management criteria.

The development follows the evacuation of Nigeria’s index patient to Switzerland for further medical care, a move that has heightened attention on the country’s capacity to sustain containment measures and prevent community transmission.

According to Pate “Following the imported Ebola index patient’s medical evacuation from Nigeria today, 26 October, our immediate priorities remain active monitoring of all identified contacts, prompt investigation of alerts and strengthened readiness across our health facilities.

“If no further confirmed or probable cases are detected, Nigeria could progress towards declaring this outbreak over under @WHO criteria, potentially as early as 7 December 2026. This date remains provisional, subject to @NCDCgov and WHO validating the 42-day countdown. Any further case would require a fresh countdown in accordance with those criteria,” Pate noted.

He said the proposed December 7 date is therefore not a final declaration that Nigeria is Ebola-free, but a conditional target that depends on the absence of further cases and the completion of the required surveillance period.

Further, he said., “Our teams, working with FCTA and state health authorities and our partners, remain focused on containment and preventing community transmission. 

“I ask Nigerians to remain calm, cooperate with contact-tracing teams and follow regular updates from @NCDCgov and @Fmohnigeria.”

Ebola evacuation exposes Nigeria’s response gaps, Academy warns

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The Academy of Medical Sciences of Nigeria has warned that the medical evacuation of the country’s first imported Ebola patient to Switzerland has exposed gaps in outbreak preparedness, including delayed diagnosis, limited isolation capacity and concerns over the welfare of exposed contacts.

Disclosing this position on Monday, the Academy, while describing the evacuation as consistent in principle with international health regulations, stressed that the patient’s departure did not end Nigeria’s responsibility to contain the outbreak.

The 42-year-old Ugandan-born woman, who is married to a Swiss embassy staff member in Abuja, was evacuated by air ambulance on Monday alongside her asymptomatic husband, following approval by the Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate.

In a public health statement and advisory signed by its President, Emeritus Professor Osato Giwa-Osagie; Foundation President, Professor Oladapo Ashiru; and Rapid Response Committee member, Professor Boaz Adegboro, the Academy said the evacuation was permissible under the International Health Regulations (IHR) 2005, provided appropriate safeguards were observed.

The statement reads: “The Academy of Medical Sciences of Nigeria (AMedS) has noted the confirmation by the
Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate, that
Nigeria's index case of Bundibugyo virus disease (BVD) was medically evacuated from Abuja to Switzerland this morning, together with her asymptomatic spouse.

“The Academy's assessment is that a properly coordinated medical evacuation of a clinically stable patient to her own country of nationality, under strict biosafety
protocols and with the agreement of both governments, is permitted under the
International Health Regulations (IHR, 2005) and consistent with WHO practice. It also follows international precedent: in 2014 Switzerland, Germany, Spain, the UK and the US received evacuated Ebola patients for care in high-level isolation units. 

“The evacuation does not, however, end Nigeria's outbreak response. The decisive work now lies with the 53 contacts under follow-up, the health workers who cared for the patient, and the gaps this case has exposed,” the statement warned.

On whether  the evacuation is consistent with international regulations, the Academy said: “Yes, in principle. The IHR (2005) does not prohibit the medical evacuation of a patient with a dangerous infectious disease. They require that any such movement be notified, coordinated between States, carried out with measures that prevent onward spread, and done with respect for the patient's dignity and rights. 

“WHO's long-standing Ebola guidance, including the 2014 temporary recommendations, advised that confirmed cases should not travel internationally except as part of an appropriate medical
evacuation. This was such an evacuation. It also follows international precedent: in 2014 Switzerland, Germany, Spain, the UK and the US received evacuated Ebola patients for care in high-level isolation units. 

“To remove any doubt, the Academy asks the Federal Ministry and NCDC to publish a short account of the evacuation protocol, the WHO and Swiss coordination, and the
decontamination steps taken.”

“At departure, the Minister reported that she was stable, conscious and communicating, with laboratory parameters returning towards baseline. He cautioned that clinical improvement does not mean she is no longer infectious; NCDC reported her samples remained positive on 25 October. Her husband's samples were negative.

