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Moirangthem R, Hosseini B, Patil A, George GS, Manjrekar A, Doibale P, Golapkar SV, Panse N, Krishnatreya M, Mishra A, Singh A, Chaturvedi A, Chaturvedi P, Dikshit R, Olsson A, Mhatre S. Occupations and the risk of buccal mucosa cancer in Indian men: A multi-centre case-control study. Cancer Epidemiol 2024; 92:102644. [PMID: 39153274 DOI: 10.1016/j.canep.2024.102644] [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: 04/02/2024] [Revised: 07/31/2024] [Accepted: 08/03/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE This study aimed to investigate the association between lifetime occupational history and risk of buccal mucosa cancer (BMC). METHODS We utilized a multi-centric, hospital-based case-control study across five centres of Tata Memorial Centre, Mumbai, India. Cases included men aged 20-75-years with histological confirmed primary cancer of the buccal mucosa. Visitor controls were frequency matched to cases for age (10 years interval) and current residential zone. Study participants were interviewed face-to-face. Logistic regression was performed to estimate odds ratio (OR) and 95 % confidence intervals (CI). RESULTS Among ever employed males, we identified 1969 BMC cases and 2145 controls. We observed an increased risk of BMC in 'Craft and Related Trades Workers' (OR 1.37; 95 % CI 1.13-1.65), 'Plant and Machine Operators and Assemblers' (OR: 1.26; 95 % CI 1.01-1.56), and 'Elementary Occupations' (OR:1.33; 95 % CI 1.12-1.58). More specifically, the increased risk was observed for 'Metal, Machinery and Related Trades Workers', 'Handicraft and Printing Workers', 'Drivers and Mobile Plant Operators', and 'Laborers in Mining, Construction, Manufacturing and Transport'. CONCLUSION Our findings suggest that certain occupations may be at a higher risk of BMC. Some fraction of BMC can be prevented by reducing exposure to hazardous agents used in these occupations. Further research is needed to identify which exposures are responsible for the increased risk. Moreover, tobacco control and early detection activities can be focused towards these occupations as tobacco consumption is also high in them, which may also be the reason for increased risk observed in these groups.
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Affiliation(s)
- Romi Moirangthem
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Bayan Hosseini
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organisation, Lyon, France
| | - Aniket Patil
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Grace Sarah George
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Ankita Manjrekar
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Pravin Doibale
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Shruti Vishwas Golapkar
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Nandkumar Panse
- Nargis Dutt Memorial Cancer Hospital, Agalgaon Road, Barshi, Solapur, Maharashtra, India
| | | | - Aseem Mishra
- Professor Head and Neck surgery, Mahamana Pandit Madan Mohan Malviya, Cancer Centre, Varanasi, India; Homi Bhabha National Institute, Varanasi, India
| | - Arjun Singh
- Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India; Department for Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Anil Chaturvedi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Pankaj Chaturvedi
- Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India; Department of Head and Neck Oncology, Tata Memorial Center, Mumbai, Maharashtra, India; Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India; Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organisation, Lyon, France
| | - Sharayu Mhatre
- Division of Molecular Epidemiology and Population Genomics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra, India; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India.
