Editorial Study: Contrasting epidemiological perspectives on environmental risk factors for breast cancer in Africa and Western regions
DOI:
https://doi.org/10.7196/10.7196/SAMJ.2025.v115i11b.3969Keywords:
breast cancer, environmental factors, climate changes,, Africa,Abstract
Background. Endocrine-disrupting chemicals (EDCs) such as pesticides, plasticisers and food-related compounds are ubiquitous environmental pollutants linked to increased breast cancer risk. While substantial evidence exists from Western settings, limited data address these associations in African populations, where exposure patterns and regulatory frameworks differ markedly.
Objectives. To synthesise global epidemiological evidence on EDC exposure and breast cancer, with a focus on identifying disparities between African and Western regions.
Methods. A systematic review of PubMed (MEDLINE) was conducted by Mahasa et al. from 30 November 2024 to 14 July 2025, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search used keywords including ‘endocrine disruptors’, ‘breast cancer’, ‘climate change’, ‘air pollution’, ‘water pollution’, ‘global warming’ and ‘greenhouse effect’, and included both case-control and cohort studies.
Results. The search identified 172 eligible studies. Most were from Western countries and used biomarker-based exposure assessments. Most studies were conducted in Western countries, mainly the USA, Canada and parts of Europe, by authors such as Wolff, Brody, Stellman, Eskenazi and Rusiecki, who used biomarker-based methods to assess exposure to key endocrine-disrupting chemicals (EDCs) including dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), bisphenol A (BPA), phthalates and polychlorinated biphenyls (PCBs). These Western studies consistently linked higher levels of DDT/DDE, PCBs and certain phthalates to increased breast cancer risk. In contrast, there were only a few studies from African countries such as South Africa, Nigeria and Egypt, despite higher potential exposure through agriculture and food systems, and these were limited in scale and methodological depth, providing less conclusive evidence.
Conclusion. Regional gaps in data limit our understanding of EDC-related breast cancer risk in Africa. Targeted research and region- specific policies are urgently needed.
References
1. Mahasa PS, Milambo MJP, Nkosi SF, Mukwada G, Nyaga MM, Tesfamichael SG. A Comprehensive analysis of epidemiological research on the relationship between endocrine disrupting substances and breast cancer. Prospero 2025 CRD42024625457. https://www.crd.york.ac.uk/PROSPERO/view/ CRD42024625457 (accessed 17 November 2025).
2. Gore AC, Chappell VA, Fenton SE, et al. EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev 2015;36(6):E1-E150. https://doi.org/10.1210/ er.2015-1010
3. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, et al. Endocrine-disrupting chemicals: An Endocrine Society scientific statement. Endocr Rev 2009;30(4):293-342. https://doi.org/10.1210/ er.2009-0002
4. Denny L, de Sanjose S, Mutebi M, et al. Interventions to close the divide for women with breast and cervical cancer between low-income and middle-income countries and high-income countries. Lancet 2017;389(10071):861-870. https://doi.org/10.1016/S0140-6736(16)31795-0
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