After a long interregnum, I have resumed breast cancer research in Nigeria and Mauritius! We are exploring new ideas in the genomics and molecular biology of breast cancer in African women that is taking advantage of new developments in Next Generation Sequencing and Pyrosequencing. More updates to follow.
With my new position at the Institute of Human Virology in Nigeria and the U.S., it is not surprising that I should focus on the commonest oncogenic virus in the world - the Human Papilloma Virus. Watch out for the link to the website for this fascinating project. Coming soon! Meanwhile, you can read about the project here http://h3africa.org/consortium/projects/16-projects/81-african-collaborative-center-for-microbiome-and-genomics-research-accme
Cancer RegistrationCancer registration is one the pillars of cancer epidemiology. However many low and middle income countries have not invested in this resources. I have championed the establishment of a Nigerian National System of Cancer Registries (NSCR) to support the development of new cancer registries in Nigeria, strengthen existing registries and improve the quality of their work, general aggregate data and make this freely available to researchers in Nigeria. See more information here http://www.socron.net/socron/NCSR-Newsletter(Nov2013).pdf
Cancer professionals training and networking
As part of efforts to provide training for cancer care professionals in Nigeria, encourage networking and research, I worked with colleagues to set up the Society of Oncology and Cancer Research of Nigeria (SOCRON). You can see more about the Society here - http://www.socron.net Please consider joining and contributing to development of cancer care and improved treatment of cancer patients in Nigeria
This has been the main focus of my teaching, clinical practice and research activities in the past several years. The incidence of breast cancer in Nigeria is increasing just like in other developing countries and those advanced countries that used to have a low incidence. I estimate that between 7 and 10,000 new cases of breast cancer developed in Nigeria in 2005.
Several factors are responsible for this increasing incidence, but the most important in my view are increasing average life expectancy, increased access to diagnostic facilities, empowerment of women which is increasing women's ability to make independent decisions about their own health care, increasing westernization of dietary, physical activity and obstetric and gynecological factors among others - http://www3.interscience.wiley.com/cgi-bin/abstract/102521183/ABSTRACT?CRETRY=1&SRETRY=0.
In our 1999 case-control study of 250 consecutive breast cancer cases seen in our Oncology Clinic between 1992 and 1995, we found that breast cancer patients tended to be taller, weighed more, had a later age at onset of first pregnancy and had a higher mean number of children than controls. That last finding was particularly interesting because it is known that multiparity protects against breast cancer. However, pregnancy has a complex relationship with breast cancer. On the short term, on account of the stimulatory effect on breast epithelial growth, pregnancy increases short term risk of breast cancer. The protective effect of pregnancy is seen decades after the pregnancy - often after the age of 40 years. In a country with low life expectancy like Nigeria therefore, case control studies are likely to highlight the early pro-carcinogenic effect of pregnancy since few women survive to the age where the protective effect of pregnancy is more prominent.
Our findings on anthropometric parameters and breast cancer risk in the 1999 study were explored further in 2003 - http://breast-cancer-research.com/content/5/2/R18 and http://linkinghub.elsevier.com/retrieve/pii/S104727970200426X. In these studies where we confined the analysis to urbanized Nigerian women, we found association of breast cancer with increasing height and waist hip ratio. This is consistent with data from other international studies including large prospective case control studies.
Recently, I established the first immunohistochemistry laboratory that provides real time results that is used to guide patient management in Nigeria. This laboratory has been generating some interesting data that is different than what had been reported so far about breast cancer in Africans. For example, we can confirm now that most breast cancer in Africans are indeed ER/PR positive and HER2 negative. We published that there is no substantial difference in the prevalence of the different molecular subtypes among Nigerian breast cancer patients compared to other populations. We also discussed some of the possible reasons for the previously reported data in the paper. We think that this paper should:
- Encourage more use of hormone treatments
- Where the ER/PR status of the patient is not known, the patient should be considered hormone receptor positive and treated as such
- Increase activities and research to increase earlier presentation and quality of care of cancer patients as possible reasons for the poor prognosis of breast cancer patients in Nigeria