Prevalence of Advanced-Stage Breast Cancer at Diagnosis in Arab Countries: A Systematic Review and Meta-Analysis
1
Medicine, University of Medical Sciences and Technology, Khartoum, Sudan
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Breast cancer is the most diagnosed cancer among women in Arab countries, with many patients presenting at advanced stages. Late-stage diagnosis contributes to increased mortality, diminished survival, and higher treatment costs. A regional synthesis of prevalence and predictors is critical for guiding early detection strategies.
METHODS:
We conducted a systematic review and meta-analysis of studies reporting stage at breast cancer diagnosis or associated predictors in Arab countries. Four databases (PubMed, Scopus, Web of Science, WHO VHL) were searched on March 22, 2025. Observational studies were included. A random-effects meta-analysis estimated the pooled prevalence of stage III–IV presentation. Subgroup analyses by country were performed. Predictors were synthesized thematically. Risk of bias was assessed using the Joanna Briggs Institute checklist.
RESULTS:
Twenty-six studies from 13 Arab countries (14,176 patients) were included. The pooled prevalence of advanced-stage presentation was 46·0% (95% CI 41·0–52·0; I²=93·6%). Prevalence ranged from 13·0% in Bahrain to 67·0% in Libya and Yemen. The test for country subgroup differences was statistically significant (χ² = 3271.72, df = 12, p < 0.001), indicating that country-level differences substantially contributed to the overall heterogeneity observed across studies. Egger’s test indicated small-study effects (intercept=1·23, p=0·048). Predictors of late-stage diagnosis clustered into four domains: health behaviours (delayed care-seeking, low breast self-examination awareness); health system access (diagnostic delays, treatment site); sociodemographic factors (unmarried status, low education); and tumour biology (non- luminal subtypes and non-breast-specific symptoms).
CONCLUSIONS:
Advanced-stage breast cancer remains highly prevalent in Arab countries, with considerable variation across settings. Strengthening early detection through tailored screening, community education, and accessible diagnostic services should be prioritised at the regional and national levels.
Breast cancer is the most diagnosed cancer among women in Arab countries, with many patients presenting at advanced stages. Late-stage diagnosis contributes to increased mortality, diminished survival, and higher treatment costs. A regional synthesis of prevalence and predictors is critical for guiding early detection strategies.
METHODS:
We conducted a systematic review and meta-analysis of studies reporting stage at breast cancer diagnosis or associated predictors in Arab countries. Four databases (PubMed, Scopus, Web of Science, WHO VHL) were searched on March 22, 2025. Observational studies were included. A random-effects meta-analysis estimated the pooled prevalence of stage III–IV presentation. Subgroup analyses by country were performed. Predictors were synthesized thematically. Risk of bias was assessed using the Joanna Briggs Institute checklist.
RESULTS:
Twenty-six studies from 13 Arab countries (14,176 patients) were included. The pooled prevalence of advanced-stage presentation was 46·0% (95% CI 41·0–52·0; I²=93·6%). Prevalence ranged from 13·0% in Bahrain to 67·0% in Libya and Yemen. The test for country subgroup differences was statistically significant (χ² = 3271.72, df = 12, p < 0.001), indicating that country-level differences substantially contributed to the overall heterogeneity observed across studies. Egger’s test indicated small-study effects (intercept=1·23, p=0·048). Predictors of late-stage diagnosis clustered into four domains: health behaviours (delayed care-seeking, low breast self-examination awareness); health system access (diagnostic delays, treatment site); sociodemographic factors (unmarried status, low education); and tumour biology (non- luminal subtypes and non-breast-specific symptoms).
CONCLUSIONS:
Advanced-stage breast cancer remains highly prevalent in Arab countries, with considerable variation across settings. Strengthening early detection through tailored screening, community education, and accessible diagnostic services should be prioritised at the regional and national levels.
| eISSN: | 2654-1459 |
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