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Tao X, Li T, Gandomkar Z, Brennan PC, Reed WM. Incidence, mortality, survival, and disease burden of breast cancer in China compared to other developed countries. Asia Pac J Clin Oncol 2023; 19:645-654. [PMID: 37026375 DOI: 10.1111/ajco.13958] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 04/08/2023]
Abstract
Breast cancer was the most diagnosed malignant neoplasm and the second leading cause of cancer mortality among Chinese females in 2020. Increased risk factors and widespread adoption of westernized lifestyles have resulted in an upward trend in the occurrence of breast cancer. Up to date knowledge on the incidence, mortality, survival, and burden of breast cancer is essential for optimized cancer prevention and control. To better understand the status of breast cancer in China, this narrative literature review collected data from multiple sources, including studies obtained from the PubMed database and text references, national annual cancer report, government cancer database, Global Cancer Statistics 2020, and Global Burden of Disease study (2019). This review provides an overview of the incidence, mortality, and survival rates of breast cancer, as well as a summary of disability-adjusted life years associated with breast cancer in China from 1990 to 2019, with comparisons to Japan, South Korea, Australia and the United States.
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Affiliation(s)
- Xuetong Tao
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Tong Li
- The Daffodil Centre, A Joint Venture with Cancer Council NSW, The University of Sydney, Sydney, New South Wales, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ziba Gandomkar
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Patrick C Brennan
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Warren M Reed
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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2
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Adejumo PO, Aniagwu TIG, Awolude OA, Adedokun B, Kochheiser M, Sowunmi A, Popoola A, Ojengbede O, Huo D, Olopade OI. Cancer Genetic Services in a Low- to Middle-Income Country: Cross-Sectional Survey Assessing Willingness to Undergo and Pay for Germline Genetic Testing. JCO Glob Oncol 2023; 9:e2100140. [PMID: 36854077 PMCID: PMC10166413 DOI: 10.1200/go.21.00140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
PURPOSE Cancer genetic testing (CGT), a pathway to personalized medicine, is also being embraced in Nigeria. However, little is known about the influence of demographics and perceptions on individuals' willingness to access and pay for CGT. This study assessed patients' willingness to undergo CGT in southwest Nigeria as a catalyst for sustainable Cancer Risk Management Program. METHODS This was a cross-sectional study using semistructured questionnaire to interview 362 patients with cancer and 10 referred first-degree relatives between July 2018 and February 2020. Participants from three Nigerian teaching hospitals-University College Hospital, Ibadan, Lagos State University Teaching Hospital, Lagos, and Lagos University Teaching Hospital, Lagos, received genetic counseling and had subsequent CGT. Primary outcomes were willingness to undergo CGT in determining cancer risk and the willingness to pay for it. Ethical approval was from appropriate ethics committees of participating hospitals. Data were analyzed with SPSS version 22. Univariate comparison of categorical variables was performed by χ2 test, multivariate analysis by logistic regression. RESULTS The participants from University College Hospital (56.2%), Lagos State University Teaching Hospital (26.3%), and Lagos University Teaching Hospital (17.5%) were mostly female (98.4%). Mean age was 48.8 years ± 11.79. Three hundred twenty-two (86.6%) patients and first-degree relatives were willing to take the test, of whom 231 (71.1%) were willing to pay for it. more than half (53.6%) of the participants were willing to pay between N10,000 and N30,000, which is less than $100 US dollars. Sociodemographic variables and willingness to test showed no association (P > .05). Education and ethnicity were found to be associated with their willingness to pay for CGT (P ≤ .05). CONCLUSION Learning clinically relevant details toward cancer prevention informs health-related decisions in patients and relatives, a motivator for willingness to pay for genetic testing in low- and middle-income countries. Increased awareness may influence outcomes of cancer risk management.
