What is the epidemiology (risk factors, age and stage at diagnosis) of breast cancer among black African women?
What is the tumour biology (histological types and grades, hormonal receptor status and genetic markers) of breast cancer among black African women?
What is the outcome of therapy (survival, post-operative complication and recurrence rates) of breast cancer among black African women?
PubMed/MEDLINE, OVID, AJOL, ECAJS, AAS, Globocan, Aortic, RSA Journals, IARC, Reference lists, Local and international Conference proceedings, unpublished data, university dissertation registers. interviews with breast cancer experts from the continent.
No search limitations/ restrictions will be imposed.
Randomized Controlled Trials , Cohort studies, Case control studies, Descriptive studies, Case series.
Condition or domain being studied
Breast cancer is the commonest cancer among women worldwide and ranks top in the cancer related mortality. It has a widely varying epidemiology that is partly explainable by race. The purpose of this review is to evaluate breast cancer among black African women according to risk factors, stage at diagnosis, histological types and grades, hormonal receptor status, jenetic marking, survival and other outcomes of therapy.
Women with breast cancer in any African country. non black Africans will be excluded
No particular interventions or exposures are being studied; the outcomes of interest include the description of the epidemiology, biology and treatment oucomes of breast cancer among black African women
Outcome measures of interest include: risk factors,age and stage at diagnosis, histological types and grades, hormonal receptor status, genetic marking, survival, and other outcomes of therapy.
Risk factors: odds ratios and relative risk
Age at diagnosis: difference in means
Stage at diagnosis: difference in proportions
Histological types and grades: difference in proportions
Genetic marking: difference in proportion
Outcomes of therapy:
Survival; difference in proportions
Complications of treatment: odds ratio, relative risk, difference in proportions
Recurrence rates: difference in proportion
Number of studies and their designs by country, author, year.
Data extraction, (selection and coding)
This will be done using a predetermined data extraction tool to collect the following information: study identity (title, authors, references), study eligibility, study quality, study characteristics, methods, participants, interventions, outcomes measures and results.
Risk of bias (quality) assessment
A predesigned tool will be used to asses for adequacy of reporting and methodological quality of the qualifying articles. Assessment of the quality of reporting will be carried out using CONSORT guidelines for RCT, STROBE guidelines for cohort, case control and descriptive studies. Furthermore, the methodological quality shall be appraised with emphasis on case definition, selection of cases and controls, randomization, allocation concealment, blinding, internal and external validity.
Strategy for data synthesis
Data on the variable being studied will be pooled and stratified by study design. Where heterogeneity is not significant, quantitative data synthesis by meta- analysis will be carried out assuming a random effects model. Otherwise qualitative data synthesis will be conducted.
Sensitivity analysis will be carried out to check the robustness of the review process and its conclusions. Some studies will be included or excluded from the meta-analysis or missing data imputed to examine the changes in summary effect measures.
Analysis of subgroups or subsets
Sub group analyses will be done to further analyze variables. Such sub groups will be described by menopausal status,parity, receptor status.
The review will be presented at local and international conferences. It will also be published in a reputable peer reviewed journal
Contact details for further information
P.O Box,27251 Kampala, Uganda
Organisational affiliation of the review
Dr Moses Galukande, Makerere University College of Health Sciences, Uganda Dr Alex Elobu, Mulago Hospital,Uganda Dr James Ssegwanyi, Rubaga Hospital, Uganda Dr Ekwaro Obuku, Joint Clinic Research Centre,Uganda Mr Richard Ssenono, Infectious Diseases Institute, Uganda Ms Nagel Ingeborg, Royal Tropical Institute, Netherlands
Anticipated or actual start date
13 August 2012
Anticipated completion date
13 August 2014
Conflicts of interest
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
African Continental Ancestry Group; Breast Neoplasms; Humans; Risk Factors; Women
Date of registration in PROSPERO
03 August 2012
Date of publication of this revision
21 February 2013
Stage of review at time of this submission
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Risk of bias (quality) assessment
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.