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Nag S, Dikshit R, Desai S, Mane A, Mhatre S, Neve R, Gurav M, Bhosale N, Perumal P, Kembhavi Y, Jethwa D, Badwe R, Gupta S. Risk factors for the development of triple-negative breast cancer versus non-triple-negative breast cancer: a case-control study. Sci Rep 2023; 13:13551. [PMID: 37599285 PMCID: PMC10440340 DOI: 10.1038/s41598-023-40443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023] Open
Abstract
The risk factors for breast cancer have been defined in several studies but there is deficient data for specific subtypes. We report here the pathological characteristics of a breast cancer cohort and risk factors for patients with triple-negative disease. In this case-control study, a prospective breast cancer cohort was evaluated for demographic, reproductive, obesity-related and other risk factors using a validated questionnaire. Tumors were characterized for routine pathological characteristics and immunohistochemical markers of basal-like breast cancer. Patients with triple-negative breast cancer (TNBC) constituted cases and those with non-TNBC were controls. Odds ratios (OR) were calculated for each risk factor and independent associations were tested in an unconditional logistic regression analysis. Between 2011 and 2014, 1146 patients were recruited, of whom 912 [TNBC 266 (29.1%), non-TNBC 646 (70.9%)] with sufficient pathology material were analysed. Reproductive factors of parity, breastfeeding, age-at-menarche, age at first full-term pregnancy and oral contraceptive use were not significantly associated with TNBC. Higher body mass index (BMI > 24.9 vs ≤ 24.9, OR 0.89, 95%CI 0.63-1.24, p = 0.49) was not significantly associated while lesser waist circumference (> 80 cm vs ≤ 80 cm, OR 0.64, 95%CI 0.45-0.9, p = 0.012) and lower waist-to-hip ratio were significantly associated (> 0.85 vs ≤ 0.85, OR 0.72, 95%CI 0.51-1.0, p = 0.056), with TNBC. History of tobacco use was not significantly associated while lower socio-economic status was borderline associated with TNBC (socio-economic category > 5 versus ≤ 5, OR 0.73, 95%CI 0.50-1.06, p = 0.106). No factor was significant after adjustment for covariates. Central obesity seems to be preferentially associated with non-TNBC, and lower socio-economic status with TNBC in India, while most other conventional risk factors of breast cancer show no significant association with TNBC versus non-TNBC.
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Affiliation(s)
- Shona Nag
- Medical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Rajesh Dikshit
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sangeeta Desai
- Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anupama Mane
- Surgical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Sharayu Mhatre
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rakesh Neve
- Surgical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Mamta Gurav
- Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Prema Perumal
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Yogesh Kembhavi
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Dinesh Jethwa
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajendra Badwe
- Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
- Tata Memorial Hospital/Centre, Room 1109, Homi Bhabha Block, Parel, Mumbai, 400012, India.
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Chaturvedi S, Biswas M, Sadhukhan S, Sonawane A. Role of EGFR and FASN in breast cancer progression. J Cell Commun Signal 2023:10.1007/s12079-023-00771-w. [PMID: 37490191 DOI: 10.1007/s12079-023-00771-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/22/2023] [Indexed: 07/26/2023] Open
Abstract
Breast cancer (BC) emerged as one of the life-threatening diseases among females. Despite notable improvements made in cancer detection and treatment worldwide, according to GLOBACAN 2020, BC is the fifth leading cancer, with an estimated 1 in 6 cancer deaths, in a majority of countries. However, the exact cause that leads to BC progression still needs to be determined. Here, we reviewed the role of two novel biomarkers responsible for 50-70% of BC progression. The first one is epidermal growth factor receptor (EGFR) which belongs to the ErbB tyrosine kinases family, signalling pathways associated with it play a significant role in regulating cell proliferation and division. Another one is fatty acid synthase (FASN), a key enzyme responsible for the de novo lipid synthesis required for cancer cell development. This review presents a rationale for the EGFR-mediated pathways, their interaction with FASN, communion of these two biomarkers with BC, and improvements to overcome drug resistance caused by them.
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Affiliation(s)
- Suchi Chaturvedi
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Madhya Pradesh, 453552, India
| | - Mainak Biswas
- School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha, 751024, India
| | - Sushabhan Sadhukhan
- Department of Chemistry, Indian Institute of Technology Palakkad, Palakkad, Kerala, 678623, India.
- Physical & Chemical Biology Laboratory and Department of Biological Sciences and Engineering, Indian Institute of Technology Palakkad, Palakkad, Kerala, 678623, India.
| | - Avinash Sonawane
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Madhya Pradesh, 453552, India.