While accepting the legitimacy of the evacuation, the Academy warned:  “The outbreak is not over, the source case leaving the country does not reduce
the risk among the 53 contacts, who include health workers and domestic staff.
Each must complete 21 days of follow-up, and WHO requires 42 days without a
a new case before an outbreak can be declared over.”

Beyond the evacuation, the Academy raised concerns about the time taken to identify the infection. It noted that about 13 days passed between symptom onset and testing, and the patient was seen at more than one private facility. 

“This exposed health workers and shows a low index of suspicion for viral haemorrhagic fever in febrile travellers, despite a PHEIC declared in May.”

The timeline, the Academy said, highlighted the need for greater suspicion of viral haemorrhagic fevers among febrile patients with relevant travel histories, particularly during an international public health emergency.

Acknowledging the work of Nigerian doctors, nurses, laboratory scientists and public health officers who cared for the patient, the statement said the evacuation underscored disparities in access to specialised treatment.

“A foreign national could be flown to a high-level isolation unit abroad; a Nigerian patient could not,” it said, calling for a healthcare system capable of providing an appropriate standard of care to everyone, regardless of nationality.”

It recommended establishing at least one high-level isolation and treatment unit in each geopolitical zone, staffed by trained personnel and supported by access to investigational therapies through WHO-coordinated clinical trials.

Among recommendations to the Federal Ministry of Health and Social Welfare and NCDC, the Academy called for publication of a brief account of the evacuation: the IHR coordination with WHO and Switzerland, the transport and decontamination protocol, and the arrangements for sharing clinical and laboratory data.

“Government should ensure complete 21-day follow-up of all contacts, with daily monitoring, rapid testing of any who become ill, and fully funded welfare for those in quarantine, offer occupational health follow-up and psychosocial support to every exposed health worker.

“The government should also issue a national alert to all public and private facilities to take a travel history from every febrile patient, and to isolate and test promptly anyone linked to affected areas, and establish at least one high-level isolation and treatment unit in each geopolitical zone, with trained staff and access to investigational therapeutics through WHO-coordinated trials, secure Nigeria's share of specimens and sequence data, and support Nigerian scientists to lead the source investigation with WHO, Uganda and Kenya.

“Nigeria contained Ebola in 2014 through speed, discipline and the sacrifice of its health workers. The same qualities are needed now. The Academy stands ready to offer its Fellows' expertise in clinical care, infection control, laboratory science and public health to the national response,” the Academy stated.

Nigeria’s Ebola index case evacuated to Switzerland

By Admin 

Nigeria’s first imported Ebola case was evacuated from Abuja to Switzerland on Monday morning following significant clinical improvement, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, has said.

Pate disclosed this in a post on his X handle, stating that the patient was stable, conscious and communicating, with laboratory test results approaching baseline levels.

He, however, warned that the patient could still be infectious, stressing that strict safety protocols remained in place during the evacuation.

The patient’s spouse, who remains asymptomatic, accompanied her to Switzerland.

Pate commended the clinical and public health teams for their roles in the patient’s care and the evacuation, adding that further updates would be provided after the pair arrived safely at their destination.

He said public health measures to contain the virus remained in place and urged Nigerians to remain vigilant and rely on credible sources of information.

Nigeria’s first imported Ebola patient departed Abuja for Switzerland earlier on Monday in a medically coordinated evacuation approved by the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate.

In a post on his X handle, Pate said the patient, whose condition had significantly improved, was stable, conscious and communicating, with laboratory test results approaching baseline levels. He cautioned, however, that she could still be infectious, making strict infection prevention measures essential throughout the transfer.

The patient was accompanied by her spouse, who remains asymptomatic. Pate did not specify the aircraft used, the Swiss hospital receiving the patient or the detailed arrangements for the journey.

He commended the clinical team responsible for the patient’s care and public health personnel who coordinated the evacuation, saying the operation was conducted in line with appropriate public health measures. He said further updates would be issued after the pair arrived safely at their destination