Within EpiMaCT, Karmen Pofagi explored the obesity paradox and its impact on breast cancer survival.
Karmen Pofagi, chercheur·e au sein de EpiMaCT (Institut de Recherche pour le Développement).
Thèse soutenue en 2025 à l'école doctorale École doctorale Ω-LIM-Biologie-Chimie-Santé (Limoges ; 2022-).
Référencée dans le réseau ABES/STAR, cette thèse répond aux critères de rigueur de l'enseignement supérieur français.
The obesity paradox in the context of breast cancer raises crucial questions about public health, particularly in Benin, a country where health challenges are numerous and complex. The comparative study between Cotonou, the economic capital of Benin, and Limoges, a French city, highlights alarming disparities in the management of this disease. In Cotonou, 70% of breast cancer cases are detected at an advanced stage, which is particularly concerning, while in France, the 5-year net survival rate reaches 88%. These figures are not merely statistics, but indicators of a healthcare system that requires urgent attention and significant reforms.
The results of this research reveal that the weight status of patients influences their survival, but in a complex and often counterintuitive manner. Obesity, often perceived as a major risk factor for many diseases, including cancer, can paradoxically offer a certain level of protection in some contexts. For example, studies have shown that obese women may have better responses to treatments in certain cases of breast cancer. This phenomenon deserves in-depth analysis, as it could influence treatment and prevention strategies. The integration of body composition analysis into prognostic studies is a key recommendation that could transform our understanding of breast cancer and the factors that influence patient survival.
It is imperative to ask: how can early screening be improved in Benin? Awareness and education programs must be strengthened to encourage women to seek consultation as soon as symptoms appear. In a country where cultural beliefs and taboos surrounding reproductive health can hinder access to care, it is crucial to develop tailored campaigns that take these realities into account. Furthermore, access to care must be improved to ensure that all patients, regardless of their socio-economic status, can benefit from early diagnosis and adequate treatment. This could involve the creation of screening centers in rural and urban areas, where women can be examined without stigma.
Policymakers must take these results into account to adapt public health policies. The establishment of screening and awareness programs could not only improve survival rates but also reduce long-term costs associated with advanced stage treatments. Indeed, early diagnosis would not only save lives but also decrease healthcare expenses related to intensive and prolonged treatments for advanced cases. In summary, this research is not limited to academic data but calls for concrete action to save lives in Benin.
It is also essential to consider the role of socio-economic factors in this issue. In Benin, access to healthcare is often limited by financial and geographical barriers. Women from disadvantaged backgrounds are particularly vulnerable, as they may not have the means to travel to healthcare facilities or pay for care. Therefore, it is crucial that public health policies take these inequalities into account and strive to reduce them. This could include initiatives such as subsidies for healthcare, free transportation to screening centers, or awareness programs specifically targeting marginalized communities.
Finally, collaboration between the public and private sectors could also play a key role in improving the situation. Businesses, NGOs, and government institutions must work together to create accessible and effective prevention and screening programs. For example, partnerships with local businesses could help fund awareness and screening campaigns while involving the community in the fight against breast cancer.
In conclusion, the obesity paradox and survival in breast cancer raise public health issues that require a multidimensional approach. It is essential to strengthen early screening, improve access to care, and consider socio-economic factors to ensure that all women, regardless of their status, can benefit from adequate care. This research should not remain a dead letter but should serve as a catalyst for concrete actions and significant changes in the health landscape in Benin.
Données clés
- 70 % : des cas de cancer du sein à Cotonou sont détectés à un stade avancé.
- 88 % : de survie nette à 5 ans pour le cancer du sein en France.
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Sources et accès
Karmen Pofagi. Paradoxe de l’obésité et survie dans le cancer du sein : Étude comparative entre Cotonou (Bénin) et Limoges (France).. Médecine humaine et pathologie. Université de Limoges; Université d'Abomey-Calavi UAC (Bénin), 2025. Français. ⟨NNT : 2025LIMO0096⟩. ⟨tel-05622011⟩