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Akoko LO, Rutashobya AK, Lutainulwa EW, Mwanga AH, Kivuyo SL. The effect of reproductive, hormonal, nutritional and lifestyle on breast cancer risk among black Tanzanian women: A case control study. PLoS One 2022; 17:e0263374. [PMID: 35139096 PMCID: PMC8827470 DOI: 10.1371/journal.pone.0263374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 01/18/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose This study aimed to determine the effect of reproductive, hormonal, lifestyle and nutritional factors on breast cancer development among Tanzanian black women. Methodology We undertook a case-control study age-matched to ±5years in 2018 at Muhimbili National Hospital. The study recruited 105 BC patients and 190 controls giving it 80% power to detect an odds ratio of ≥2 at the alpha error of <5% for exposure with a prevalence of 30% in the control group with 95% confidence. Controls were recruited from in patients being treated for non-cancer related conditions. Information regarding hormonal, reproductive, nutritional and lifestyle risk for breast cancer and demography was collected by interviews using a predefined data set. Conditional multinomial logistic regression used to determine the adjusted odds ratio for variables that had significant p-value in the binomial logistic regression model with 5% allowed error at 95% confidence interval. Results The study recruited 105 cases and 190 controls. Only old age at menopause had a significant risk, a 2.6 fold increase. Adolescent obesity, family history of breast cancer, cigarette smoking and alcohol intake had increased odds for breast cancer but failed to reach significant levels. The rural residency had 61% reduced odds for developing breast cancer though it failed to reach significant levels. Conclusion Older age at menopause is a significant risk factor for the development of breast cancer among Tanzanian women. This study has shed light on the potential role of modifiable risk factors for breast cancer which need to be studied further for appropriate preventive strategies in similar settings.
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Affiliation(s)
- Larry Onyango Akoko
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- * E-mail:
| | - Amonius K. Rutashobya
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Ally H. Mwanga
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sokoine L. Kivuyo
- National Institute for Medical Research, Muhimbili Branch, Dar es Salaam, Tanzania
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McDonald JA, Rao R, Gibbons M, Janardhanan R, Jaswal S, Mehrotra R, Pandey M, Radhakrishnan V, Ramakant P, Verma N, Terry MB. Symposium report: breast cancer in India-trends, environmental exposures and clinical implications. Cancer Causes Control 2021; 32:567-575. [PMID: 33909208 PMCID: PMC8089075 DOI: 10.1007/s10552-021-01428-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/29/2021] [Indexed: 12/02/2022]
Abstract
Purpose Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to screening. Investigations are needed to understand the potential drivers of this trend. Methods An international team of experts convened to discuss the trends, environmental exposures, and clinical implications associated with BC in India and outlined recommendations for its management. Results Panels were structured across three major BC themes (n = 10 presentations). The symposium concluded with a semi-structured Think Tank designed to elicit short-term and long-term goals that could address the challenges of BC in India. Conclusion There was consensus that the prevalence of late-stage BC and the high BC mortality rates are associated with the practice of detection, which is primarily through clinical and self-breast exams, as opposed to mammography. Triple-Negative BC (TNBC) was extensively discussed, including TNBC etiology and potential risk factors, the limited treatment options, and if reported TNBC rates are supported by rigorous scientific evidence. The Think Tank session yielded long-term and short-term goals to further BC reduction in India and included more regional etiological studies on environmental exposures using existing India-based cohorts and case–control studies, standardization for molecular subtyping of BC cases, and improving the public’s awareness of breast health.
