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Dassen RRE, Pelders S, de Munck L, Jager A, Hooning MJ, van Dam JH, Heemskerk-Gerritsen BAM. The effect of attendance in the Dutch breast cancer screening program on breast tumor characteristics among migrant women. Breast 2023; 69:290-298. [PMID: 36940631 PMCID: PMC10034141 DOI: 10.1016/j.breast.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/10/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND In general, migrant women have a lower breast cancer (BC) incidence rate and higher BC mortality than autochthonous women. Further, migrant women show lower participation in the national BC screening program. To further investigate those aspects, we aimed to determine differences in incidence and tumor characteristics between autochthonous and migrant BC patients in Rotterdam, the Netherlands. METHODS We selected women diagnosed with BC in Rotterdam during 2012-2015 from the Netherlands Cancer Registry. Incidence rates were calculated by migrant status (i.e., women with or without migration background). Multivariable analyses revealed adjusted odds ratios (OR) and 95% confidence intervals (CI) on the association between migration status and patient and tumor characteristics, additionally stratified by screening attendance (yes/no). RESULTS In total 1372 autochthonous and 450 migrant BC patients were included for analysis. BC incidence was lower among migrants than among autochthonous women. Overall, migrant women were younger at BC diagnosis (53 vs. 64 years, p < 0.001), and had higher risks of positive lymph nodes (OR 1.76, 95% CI 1.33-2.33) and high grade tumors (OR 1.35, 95% CI 1.04-1.75). Especially non-screened migrant women had higher risk of positive nodes (OR 2.73, 95% CI 1.43-5.21). Among the subgroup of screened women, we observed no significant differences between migrant and autochthonous patients. CONCLUSION Migrant women have lower BC incidence than autochthonous women, but diagnosis was more often at younger age and with unfavorable tumor characteristics. Attending the screening program strongly reduces the latter. Therefore, promotion of participation in the screening program is recommended.
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Affiliation(s)
- R R E Dassen
- Erasmus MC Cancer Institute, Medical Oncology, Rotterdam, Netherlands
| | - S Pelders
- Erasmus MC Cancer Institute, Medical Oncology, Rotterdam, Netherlands
| | - L de Munck
- Netherlands Comprehensive Cancer Organization, Research and Development, Utrecht, Netherlands
| | - A Jager
- Erasmus MC Cancer Institute, Medical Oncology, Rotterdam, Netherlands
| | - M J Hooning
- Erasmus MC Cancer Institute, Medical Oncology, Rotterdam, Netherlands
| | - J H van Dam
- Erasmus MC Cancer Institute, Oncological Surgery, Rotterdam, Netherlands
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4
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de Kruif AJT, Chrifou R, Langeslag GL, Sondaal AEC, Franssen MMM, Kampman E, Winkels RM, de Boer MR, Visser M, Westerman MJ. Perceptions of non-Western immigrant women on having breast cancer and their experiences with treatment-related changes in body weight and lifestyle: A qualitative study. PLoS One 2020; 15:e0235662. [PMID: 32634154 PMCID: PMC7340308 DOI: 10.1371/journal.pone.0235662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 06/21/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The number of non-Western immigrants with breast cancer in the Netherlands has increased over the past decades and is expected to triple by 2030. Due to insufficient representation in clinical studies, it is unclear what the specific experiences and needs of these women are. Understanding how culture and religion affect these women's experience of breast cancer and how they deal with chemotherapy and treatment-related changes in body weight and lifestyle is crucial for health care professionals to be able to provide effective support. METHODS A qualitative study was conducted using semi-structured interviews with 28 immigrant women with a history of breast cancer treated with chemotherapy. RESULTS Women often associated breast cancer with taboo, death or bad luck. Religion offered these women guidance, strength and meaning to the disease, but also limited the women to openly talk about their disease. Women perceived lifestyle factors to have little influence on the development and treatment of cancer. After treatment, however, their thinking changed and these lifestyle factors became of paramount importance to them. They realised that they missed out on information about managing their own diet, exercise and body weight and were eager to share their experiences with other women in their culture with newly diagnosed breast cancer. CONCLUSION Women became aware during and after breast cancer treatment that it was difficult for them to actively deal with their illness under the influence of their culture and religion. Based on their own experiences and acquired knowledge, they would like to give advice to newly diagnosed women on how to deal with breast cancer within their own culture and religion. Their recommendations could be used by mosques, churches, support groups and health care professionals, to ensure interventions during breast cancer treatment meet their religious and cultural needs and thus improve their quality of life.