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Affiliation(s)
- Prisca O Adejumo
- Department of Nursing, College of Medicine, University of Ibadan, Nigeria
| | - Toyin I G Aniagwu
- School of Occupational Health Nursing, University College Hospital, Ibadan, Nigeria
| | - Olutosin A Awolude
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo, Nigeria
| | - Babatunde Adedokun
- Center for Clinical Cancer Genetics & Global Health, Department of Medicine, The University of Chicago, Chicago, IL
| | - Makayla Kochheiser
- Center for Clinical Cancer Genetics & Global Health, Department of Medicine, The University of Chicago, Chicago, IL
| | | | | | - Oladosu Ojengbede
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Dezheng Huo
- Department of Public Health Sciences, The University of Chicago, Chicago, IL
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics & Global Health, Department of Medicine, The University of Chicago, Chicago, IL
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Luo C, Li N, Lu B, Cai J, Lu M, Zhang Y, Chen H, Dai M. Global and regional trends in incidence and mortality of female breast cancer and associated factors at national level in 2000 to 2019. Chin Med J (Engl) 2022; 135:42-51. [PMID: 34593698 PMCID: PMC8850868 DOI: 10.1097/cm9.0000000000001814] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Female breast cancer (FBC) has become the most prevalent malignancy worldwide. We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of FBC. METHODS FBC incidence and mortality in 60 selected countries by cancer registry data integrity in 2020 were estimated from the GLOBOCAN database, and their association with the human development index (HDI) was further evaluated. Trends of age-standardized rates of incidence and mortality in 60 countries from 2000 through 2019 were evaluated by joinpoint regression analysis using data of Global Burden of Disease 2019. The association between potential behavioral, metabolic, and socioeconomic risk factor exposure at the nation level retrieved from the World Bank and Global Health Observatory and the incidence and mortality of FBC were evaluated by multivariate linear regression. RESULTS FBC incidence and mortality varied greatly in the 60 included countries. Higher incidence and mortality rates were typically observed in countries with higher HDIs and vice versa. During 2000 to 2019, significantly increasing trends in incidence and mortality were observed in 26 (average annual percent changes [AAPCs], 0.35-2.96) and nine countries (AAPC, 0.30-1.65), respectively, while significantly decreasing trends in both incidence and mortality were observed in 22 countries, most of which were high-HDI countries. Among the population aged ≥40 years, there were 26 and 11 countries showing significantly increased trends in incidence and mortality, respectively. Ecological analysis showed that countries with higher prevalence rates of high cholesterol and higher health expenditures were more likely to have higher FBC incidence, and countries with higher rates of obesity and poorer universal health coverage were more likely to have higher FBC mortality. CONCLUSIONS Despite decreased or stabilized FBC incidence and mortality rates were observed in some countries with high HDI over the past decades, disease burden became even severer in developing countries, especially for the population aged ≥40 years. Effective targeted preventive programs are strongly encouraged to reduce the FBC disease burden worldwide.
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Affiliation(s)
- Chenyu Luo
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Na Li
- Department of Cancer Prevention, Hunan Cancer Hospital, Changsha, Hunan 410006, China
| | - Bin Lu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jie Cai
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ming Lu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuhan Zhang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongda Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Huang J, Ngai CH, Deng Y, Tin MS, Lok V, Zhang L, Yuan J, Xu W, Zheng ZJ, Wong MCS. Cancer Incidence and Mortality in Asian Countries: A Trend Analysis. Cancer Control 2022; 29:10732748221095955. [PMID: 35770775 PMCID: PMC9252010 DOI: 10.1177/10732748221095955] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to evaluate the updated burden and temporal trends of cancer incidence and mortality in Asian countries. Methodology The data used in this study were retrieved from the Global Cancer Observatory, Cancer Incidence in Five Continents volumes I-XI, and the World Health Organization mortality database. These data were used to calculate the Average Annual Percentage Change (AAPC), with a 95% confidence interval (CI) by joinpoint regression analysis to