In 2003, an estimated 20,000 new cases of breast cancer were diagnosed among black women in the United States, making it the most common malignancy in this population (1). The rates of breast cancer incidence in Caucasian women and African American women are 113.2 and 99.3 cases per 100,000, respectively (1). In West Africa, the founder population of most African Americans, breast cancer has been considered to be a rare virulent disease of young women. According to the International Agency of Research on Cancer, breast cancer incidence in seven African countries has doubled, going from an average of 15.3 cases per 100,000 in 1976 to 33.6 per 100,000 in 1998 (2) (also see the contribution of Max Parkin in this book). This could be due to an actual increase in incidence or may be the result of improved reporting of cases. Unfortunately, the large numbers of resource poor nations in Africa make it extremely difficult to have accurate estimates of the number of breast cancer cases diagnosed in those countries. Nevertheless, the incidence of cancer, in general, appears to have increased in Africa and may likely be related to the changes in social conditions, life-style, and emergence of the AIDS epidemic (3). Although the AIDS epidemic has resulted in a striking increase in the incidence of Kaposi's sarcoma (now the most common cancer in Africa), there has not been an increase in incidence of AIDS-associated breast cancer (4, 5).
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