Prospective breast cancer risk factors prediction in Saudi women

Obesity, Physical Activity, and Cancer Incidence in Two Geographically Distinct Populations; The Gulf Cooperation Council Countries and the United Kingdom-A Systematic Review and Meta-Analysis

BACKGROUND

The relationship between obesity, physical activity, and cancer has not been well studied across different countries. The age-standardized rate of cancer in the UK is double-triple that in the Gulf Cooperation Council Countries (GCCCs). Here, we study the association between obesity, physical activity, and cancer incidence with the aim to elucidate cancer epidemiology and risk factors in two geographically, ethnically, and climatically different parts of the world.

METHODS

Our systematic search (from 2016 to 2023) in PubMed, EMBASE, Scopus, and APA PsycINFO databases resulted in 64 studies totaling 13,609,578 participants. The Cochrane risk of bias tool, GRADE, R programming language, and the meta package were used.

RESULTS

Significant associations between obesity and cancer were found in both regions, with a stronger association in the UK (p ≤ 0.0001) than the GCCCs (p = 0.0042). While physical inactivity alone did not show a statistically significant association with cancer incidence, the pooled hazard ratio analysis revealed that the presence of both obesity and physical inactivity was associated with a significantly higher cancer incidence. The most common types of cancer were breast cancer in the UK and colorectal cancer across the GCCCs.

CONCLUSION

Although both regions share similarities, advanced healthcare systems, genetic characteristics, dietary habits, and cultural practices may influence cancer incidence and types.

Modelling of the time to death of breast cancer patients at Hiwot Fana Specialized University Hospital

Breast cancer is the most common cause of cancer death and is a frequently diagnosed cancer among women worldwide. It is becoming a challenging health condition in Ethiopia with a high rate of morbidity and mortality. The main aim of this study was to model the time to death in breast cancer patients at Hiwot Fana Specialized University Hospital. A retrospective cohort study was carried out from April 1st, 2020, to April 1st, 2023, and 296 women were included in the study. We used nonparametric methods and Bayesian accelerated failure time models (with Laplace approximation) to identify risk factors and choose a model fitting breast cancer patient data. Model comparison was performed using the marginal likelihood, deviance information criterion and Watanabe Akaike information criterion. From the total of 296 patients in the study, 56 (18.9%) died. The estimated median survival time was 33 months. The log-rank test showed that age group, stage, alcohol consumption, smoking habit, and comorbidity were potential risk factors associated with the time to death in breast cancer patients at the 5% level of significance. The Bayesian Weibull accelerated failure time model was found to be the best fitted model for predicting the survival time of patients with minimum DIC (520.39) and WAIC (521.59) values. The final Bayesian Weibull AFT model with the integrated nested Laplace approximation estimation technique revealed that age group, stage, alcohol consumption, smoking habit, and comorbidity were significantly associated with the time to death in breast cancer patients. Individuals older than 65 years, with stage IV disease, drinking alcohol, smoking cigarettes and having comorbidities had shortened survival times in patients with breast cancer. Hence, Hiwot Fana Specialized University Hospital and related bodies should work on awareness creation to reduce smoking habits and alcohol use as well as give due attention to elderly and stage IV breast cancer patients during intervention.

The epidemiological and clinicopathological features of breast cancer in Riyadh, Saudi Arabia

OBJECTIVES

To investigate the epidemiological and clinicopathological features of breast cancer (BC) in Saudi Arabia to improve decisions regarding resource allocation, disease control, and management.

METHODS

We retrieved the records of all patients who presented with histologically proven BC at King Fahad Medical City between 2019 and 2020. The data were analyzed quantitatively, and the results were expressed as percentages and frequencies.

RESULTS

This study comprised 419 patients. The mean age was 50.13 (± 10.96) years. The majority of the patients were obese (56.6%), and approximately a quarter had a history of oral contraceptive pill use, breast biopsy, or an affected family member. Most cases were from the central region (80.1%), followed by the southern provinces (12.7%). Breast lumps were the most common complaint (89%), whereas hypertension and diabetes mellitus were the most common comorbidities. Invasive ductal carcinoma was the most common pathologic type (89.7%). Most patients presented with TNM stages II and III (55.2%), and 27.7% had metastasis. The main therapeutic modalities included radical mastectomy (63.8%), neoadjuvant chemotherapy (60.4%), and adjuvant radiotherapy (82.9%).

CONCLUSION

In Saudi Arabia, a trend of BC incidence migration towards older patients may be ensuing. However, prediction of an advanced and aggressive presentation requires the enhancement of screening programs and standardized protocols for disease management.

Breastfeeding and its Association with Breast Cancer: a Systematic Review of the Literature

Objective:Breast cancer is a global public health issue. The disease can be diagnosed in both older and younger women, with the latter facing several dilemmas. Breastfeeding is of general concern to the scientific community as well as its connection with the prevention of breast cancer is being sought. The purpose of this review is to search for studies investigating the relationship between breast cancer and breastfeeding. Material and methods: The articles included in the present paper were searched in PubMed and Scopus databases according to PRISMA guidelines for systematic reviews. This systematic review sought primary studies investigating the relationship between breastfeeding and breast cancer and that were published in English between 2017-2022. Results:Seventeen articles that investigated the relationship of breast cancer with lactation duration, women's age, family history and lifestyle were included in the present review. Conclusion:It was found that, in most studies, breastfeeding could be evaluated as a protective factor of the disease. From all studied articles, the need for the design of additional studies investigating the relationship between breastfeeding and breast cancer emerges.