determine the epidemiological trend in the past decade. Results In 2020, the cancer incidence in Asia was 169.1 per 1 00 000, accounting for 49.3% of the global cancer incidence. The most common cancers included lung (13.8%), breast (10.8%) and colorectal (10.6%) cancers. Its mortality was 101.6 per 1 00 000 (58.3% of the global cancer death) with lung (19.2%), liver (10.5%) and stomach (9.9%) cancers being the most common causes of cancer death. The cancer incidence had been increasing in female population, with Korea (AAPC = 5.73, 95% CI [5.30, 6.17], P < .001), Japan (AAPC = 2.67, 95% CI [2.12, 3.23], P < .001) and Kuwait (AAPC = 2.08, 95% CI [.49, 3.69], P = .016) showing the most significant increases in the past decade. The incidence increase was also observed among population aged <40 years old, with Korea (female AAPC = 8.42, 95% CI [7.40, 9.45], P < .001; male AAPC = 5.28, 95% CI [4.23, 6.33], P <.001), China (female AAPC = 2.94, 95% CI [2.07, 3.81], P < .001; male AAPC = 1.37, 95% CI [.57, 2.18], P = .004) and Japan (female AAPC = 2.88, 95% CI [1.88, 3.88], P = .016; male AAPC = 1.59, 95% CI [.40, 2.78], P = .015) showing the most significant increases. However, there was an overall decreasing trend of cancer mortality. Conclusions There was a substantial burden of cancer incidence and mortality in Asia. Although there was a decreasing trend in cancer mortality, its incidence had been increasing especially among female and younger populations. Future studies could be done to further investigate the potential reasons for these epidemiologic trends.
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Affiliation(s)
- Junjie Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Chun Ho Ngai
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Yunyang Deng
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Man Sing Tin
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Veeleah Lok
- Department of Global Public Health, Karolinska University Hospital, 27106Karolinska Institute, Stockholm, Sweden
| | - Lin Zhang
- Centre of Cancer Research, 569586Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China
| | - Jinqiu Yuan
- Clinical Research Centre, The Seventh Affiliated Hospital, 543160Sun Yat-sen University, Shenzhen, China.,Scientific Research Centre, The Seventh Affiliated Hospital, 543160Sun Yat-sen University, Shenzhen, China
| | - Wanghong Xu
- School of Public Health, 12478Fudan University, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, 26451Peking University, Beijing, China
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.,Department of Global Health, School of Public Health, 26451Peking University, Beijing, China
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Okati-Aliabad H, Ansari-Moghadam A, Mohammadi M, Kargar S, Shahraki-Sanavi F. The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer. Support Care Cancer 2021; 30:703-710. [PMID: 34365523 DOI: 10.1007/s00520-021-06477-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Diagnosis of breast cancer and its treatment dramatically affects women's psychological health. This study investigated the prevalence of depression and anxiety and their related factor in breast cancer women. METHODS We conducted a cross-sectional study with a sample of 120 women with breast cancer in Zahedan, Iran, 2020. Data were collected using instruments included: Hospital Anxiety and Depression Scale (HADS), Supportive Care Needs Survey (SCNS-SF34), Multidimensional Scale of Perceived Social Support (MSPSS), The adjustment to illness measurement inventory for Iranian women with breast cancer (AIMI-IBC). We analyzed the data using the ANOVA, independent sample t-test, Kruskal Wallis, Mann-Whitney U test, Pearson's and Spearman's correlation coefficients. RESULTS The prevalence of depression and anxiety in women with breast cancer was 66.6% and 60%, respectively. A significant positive correlation was found between anxiety and depression and unmet psychological needs, care/support needs, and emotional turmoil coping strategy, while reasonable efforts and avoidance coping strategies and adjusting to disease were negatively correlated with anxiety and depression. Also, linear regression results indicated unmet psychological needs, emotional turmoil coping strategy, and a high level of depression predicted a high anxiety level. A lower level of depression was indicated by reasonable efforts strategy and less level of anxiety. CONCLUSIONS Women with breast cancer reported a high level of depression and anxiety in Zahedan, and clinicians should pay more attention to these patients' psychological distress. Resolving the unmet need of patients, increasing social support, and using the right coping strategy have an essential role in breast cancer women's psychological distress control.
