Abstract
BACKGROUND: Breast cancer is the most common cancer among women globally, with rising prevalence in low- and middle-income countries, including Sierra Leone. Despite this growing burden, sex-disaggregated data on breast cancer prevalence and inequality measures remain limited in sub-Saharan Africa. This study examined the trends in breast cancer prevalence in Sierra Leone from 2000 to 2019, with a focus on sex-based disparities. METHODS: Using age-standardized data from the World Health Organization equity datasets, breast cancer prevalence (per 100,000 population) in Sierra Leone was analysed for the years 2000, 2005, 2010, 2015, and 2019. Sex-disaggregated trends were assessed, and inequality measures, including difference, ratio, population attributable fraction, and population attributable risk, were calculated to quantify disparities. A 95% confidence intervals was used to reflect uncertainty in prevalence estimates. RESULTS: The prevalence of breast cancer in Sierra Leone increased from 52.4 cases per 100,000 in 2000 to 78.3 cases per 100,000 in 2019. Among females, prevalence increased from 102.7 cases per 100,000 (95% CI: 80.0-129.7) in 2000 to 157.9 cases per 100,000 (95% CI: 117.3-218.3) in 2019. In contrast, prevalence among males remained consistently low and stable, ranging from 0.7 cases per 100,000 (95% CI: 0.5-1.0) in 2000 to 0.8 cases per 100,000 (95% CI: 0.5-1.1) in 2019. Inequality measures showed disparities, with the absolute difference among females and males increasing from 102.0 cases per 100,000 in 2000 to 157.1 cases per 100,000 in 2019. Furthermore, the prevalence ratio of females to males increased from 143.5 in 2000 to 198.1 in 2019, indicating that female prevalence was higher than male prevalence and that this disparity has increased over time. CONCLUSION: The study underscore the growing burden of breast cancer in Sierra Leone and the disparities between sexes with females having a higher burden than men. The findings underscore the need for strengthening cancer registries, improving access to early detection and treatment, and addressing structural barriers to equitable healthcare are critical for reducing the burden of breast cancer in Sierra Leone.