The Breast Cancer Screening Gap in Muslim-Majority Countries: Beyond Human Development Index

Countries with a greater Human Development Index (HDI) have greater breast cancer incidence rates compared to those with lower developmental statuses, but Muslim-majority countries do not follow this pattern, raising concerns about why Muslim countries have overall lower incidence rates regardless of HDI. The goal of this study was to examine the relationship between HDI, Muslim population percentage, and breast cancer incidence rates across countries to address a gap in breast cancer incidence and provide reasoning as to why a gap might be present. Breast cancer data from the GLOBOCAN database of the age-adjusted incidence of breast cancer were taken for 46 Muslim-majority countries (> 50% Muslim population) and 14 non-Muslim territories for a total of n = 60 countries, and countries were grouped into high and low HDI. Welch's t-tests compared average ASR between high- and low-HDI Muslim-majority countries, and between high-HDI Muslim-majority and high-HDI non-Muslim countries, and Linear regression assessed the relationship between percent Muslim population and breast cancer incidence. Among Muslim-majority countries, high-HDI countries had significantly greater average incidence rates than low-HDI countries (p = 0.0047). However, when comparing only high-HDI countries, Muslim-majority countries had significantly lower incidence rates than non-Muslim countries (p = 2.48e-11). Linear regression showed a statistically significant negative correlation between percent Muslim population and breast cancer incidence rates (R² = 0.144, p = 0.0085). Muslim-majority countries do not follow the global trends between HDI and breast cancer incidence, since even high HDI countries have lower breast cancer incidence rates, suggesting that there is a significant screening gap in Muslim countries. These findings emphasize the need for culturally tailored breast cancer screening and awareness programs across Muslim-majority countries, regardless of development status.