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Affiliation(s)
- Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shiva Kargar
- School of Health, Zahedan University of Medical Sciences, Zahedan, Iran.
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Sharma R. Examination of incidence, mortality and disability-adjusted life years and risk factors of breast cancer in 49 Asian countries, 1990-2019: estimates from Global Burden of Disease Study 2019. Jpn J Clin Oncol 2021; 51:826-835. [PMID: 33621341 DOI: 10.1093/jjco/hyab004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study presents an up-to-date, comprehensive and comparative examination of breast cancer's temporal patterns in females in Asia in last three decades. METHODS The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. RESULTS In Asia, female breast cancer incidence grew from 245 045[226 259-265 260] in 1990 to 914 878[815 789-1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6-22.9] to 35.9/100 000[32.0-40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094-148 380] to 337 822[301 454-375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0-13.1]; 2019: 13.4[12.0-14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95-21.4] in Mongolia to 122.5[92.1-160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2-8.8] in South Korea to 51.9[39.0-69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. CONCLUSION With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.
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Affiliation(s)
- Rajesh Sharma
- Assistant Professor, University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
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FOXO3a inhibits the EMT and metastasis of breast cancer by regulating TWIST-1 mediated miR-10b/CADM2 axis. Transl Oncol 2021; 14:101096. [PMID: 33882368 PMCID: PMC8081990 DOI: 10.1016/j.tranon.2021.101096] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/29/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Breast cancer is the most common malignancy and has been considered as a leading cause of cancer death in women. Exploring the mechanism of breast cancer metastasis is extremely important for seeking novel therapeutic strategies and improving prognosis. METHODS Clinical specimens and pathological characteristics were collected for evaluating the expression of forkhead box class O 3a (FOXO3a) and twist-related protein 1 (TWIST-1) in breast cancer tissues. CCK-8 assay was used to analyze cell proliferation. Cell invasion and migration were assessed by transwell assays. The expression of FOXO3a, TWIST-1, miR-10b, CADM2, FAK, phosphor-AKT and the epithelial-mesenchymal transition (EMT)-related protein (N-cadherin, E-cadherin and vimentin) were analyzed by RT-qPCR, immunohistochemical staining, immunofluorescence assay or western blot, respectively. Xenograft mouse models were used to analyze the role of the FOXO3a in breast cancer. RESULTS FOXO3a was down-regulated and TWIST-1 was up-regulated in breast cancer tissues. Overexpression of FOXO3a or knockdown of TWIST-1 suppressed the proliferation, invasion, migration and EMT of breast cancer cells. Overexpression of TWIST-1 could reverse the effect of FOXO3a on the proliferation, invasion, migration and EMT of breast cancer. Moreover, FOXO3a suppressed the growth and metastasis of breast cancer by targeting TWIST1 in vivo. CONCLUSION FOXO3a inhibited the EMT and metastasis of breast cancer via TWIST-1/miR-10b/CADM2 axis.
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Mubarik S, Wang F, Fawad M, Wang Y, Ahmad I, Yu C. Trends and Projections in Breast Cancer Mortality among four Asian countries (1990-2017): Evidence from five Stochastic Mortality Models. Sci Rep 2020; 10:5480. [PMID: 32214176 PMCID: PMC7096499 DOI: 10.1038/s41598-020-62393-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/12/2020] [Indexed: 11/24/2022] Open
Abstract
The current study aimed to explore some important insights into the breast cancer mortality (BCM) trends and projections among four Asian countries by using five advanced stochastic mortality models. BCM data over 28 years from 1990-2017 with ages 20-84 were retrieved from the Global Burden of Disease (GBD) Study 2017 for four Asian countries, namely, China, India, Pakistan, and Thailand. Five stochastic mortality models with the family of generalized age-period-cohort were implemented to find the present and future BCM trends in these four Asian countries. Based on Cairns-Blake-Dowd (CBD) model and Lee-Carter model (LCM), overall, results revealed that BCM increased with the passage of time. Aging factor was the most influential factor of elevated BCM in each Asian country under consideration. Projection of BCM showed that mortality rates might continue to grow with time, especially in older ages in each Asian country under study. The highest forecasted BCM rates were observed in Pakistan as compared to other countries. The obvious increase in BCM suggested that earlier tactics should be implemented to reduce the subsequent morbidity and mortality due to breast cancer. The last but not least, some additional tactics to mitigate the BCM in older ages must be adopted.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China
| | - Muhammad Fawad
- Henan Academy of Big Data, Zhengzhou University, Zhengzhou, 450052, China
- School of Mathematics and Statistics, Zhengzhou University, Zhengzhou, 450001, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China
| | - Ishfaq Ahmad
- Department of Mathematics and Statistics, Faculty of Basic and Applied Sciences, International Islamic University, Islamabad, Pakistan
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China.
