The Breast Cancer Clinical Trial Disparities in Africa: Limited Evidence for a High-Burden Population: Limited Evidence for a High-Burden Population

Abstract

Introduction

Breast cancer outcomes in Africa remain poor despite increasing incidence and younger age at presentation among affected women. We investigated whether breast cancer clinical trial activity in Africa reflects the region’s disease burden.

Methods
Using ClinicalTrials.gov API v2 through April 7, 2026, we performed a cross-sectional audit of registered interventional breast cancer trials in Africa and the United States.
Registry data were analyzed to compare trial representation and research investment across regions.

Results
Africa contributed only 128 breast cancer trials among 23,873 registered interventional studies, compared with 5,740 of 190,644 in the United States.
Although trial registrations increased substantially over time, most African countries, including Uganda which remain minimally represented in breast cancer research.

Conclusion
The resulting evidence gap may compromise development of contextually relevant treatment strategies for African women with aggressive breast cancer subtypes.