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Affiliation(s)
- Jasmine A McDonald
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA. .,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - Roshni Rao
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.,Division of Breast, Melanoma and Soft Tissue Surgery, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Marley Gibbons
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA
| | - Rajiv Janardhanan
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Uttar Pradesh, India
| | - Surinder Jaswal
- School of Research Methodology, Centre for Health and Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Ravi Mehrotra
- Indian Council of Medical Research (ICMR) - India Cancer Research Consortium, New Delhi, India
| | - Manoj Pandey
- Institute of Medical Sciences, Department of Surgical Oncology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | - Pooja Ramakant
- King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Nandini Verma
- TNBC Precision Medicine Research Laboratory, Advanced Centre for Treatment, Research, and Education in Cancer, Tata Memorial Center, Khargar, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra, India
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
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Basu P, Zhang L, Hariprasad R, Carvalho AL, Barchuk A. A pragmatic approach to tackle the rising burden of breast cancer through prevention & early detection in countries 'in transition'. Indian J Med Res 2020; 152:343-355. [PMID: 33380699 PMCID: PMC8061594 DOI: 10.4103/ijmr.ijmr_1868_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Indexed: 12/16/2022] Open
Abstract
Among the emerging economies Brazil, Russia, India, China and South Africa (together known as the BRICS countries) share collectively approximately 40 per cent of the global population and contribute to 25 per cent of the world gross domestic products. All these countries are facing the formidable challenge of rising incidence of breast cancer and significant number of premature deaths from the disease. A multidimensional approach involving prevention, early detection and improved treatment is required to counteract the growing burden of breast cancer. A growing trend in the prevalence of major preventable risk factors of breast cancer such as obesity, western dietary habits, lack of physical activity, consumption of alcohol and smoking is contributing significantly to the rising burden of the disease in BRICS nations. Specific interventions are needed at the individual and population levels to mitigate these risk factors, preferably within the broader framework of non-communicable disease control programme. Population-based quality assured mammography-based screening of the 50-69 yr old women can reduce breast cancer mortality at least by 20 per cent. However, none of the BRICS countries have been able to implement population-based organized screening programme. Large scale opportunistic screening with mammography targeting predominantly the younger women is causing harms to the women and wasting precious healthcare resources. There are recent national recommendations to screen women with mammography in Brazil and Russia and with clinical breast examination in China (along with ultrasound) and India. Given the challenges of implementing systematic screening of the population, the BRICS countries should prioritize the early diagnosis approach and invest in educating the women about the breast cancer symptoms, training the frontline health providers to clinically detect breast cancers and appropriately refer for diagnostic confirmation, and creating improved access to good quality diagnostic and treatment facilities for breast cancer. The early diagnosis approach has been proved to achieve downstaging and improve survival at a fraction of the resources needed for population screening. The countries also need to focus on improving the services and capacity for multidisciplinary treatment of breast cancer, histopathology and immunohistochemistry, safe administration of chemotherapy and palliative care.
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Affiliation(s)
- Partha Basu
- Screening Group, Early Detection & Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Li Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Roopa Hariprasad
- Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Andre L. Carvalho
- Screening Group, Early Detection & Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Anton Barchuk
- Faculty of Social Sciences/Health Sciences, Tampere University, Tampere, Finland
- N.N. Petrov National Research Medical Center of Oncology, Saint Petersburg, Russia
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Niclis C, Shivappa N, Hébert JR, Tumas N, Díaz MDP. The Inflammatory Potential of Diet is Associated with Breast Cancer Risk in Urban Argentina: A Multilevel Analysis. Nutr Cancer 2020; 73:1898-1907. [PMID: 32900242 DOI: 10.1080/01635581.2020.1817953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Dietary patterns have been associated with breast cancer (BC) in Argentina. However, little evidence exists relating the inflammatory potential of diet and BC in Latin American countries and how this may relate to rurality.The aim of the present study was to evaluate the association between the Dietary Inflammatory Index (DII®) and BC considering urbanization contexts in Córdoba, Argentina.A frequency-matched case-control study (317 BC cases, 526 controls) was conducted from 2008 through 2016. DII scores were computed based on dietary intake assessed by a validated food frequency questionnaire. Multi-level logistic regression models were fit to evaluate the association between DII and BC, following adjustment for age, body mass index, age at menarche, number of children, smoking habits, socio-economic status and family history of BC as first-level covariates and urbanization level as the contextual variable.Increasing DII score showed significant positive associations with BC risk (ORtertile3vs.tertile1 1.34; 95%CI 1.05, 1.70). The association was stronger in overweight and obese women (ORtertile3vs.tertile1 1.98; 95%CI 1.86, 2.10). The DII effect on BC was higher with increased urbanization.A pro-inflammatory diet, reflected by higher DII scores, was positively associated with BC, especially in overweight women and with increased urbanization.