- Global Health Institute, Wuhan University, Wuhan, Hubei, 430071, China.
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Mubarik S, Malik SS, Wang Z, Li C, Fawad M, Yu C. Recent insights into breast cancer incidence trends among four Asian countries using age-period-cohort model. Cancer Manag Res 2019; 11:8145-8155. [PMID: 31564974 PMCID: PMC6731990 DOI: 10.2147/cmar.s208323] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/26/2019] [Indexed: 01/07/2023] Open
Abstract
Purpose Breast cancer is one of the rapidly increasing cancers among women and a significant cause of cancer-related morbidity and mortality worldwide. Therefore, the current study was designed to examine and compare trends of breast cancer incidence (BCI) during the observed period (1990–2015) in specific age groups and investigate age-specific, time period, and birth cohort-related effects on BCI in China, India, Pakistan, and Thailand. Patients and method Data related to BCI were retrieved from the Institute for Health Metrics and Evaluation. Age–period–cohort model joint with intrinsic estimator algorithm was used to estimate the effect of age, period, and birth cohort on BCI. BCI rates were analyzed among different age groups ranging from 20 to 84 years in specified periods. Result Overall, results showed an increasing trend of BCI among four Asian countries during the study period especially in age groups 50 to 84 years. Higher incidence rates were observed in 2015 in the age group 70–74, 65–69, 50–54, and 60–64 in Pakistan, China, India, and Thailand, respectively. Age period cohort analysis revealed significantly raised effect of age and period and declined effect of the cohort on incidence rates. Conclusion The current study reported increased BCI with time in selected four Asian countries. Overall, BCI remained high in Pakistan as compared to China, India, and Thailand. Although proper registries are not available in most of the developing Asian countries, the current study highlighted the increased incidence and may play an essential role in registries development or spreading awareness against this disease. Therefore, maintaining proper records to build registries at the national level along with advancements in breast cancer screening and treatment are highly recommended to deal with the increasing burden of this disease. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/7yX8RwLIBXc
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, People's Republic of China
| | - Saima Shakil Malik
- Microbiology and Biotechnology Research Lab., Fatima Jinnah Women University, The Mall Rawalpindi 46000, Pakistan
| | - Zhenkun Wang
- Human Resource Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430071, People's Republic of China
| | - Chunhui Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430071, Hubei, People's Republic of China
| | - Muhammad Fawad
- School of Mathematics and Statistics, Central China Normal University, Wuhan 430072, Hubei, People's Republic of China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, People's Republic of China.,Global Health Institute, Wuhan University, Wuhan 430071, Hubei, People's Republic of China
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10
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Temilola DO, Wium M, Coulidiati TH, Adeola HA, Carbone GM, Catapano CV, Zerbini LF. The Prospect and Challenges to the Flow of Liquid Biopsy in Africa. Cells 2019; 8:E862. [PMID: 31404988 PMCID: PMC6721679 DOI: 10.3390/cells8080862] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 07/30/2019] [Accepted: 08/03/2019] [Indexed: 12/24/2022] Open
Abstract
Liquid biopsy technologies have the potential to transform cancer patient management as it offers non-invasive diagnosis and real-time monitoring of disease progression and treatment responses. The use of liquid biopsy for non-invasive cancer diagnosis can have pivotal importance for the African continent where access to medical infrastructures is limited, as it eliminates the need for surgical biopsies. To apply liquid biopsy technologies in the African setting, the influence of environmental and population genetic factors must be known. In this review, we discuss the use of circulating tumor cells, cell-free nucleic acids, extracellular vesicles, protein, and other biomolecules in liquid biopsy technology for cancer management with special focus on African studies. We discussed the prospect, barriers, and other aspects that pose challenges to the use of liquid biopsy in the African continent.