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Affiliation(s)
- Anja JThCM de Kruif
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Rabab Chrifou
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Ghislaine L Langeslag
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemijn E C Sondaal
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margret M M Franssen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Michiel R de Boer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjan J Westerman
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
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5
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Ragin C, Banydeen R, Zhang C, Ben A, Calabrese V, Villa NN, Reville J, Dasgupta S, Bandyopadhyay M, Louden D, Dasgupta S. Breast Cancer Research in the Caribbean: Analysis of Reports From 1975 to 2017. J Glob Oncol 2018; 4:1-21. [PMID: 30481085 PMCID: PMC6818300 DOI: 10.1200/jgo.18.00044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Breast cancer is among the leading causes of death resulting from cancer in Caribbean women. Studies examining exogenous and genetically predetermined endogenous risk factors are critical to define breast cancer susceptibility in Caribbean women. The purpose of this systematic review is to assess the existing scientific literature in the last 42 years (1975 to 2017) to describe the body of research generated for the population of this region and determine future research directions. METHODS We selected published research articles using a combination of definite keyword searches in PubMed. Only articles presenting the Caribbean population as the focus of their research objectives were included in this analysis. RESULTS Studies on breast cancer in the Caribbean are limited. A majority of publications on Caribbean populations were descriptive, focusing on cancer trends and clinicopathologic factors. High incidence and mortality rates for breast cancer are reported for the region, and there seem to be some differences between countries in the frequency of cases according to age at presentation. A limited number of epidemiologic, behavioral, and genetic and molecular studies were conducted in more recent years. CONCLUSION A regional strategy for cancer registration is needed for the Caribbean to address possible underestimates of breast cancer incidence. Furthermore, behavioral, molecular, genetic, and epidemiologic investigations of breast cancer are critical to address the concerns related to currently described high incidence and mortality rates in the Caribbean.
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Affiliation(s)
- Camille Ragin
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Rishika Banydeen
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Christine Zhang
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Athena Ben
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Victoria Calabrese
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Nina N. Villa
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Jade Reville
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Shaoni Dasgupta
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Mausumi Bandyopadhyay
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Delroy Louden
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Subhajit Dasgupta
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
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6
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Brown CR, Hambleton IR, Hercules SM, Alvarado M, Unwin N, Murphy MM, Harris EN, Wilks R, MacLeish M, Sullivan L, Sobers-Grannum N. Social determinants of breast cancer in the Caribbean: a systematic review. Int J Equity Health 2017; 16:60. [PMID: 28381227 PMCID: PMC5382386 DOI: 10.1186/s12939-017-0540-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/21/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Breast cancer is the leading cause of cancer deaths among women in the Caribbean and accounts for >1 million disability adjusted life years. Little is known about the social inequalities of this disease in the Caribbean. In support of the Rio Political Declaration on addressing health inequities, this article presents a systematic review of evidence on the distribution, by social determinants, of breast cancer risk factors, frequency, and adverse outcomes in Caribbean women. METHODS MEDLINE, EMBASE, SciELO, CINAHL, CUMED, LILACS, and IBECS were searched for observational studies reporting associations between social determinants and breast cancer risk factors, frequency, or outcomes. Based on the PROGRESS-plus checklist, we considered 8 social determinant groups for 14 breast cancer endpoints, which totalled to 189 possible ways ('relationship groups') to explore the role of social determinants on breast cancer. Studies with >50 participants conducted in Caribbean territories between 2004 and 2014 were eligible for inclusion. The review was conducted according to STROBE and PRISMA guidelines and results were planned as a narrative synthesis, with meta-analysis if possible. RESULTS Thirty-four articles were included from 5,190 screened citations. From these included studies, 75 inequality relationships were reported examining 30 distinct relationship groups, leaving 84% of relationship groups unexplored. Most inequality relationships were reported for risk factors, particularly alcohol and overweight/obesity which generally showed a positive relationship with indicators of lower socioeconomic position. Evidence for breast cancer frequency and outcomes was scarce. Unmarried women tended to have a higher likelihood of being diagnosed with breast cancer when compared to married women. While no association was observed between breast cancer frequency and ethnicity, mortality from breast cancer was shown to be slightly higher among Asian-Indian compared to African-descent populations in Trinidad (OR 1.2, 95% CI 1.1-1.4) and Guyana (OR 1.3, 95% CI 1.0-1.6). CONCLUSION Study quantity, quality, and variability in outcomes and reporting limited the synthesis of evidence on the role of social determinants on breast cancer in the Caribbean. This report represents important current evidence on the region, and can guide future research priorities for better describing and understanding of Caribbean breast cancer inequalities.
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Affiliation(s)
| | | | | | | | - Nigel Unwin
- Chronic Disease Research Centre, Bridgetown, Barbados
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