Breast Cancer Disparities in African and African-Ancestry Populations: Genetics, Epigenetics, Structural Barriers and...

Area of Science:

• Oncology
• Genetics
• Epidemiology

Background:

• Breast cancer is a major global health issue, with higher incidence and poorer outcomes in African and African-ancestry populations.
• While inherited BRCA1/BRCA2 mutations are known risk factors, BRCA1 promoter methylation is increasingly recognized in sporadic and triple-negative breast cancers (TNBC), prevalent in these groups.

Purpose of the Study:

• To review the genetic and epigenetic factors of breast cancer susceptibility in African and diaspora populations.
• To emphasize the prognostic and treatment implications of unique mutation spectra and elevated BRCA1 methylation.
• To evaluate systemic barriers and emerging technological solutions to address breast cancer disparities.

Main Methods:

• Literature review synthesizing genetic, epigenetic, and clinical data.
• Analysis of disparities in breast cancer incidence, subtypes, and outcomes.
• Evaluation of health system challenges and innovative interventions.

Main Results:

• African-ancestry populations exhibit distinct genetic and epigenetic profiles, including higher frequencies of BRCA1 methylation.
• Systemic barriers like limited infrastructure and structural racism contribute to late diagnosis and inequities.
• Emerging solutions like telemedicine and AI diagnostics show promise for improving access and care.

Conclusions:

• Addressing both biological (BRCA1 methylation) and structural drivers is crucial for reducing breast cancer outcome gaps.
• Context-specific research and investment are needed to integrate molecular insights with health system interventions.
• Urgent action is required to close breast cancer outcome disparities in Africa and similar settings.