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Affiliation(s)
- Dada Oluwaseyi Temilola
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa
- Integrative Biomedical Sciences Division, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Martha Wium
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa
| | - Tangbadioa Herve Coulidiati
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa
- Training and Research unit in Sciences and Technology, University Norbert Zongo, P.O. Box 376, Koudougou 376, Burkina Faso
| | - Henry Ademola Adeola
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa
| | - Giuseppina Maria Carbone
- Institute of Oncology Research, Università della Svizzera Italiana, Via Vincenzo Vela 6, CH-6500 Bellinzona, Switzerland
| | - Carlo Vittorio Catapano
- Institute of Oncology Research, Università della Svizzera Italiana, Via Vincenzo Vela 6, CH-6500 Bellinzona, Switzerland
| | - Luiz Fernando Zerbini
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa.
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Schlemmer HP, Bittencourt LK, D’Anastasi M, Domingues R, Khong PL, Lockhat Z, Muellner A, Reiser MF, Schilsky RL, Hricak H. Global Challenges for Cancer Imaging. J Glob Oncol 2018; 4:1-10. [PMID: 30241164 PMCID: PMC6180759 DOI: 10.1200/jgo.17.00036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Imaging plays many essential roles in nearly all aspects of high-quality cancer care. However, challenges to the delivery of optimal cancer imaging in both developing and advanced countries are manifold. Developing countries typically face dramatic shortages of both imaging equipment and general radiologists, and efforts to improve cancer imaging in these countries are often complicated by poor infrastructure, cultural barriers, and other obstacles. In advanced countries, on the other hand, although imaging equipment and general radiologists are typically accessible, the complexity of oncologic imaging and the need for subspecialists in the field are largely unrecognized; as a result, training opportunities are lacking, and there is a shortage of radiologists with the necessary subspecialty expertise to provide optimal cancer care and participate in advanced clinical research. This article is intended to raise awareness of these challenges and catalyze further efforts to address them. Some promising strategies and ongoing efforts are reviewed, and some specific actions are proposed.
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Affiliation(s)
- Heinz-Peter Schlemmer
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Leonardo K. Bittencourt
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Melvin D’Anastasi
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Romeu Domingues
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Pek-Lan Khong
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Zarina Lockhat
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Ada Muellner
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Maximilian F. Reiser
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Richard L. Schilsky
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
| | - Hedvig Hricak
- Heinz-Peter Schlemmer, German Cancer Research Center,
Heidelberg; Melvin D’Anastasi and Maximilian F.
Reiser, Ludwig-Maximilians-University Hospital, Munich, Germany;
Leonardo K. Bittencourt, Fluminense Federal University,
Niterói; Leonardo K. Bittencourt and Romeu
Domingues, Clínica de Diagnóstico por Imagem
(CDPI/Dasa), Rio de Janeiro, Brazil; Pek-Lan Khong, University of
Hong Kong, Queen Mary Hospital, Hong Kong, China; Zarina Lockhat,
University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa;
Ada Muellner and Hedvig Hricak, Memorial Sloan
Kettering Cancer Center, New York, NY; and Richard L. Schilsky,
American Society of Clinical Oncology, Alexandria, VA
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12
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Park JH, Lee SK, Lee JE, Kim SW, Nam SJ, Kim JY, Ahn JS, Park W, Yu J, Park YH. Breast Cancer Epidemiology of the Working-Age Female Population Reveals Significant Implications for the South Korean Economy. J Breast Cancer 2018; 21:91-95. [PMID: 29628989 PMCID: PMC5880971 DOI: 10.4048/jbc.2018.21.1.91] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/16/2018] [Indexed: 12/21/2022] Open
Abstract
In this study, we aimed to evaluate the economic loss due to the diagnosis of breast cancer within the female South Korean working-age population. A population-based cost analysis was performed for cancer-related diagnoses between 1999 and 2014, using respective public government funded databases. Among the five most common cancers, breast cancer mortality was strongly associated with the growth in gross domestic product between 1999 and 2014 (R=0.98). In the female population, breast cancer represented the greatest productivity loss among all cancers, which was a consequence of the peak in the incidence of breast cancer during mid-working age in the working-age population, in addition to being the most common and fastest growing cancer among South Korean women. Our study shows that breast cancer not only represents a significant disease burden for individual patients, but also contributes a real, nonnegligible loss in productivity in the South Korean economy.
