ArticleArchives of public health = Archives belges de sante publique2026
Breast cancer incidence and predictive parish-level social determinants of health in and around Kampala, Uganda.
Article in Archives of public health = Archives belges de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeBreast cancer is the second most common cancer globally and among Ugandan women. Nearly 89% of Ugandan women are diagnosed at stage III/IV and five-year survival is 46%-56%. Identifying geographical social determinants of health (SDOH) predicting high burden areas will inform cancer resource allocation. Therefore, this study aimed to identify parish-level SDOH associated with breast cancer incidence within the Kampala Cancer Registry (KCR) catchment area.
methodsKCR data on 113 breast cancer diagnoses from years 2014 to 2017 was merged with data from the Uganda Bureau of Statistics (UBOS). A stepwise-Forward fitting Poisson regression model was used to estimate incidence rate ratios (IRRs), to analyze the association between SDOH and incidence of breast cancer. SDOH factors examined include measures of infrastructure, gender equality, and economy, controlling for population density, and were selected based on their availability in the UBOS dataset and by how representative they were of one of the aforementioned themes. Alpha was set at 0.05.
resultsFactors associated with higher incidence of breast cancer were a higher girl-to-boy ratio of 6–12-year-olds not attending school (IRR = 1.24, 95%CI [1.07, 1.43], p = 0.003), and higher proportions of 10–17-year-olds ever married (IRR = 1.25, 95%CI [1.06, 1.47], p = 0.007), households receiving remittances (IRR = 1.03, 95%CI [1.00, 1.07], p = 0.024) and households properly disposing of solid waste (IRR = 1.09, 95%CI [1.03,1.15], p = 0.004). Factors associated with lower incidence included higher proportions of household owner occupancy (IRR = 0.95, 95%CI [0.92, 0.98], p = 0.016) and households with piped water (IRR = 0.97, 95%CI [0.95, 0.99], p = 0.014).
conclusionIn this study, SDOH related to gender equity, economic dependence, and infrastructure are associated with breast cancer incidence in the Kampala region. Areas with indicators of female disempowerment, informal infrastructure, and more households receiving remittances may benefit from prioritization for breast cancer prevention/control efforts.
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