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Affiliation(s)
- Camila Niclis
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina.,Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hébert
- Connecting Health Innovations LLC, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
| | - Natalia Tumas
- Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina.,Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Córdoba, Argentina
| | - María Del Pilar Díaz
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina.,Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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8
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A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study. Indian J Surg Oncol 2017; 9:323-327. [PMID: 30287991 DOI: 10.1007/s13193-017-0703-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022] Open
Abstract
Breast cancer (BC) has become the most common cancer in urban women. Unfortunately, most women are not aware of BC symptoms/signs, prevention, and management. In resource-limited countries like India where we do not have structured screening/awareness programs, a majority of women present with locally advanced BC. The aim of our study is to identify the present status of awareness about BC prevention, early detection, symptoms, and management in urban and rural Indian women (medical, paramedical, and nonmedical) and to assess whether education and socioeconomic strata have any role in better awareness about BC or not. We did a prospective cross-sectional observation study among the medical, paramedical, and nonmedical women in the northern part of India. We designed a questionnaire keeping in mind the three domains about BC-knowledge (questions 1-25 include risk factors, genetics, lifestyle changes, hormones, associated cancers, and modes of presentation like lump, nipple/skin changes), breast self-examination (questions 25-37), and attitude to prevention and early detection (questions 38-44). We also asked how many do breast self-examination (BSE) and what they think are the three main factors responsible for late presentation and the three main ways to increase BC awareness. The Likert scale was used for objective assessment. We analyzed the whole data using SPSS software version 15. A total of 220 women out of 270 completed the questionnaire. Out of 220 women, 26.4% were medical, 20.9% paramedical, and 52.7% nonmedical. Most women were educated (82.7%) and married (65%). 59.5% women resided in urban areas and the rest (40.5%) were from rural areas. We found that there was relatively more knowledge in the medical group; however, the skills of BSE and attitude to prevention and early detection in all the three subgroups and among rural and urban women were suboptimal and not different significantly. The three main factors responsible for delayed presentation were shyness and not knowing BSE, ignorance about BC symptoms, and social stigma of cancer along with financial constraints. The three main ways to improve BC awareness suggested were to have more advertisements on television and social media, roadside campaigns and in colleges along with group discussions and debates, and at grassroots level to involve Anganwadi workers and nurses to create more awareness in villages. There was less breast cancer knowledge and awareness among the nonmedical women compared to those among the medical and paramedical, the skills of BSE and attitude to prevention and early detection were suboptimal in all the three groups. Rural or urban dwellings did not make much difference in BC knowledge, skills of BSE, and attitude to prevention. More awareness regarding breast cancer symptoms with early detection and BSE need to be addressed with more information dissemination via social media, campaigns, and involvement of paramedics and social workers.