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Affiliation(s)
- Jeong Hyun Park
- Strategic Planning Team, Office of Management & Support, Samsung Medical Center, Seoul, Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin-Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Park
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hee Park
- Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
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13
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Azubuike SO, Muirhead C, Hayes L, McNally R. Rising global burden of breast cancer: the case of sub-Saharan Africa (with emphasis on Nigeria) and implications for regional development: a review. World J Surg Oncol 2018; 16:63. [PMID: 29566711 PMCID: PMC5863808 DOI: 10.1186/s12957-018-1345-2] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 02/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Despite mortality from breast cancer in Africa being higher than in high income countries, breast cancer has not been extensively studied in the region. The aim of this paper was to highlight the rising burden of breast cancer with an emphasis on sub-Saharan Africa as well as trends, characteristics, controversies and their implications for regional development. METHODOLOGY A review of published studies and documents was conducted in Medline, Scopus, Pubmed and Google using combinations of key words-breast neoplasm, breast cancer, cancer, incidence, mortality, Africa, Nigeria. Graphical and frequency analyses were carried out on some of the incidence and mortality figures retrieved from published papers and the GLOBOCAN website. FINDINGS Globally, about 25% and 15% of all new cancer cases and cancer deaths respectively among females were due to breast cancer. Africa currently had the highest age-standardized breast cancer mortality rate globally, with the highest incidence rates being recorded within the sub-Saharan African sub-region. Incidence trends such as inherently aggressive tumour and younger age profile had been subject to controversies. Certain factors such as westernized diet, urbanization and possibly increasing awareness had been implicated, though their specific contributions were yet to be fully established. CONCLUSION Unless urgent action is taken, breast cancer will compound sub-Saharan Africa's disease burden, increase poverty and gender inequality as well as reverse the current global gains against maternal and neonatal mortality.
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Affiliation(s)
- Samuel O. Azubuike
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building Richardson Road, Newcastle upon Tyne, NE2 4AX UK
- Department of Public and Environmental Health, National Open University of Nigeria, Plot 91, Cadastral Zone, Nnamdi Azikiwe Express Way, Jabi, Abuja, Nigeria
| | - Colin Muirhead
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building Richardson Road, Newcastle upon Tyne, NE2 4AX UK
| | - Louise Hayes
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building Richardson Road, Newcastle upon Tyne, NE2 4AX UK
| | - Richard McNally
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building Richardson Road, Newcastle upon Tyne, NE2 4AX UK
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14
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Temporal Trends of Common Female Malignances on Breast, Cervical, and Ovarian Cancer Mortality in Japan, Republic of Korea, and Singapore: Application of the Age-Period-Cohort Model. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5307459. [PMID: 29750160 PMCID: PMC5884400 DOI: 10.1155/2018/5307459] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/30/2018] [Accepted: 02/15/2018] [Indexed: 11/18/2022]
Abstract