Prospective Functions of miRNA Variants May Predict Breast Cancer Among Saudi Females

Background Growing knowledge supports the importance of microRNAs (miRNAs) in modulating the initiation and development of breast cancer (BC) and underlying mechanisms. BC is a significant public health in females worldwide, where it remains the leading cause of death among Saudi females. Here, we evaluate the susceptibility of the miRNA genetic variants to the risk of BC in Saudi females. Methods One hundred fifty-four females, including 76 females diagnosed with BC and 78 healthy controls, were analyzed using TaqMan™ (Thermo Fischer Scientific, Waltham, MA) genotyping assays for the miR-196a2 rs11614913 C>T, miR-146a rs2910164 C>G, and miR-499 rs3746444 A>G. We utilized the SNPStats software (https://www.snpstats.net) (Institut Català d'Oncologia, Barcelona, Spain) to choose the best interactive inheritance model for the examined miRNAs. Results The examined miRNA single-nucleotide polymorphisms (SNPs) showed no clear association with the risk of BC (P > 0.05). As for genotypic distributions, significant associations were found for the rs2910164 SNP in most interactive models of inheritance: 2.50 (95% confidence interval {CI}, 1.2-5.17; P = 0.0135) in the codominant model, 2.34 (95% CI, 1.11-4.8; P = 0.0197) in the dominant model, and 2.40 (95% CI, 1.22-4.73; P = 0.0113) in overdominant model. The rs2910164 C/G heterozygosity showed overexpression in cases compared to controls (73.7% versus 53.9%; chi-squared (χ2) = 6.5; P = 0.0109), but the homozygous rs2910164 G/G showed a significant protective effect (21.1% versus 38.5%; χ2 = 17.4; P = 0.019). The heterozygosity did not affect the risk to the BC in the two miRNAs (rs11614913 C>T and rs3746444 A>G). Conclusion Despite lacking associations with the examined miRNAs, the heterozygous genotype rs2910164 C/G can identify at-risk females. More studies should be replicated using a panel of miRNA genes to discover significant associations with the risk of BC.

Correlation of prognostic and predictive indicators in breast cancer patients from the eastern province of Saudi Arabia

OBJECTIVES

To highlight and correlate demographic and histopathological features of breast cancer along with prognostic and predictive biomarkers, in Saudi patients from the Eastern Province and compare it to a cohort of non-Saudi patients.

METHODS

In a retrospective study between January 1998 and December 2017, data were collected from the medical records of breast cancer patients who were admitted at King Fahd University Hospital (KFHU), Dammam, Saudi Arabia. The information included demographic, histopathological, and immunohistochemical findings.

RESULTS

Out of 482 breast cancer patients, 60% (n=286) were Saudis, and 40% (n=196) were non-Saudis. Data showed a wide age distribution; however, most cases (80%) were seen in the third through fifth decades, with a median age at diagnosis of 51 ±12 years. Over years, breast cancer in Saudi patients was increasingly seen at a younger age (p=0.003). While tumors were increasingly detected at earlier stages (p=0.003); however, stage III & IV tumors (p=0.033) and human epidermal growth factor receptor-2 overexpressed tumors (p=0.035) were more frequently seen at a younger age. Interestingly, these associations were not significant in non-Saudi patients.

CONCLUSION

Although, the current findings might help future studies to identify variables that could lead to better management of breast cancer in this region; however, a wider investigation including other centers in the eastern province is needed.

Establish a Scoring Model for High-Risk Population of Gastric Cancer and Study on the Pattern of Opportunistic Screening

Objective

To investigate and study the related risk factors of gastric cancer (GC) patients, to establish a high-risk scoring model of GC by multiple logistic regression analysis, and to explore the establishment of a GC screening mode with clinical opportunistic screening as the main method, and by using the pattern of opportunistic screening to establish the screening of high-risk GC patients and the choice of screening methods in the clinical outpatient work.

Methods

Collected the epidemiological questionnaire of 99 GC cases and 284 non-GC patients (other chronic gastric diseases and normal) diagnosed by the General Hospital of Ningxia Medical University from October 2017 to March 2019. Serum pepsinogen (PG) levels were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed Helicobacter pylori (Hp) infection in gastric mucosa tissues by Giemsa staining. Determined the high-risk factors and established a scoring model through unconditional logistic regression model analysis, and the ROC curve determined the cut-off value. Then, we followed up 26 patients of nongastric cancer patients constituted a validation group, which validated the model.

Results

The high-risk factors of GC included age ≥ 55, male, drinking cellar or well water, family history of GC, Hp infection, PGI ≤ 43.6 μg/L, and PGI/PGII ≤ 2.1. Established the high-risk model: Y = A × age + 30 × gender + 30 × drinking water + 30 × Hp infection + 50 × family history of GC + B × PG level. The ROC curve determined that the cut-off value for high-risk GC population was ≥155, and the area under the curve (AUC) was 0.875, the sensitivity and specificity were 87.9% and 71.5%.

Conclusions

According to the risk factors of GC, using statistical methods can establish a high-risk scoring model of GC, and the score ≥ 155 is divided into the screening cut-off value for high-risk GC population. Using this model for clinical outpatient GC screening is cost-effective and has high sensitivity and specificity.