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Elidrissi Errahhali M, Elidrissi Errahhali M, Ouarzane M, Boulouiz R, Bellaoui M. Cancer incidence in eastern Morocco: cancer patterns and incidence trends, 2005-2012. BMC Cancer 2017; 17:587. [PMID: 28851324 PMCID: PMC5575884 DOI: 10.1186/s12885-017-3597-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/23/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cancer is one of the major health problems worldwide. In this article, we present for the first time the cancer incidence trends, the distribution and the socioeconomic profile of incident cancer cases in Eastern Morocco over a period of eight years. METHODS Retrospective descriptive study of patients diagnosed with cancer at the Hassan II Regional Oncology Center (ROC) since it was created in October 2005 until December 2012. During the study period, the ROC was the only hospital specialized in cancer care in Eastern Morocco. RESULTS A total of 7872 incident cases of cancer were registered in Eastern Morocco. Among these incident cases 5220 cases were women and 2652 were men, with a female to male ratio of 1.97. The mean age at diagnosis was 58 years for males and 52 for females and 94% of the patients aged over 30 years. For both sexes combined and for all cancer sites, breast cancer was the commonest followed by cervix uteri, colon-rectum, lung, nasopharynx, and stomach cancers. The most common cancer in women was breast cancer, followed respectively by cervix uteri cancer, colon-rectum cancer, ovary cancer, and stomach cancer. In men, the lung cancer ranked first, followed respectively by colon-rectum cancer, nasopharynx cancer, prostate cancer, and stomach cancer. For most cancers, crude incidence rates (CR) have increased significantly. The CR for all cancers combined has increased from 56.6 to 80.3 per 100,000 females and from 32.3 to 42.6 per 100,000 males during the study period. Patients profile analysis showed that 79% of cancer patients were from urban areas, 83% were unemployed and 85% had no health insurance. CONCLUSIONS The distribution of cancers in Eastern Morocco is different from those observed in other regions of Morocco. Unlike most countries, women were much more affected with cancer than men in Eastern Morocco. More importantly, the rates of many cancers are rising. Therefore, our data justify the need to develop effective programs for cancer control and prevention in Eastern Morocco. A better access to cancer care should be a priority of the health policies, given that the majority of cancer patients in Eastern Morocco are unemployed, and do not have medical care coverage.
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Affiliation(s)
- Manal Elidrissi Errahhali
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | | | - Meryem Ouarzane
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Redouane Boulouiz
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Mohammed Bellaoui
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco.
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10
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Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol 2017; 13:289-295. [PMID: 28181405 DOI: 10.1111/ajco.12661] [Citation(s) in RCA: 251] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 11/03/2016] [Accepted: 12/03/2016] [Indexed: 12/01/2022]
Abstract
Breast cancer has ranked number one cancer among Indian females with age adjusted rate as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women. Data reports from various latest national cancer registries were compared for incidence, mortality rates. The age adjusted incidence rate of carcinoma of the breast was found as high as 41 per 100,000 women for Delhi, followed by Chennai (37.9), Bangalore (34.4) and Thiruvananthapuram District (33.7). A statistically significant increase in age adjusted rate over time (1982-2014) in all the PBCRs namely Bangalore (annual percentage change: 2.84%), Barshi (1.87%), Bhopal (2.00%), Chennai (2.44%), Delhi (1.44%) and Mumbai (1.42%) was observed. Mortality-to-incidence ratio was found to be as high as 66 in rural registries whereas as low as 8 in urban registries. Besides this young age has been found as a major risk factor for breast cancer in Indian women. Breast cancer projection for India during time periods 2020 suggests the number to go as high as 1797900. Better health awareness and availability of breast cancer screening programmes and treatment facilities would cause a favorable and positive clinical picture in the country.
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Affiliation(s)
- Shreshtha Malvia
- National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, India
| | | | - Uma S Dubey
- Birla institute of Technology, Pilani, Rajasthan, India
| | - Sunita Saxena
- National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, India
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11
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Nagrani R, Mhatre S, Rajaraman P, Soerjomataram I, Boffetta P, Gupta S, Parmar V, Badwe R, Dikshit R. Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity. Eur J Cancer 2016; 66:153-61. [PMID: 27573429 PMCID: PMC5040194 DOI: 10.1016/j.ejca.2016.07.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Current evidence suggests that the relationship between obesity and breast cancer (BC) risk may vary between ethnic groups. METHODS A total of 1633 BC cases and 1504 controls were enrolled in hospital-based case-control study in Mumbai, India, from 2009 to 2013. Along with detailed questionnaire, we collected anthropometric measurements on all participants. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence interval (CI) for BC risk associated with anthropometry measurements, stratified on tumour subtype and menopausal status. RESULTS Waist-to-hip ratio (WHR) of ≥0.95 was strongly associated with risk of BC compared to WHR ≤0.84 in both premenopausal (OR = 4.3; 95% CI: 2.9-6.3) and postmenopausal women (OR = 3.4; 95% CI: 2.4-4.8) after adjustment for body mass index (BMI). Premenopausal women with a BMI ≥30 were at lower risk compared to women with normal BMI (OR = 0.5; 95% CI: 0.4-0.8). A similar protective effect was observed in women who were postmenopausal for <10 years (OR = 0.6; 95% CI: 0.4-0.9) but not in women who were postmenopausal for ≥10 years (OR = 1.8; 95% CI: 1.1-3.3). Overweight and obese women (BMI: 25-29.9 and ≥ 30 kg/m(2), respectively) were at increased BC risk irrespective of menopausal status if their WHR ≥0.95. Central obesity (measured in terms of WC and WHR) increased the risk of both premenopausal and postmenopausal BCs irrespective of hormone receptor (HR) status. CONCLUSIONS Central obesity appears to be a key risk factor for BC irrespective of menopausal or HR status in Indian women with no history of hormone replacement therapy.
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Affiliation(s)
- R Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India
| | - S Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India
| | - P Rajaraman
- Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA
| | - I Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX, France
| | - P Boffetta
- Institute For Translational Epidemiology, Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA
| | - S Gupta
- Advanced Centre for Treatment, Research and Education in Cancer, Navi Mumbai, Maharashtra 400 012, India
| | - V Parmar
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra 400 012, India
| | - R Badwe
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra 400 012, India
| | - R Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, 400 012, India.
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12
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Affiliation(s)
- Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
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13
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Keshet-Sitton A, Or-Chen K, Yitzhak S, Tzabary I, Haim A. Light and the City: Breast Cancer Risk Factors Differ Between Urban and Rural Women in Israel. Integr Cancer Ther 2016; 16:176-187. [PMID: 27440788 PMCID: PMC5739126 DOI: 10.1177/1534735416660194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Women are exposed to indoor and outdoor artificial light at night (ALAN) in urban and rural environments. Excessive exposure to hazardous ALAN containing short wavelength light may suppress pineal melatonin production and lead to an increased breast cancer (BC) risk. Our objective was to address the differences in BC risks related to light exposure in urban and rural communities. We examined indoor and outdoor light habits of BC patients and controls that had lived in urban and rural areas in a 5-year period, 10 to 15 years before the time of the study. Individual data, night time sleeping habits and individual exposure to ALAN habits were collected using a questionnaire. A total of 252 women (110 BC patients and 142 controls) participated in this study. The sample was divided to subgroups according to dwelling area and disease status. Age matching was completed between all subgroups. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for urban and rural women separately, using binary logistic regression. OR results of urban population (92 BC patients and 72 control) revealed that BC risk increases with daily use of cellphone (OR = 2.13, 95% CI = 1.01-4.49, P < .05) and residence near strong ALAN sources (OR = 1.51, 95% CI = 0.99-2.30, P < .06). Nevertheless, BC risk decreases if a woman was born in Israel (OR = 0.44, 95% CI = 0.21-0.93, P < .03), longer sleep duration (OR = 0.75, 95% CI = 0.53-1.05, P < .1), and reading with bed light illumination before retiring to sleep (OR = 0.77, 95% CI = 0.61-0.96, P < .02). Furthermore, in the rural population (18 BC patients and 66 control) BC risk increases with the number of years past since the last menstruation (OR = 1.12, 95% CI = 1.03-1.22, P < .01). However, BC risk decreases with longer sleep duration (OR = 0.53, 95% CI = 0.24-1.14, P < .1), reading with room light illumination before retiring to sleep (OR = 0.55, 95% CI = 0.29-1.06, P < .07), and sleeping with closed shutters during the night (OR = 0.66, 95% CI = 0.41-1.04, P < .08). These data support the idea that indoor and outdoor nighttime light exposures differ between urban and rural women. Therefore, we suggest that women can influence BC risk and incidence by applying protective personal lighting habits. Further studies with larger sample sizes are needed to strengthen the results.
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Affiliation(s)
| | | | | | - Ilana Tzabary
- 3 Soroka University Medical Center, Beer-Sheva, Israel
| | - Abraham Haim
- 1 University of Haifa, Mount Carmel, Haifa, Israel
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