Background Reproductive system cancer is an important cause of morbidity and mortality worldwide which threatens women's health and lives. Breast, cervical, and ovarian cancer have the higher incidence and mortality among a series of gynecology malignant tumor. We aimed to compare and assess the temporal trends of common female malignances on breast, cervical, and ovarian cancer mortality in developed regions of Asia including Japan, Republic of Korea, and Singapore and analyze the detached effects of chronological age, time period, and birth cohort by age-period-cohort (APC) analysis. Methods The mortality data for these three cancers were collected from the WHO Mortality Database in Japan, Republic of Korea, and Singapore from 1954 to 2013, from 1989 to 2013, and from 1964 to 2013, respectively. We fitted an age-period-cohort model and intrinsic estimator method to estimate the independent effect of each age, time period, and birth cohort on cancer mortality and describe the secular changes in three Asian countries. Results For the overall trends of breast cancer, the ASMRs of breast cancer showed a general increasing trend among three countries during the study periods while the change pattern in Singapore was different from the rest of the two countries for cervical and ovarian cancer. By APC analysis, the three cancer mortality risks generally increased with age and decreased with birth cohort. For period effects of breast and ovarian cancer, increasing effects with time were observed; however, for period effects of cervical cancer, converse change pattern was presented among three countries. Conclusions Our study shows that the ASMRs of breast, cervical, and ovarian cancer remain high in Singapore compared to Japan and Korea. Generally speaking, the mortality risk of three cancers increased with age, and period and cohort effects may collectively affect the common female malignances mortality for East Asian women.
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15
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Tsai HY, Kuo RNC, Chung KP. Quality of life of breast cancer survivors following breast-conserving therapy versus mastectomy: a multicenter study in Taiwan. Jpn J Clin Oncol 2017; 47:909-918. [PMID: 28981734 DOI: 10.1093/jjco/hyx099] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/28/2017] [Indexed: 01/22/2023] Open
Abstract
Background Breast cancer is the most common female malignancy worldwide. The aim of this study was to investigate the influence of surgical procedures and quality-of-care (QoC) on quality-of-life (QoL) among breast cancer survivors who underwent breast-conserving therapy (BCT) or mastectomy, and to identify provider- and patient-related factors pertaining to QoL. Method In this cross-sectional study, structured-questionnaires were distributed among breast cancer survivors in 19 hospitals. QoL was evaluated using the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the breast cancer specific module (EORTC QLQ-BR23). QoC is indicated by adherence to the core measures stipulated for the treatment of breast cancer. Multiple regression and hierarchical linear modeling were used for multivariate analysis. Results A total of 544 female survivors of Stage 0-III breast cancer were included, among whom 217 (39.9%) underwent BCT and 327 (60.1%) underwent mastectomy. Surgical modality does not appear to have a notable impact on any QoL domains except body image; i.e. patients who underwent BCT reported better body image (diff = 11.20, P < 0.001), particularly at 1-5 years after the initial treatment. Independent factors including age, education, employment, marital status, income, chemotherapy, duration since treatment, recurrence status, primary hospital accreditation level and location all appear to be correlated to QoL. Conclusion Patients with breast cancer should be informed of differences in QoL when discussing treatment options. Furthermore, physicians should recognize that the impact of surgical treatment modality on QoL may vary according to patients' sociodemographic and clinical characteristics.
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Affiliation(s)
- Hsin-Yun Tsai
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Raymond Nien-Chen Kuo
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kuo-Piao Chung
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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16
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Chen L, Yuan Y, Kar S, Kanchi MM, Arora S, Kim JE, Koh PF, Yousef E, Samy RP, Shanmugam MK, Tan TZ, Shin SW, Arfuso F, Shen HM, Yang H, Goh BC, Park JI, Gaboury L, Lobie PE, Sethi G, Lim LHK, Kumar AP. PPARγ Ligand-induced Annexin A1 Expression Determines Chemotherapy Response via Deubiquitination of Death Domain Kinase RIP in Triple-negative Breast Cancers. Mol Cancer Ther 2017; 16:2528-2542. [PMID: 29021293 DOI: 10.1158/1535-7163.mct-16-0739] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 05/17/2017] [Accepted: 07/20/2017] [Indexed: 11/16/2022]
Abstract
Metastatic breast cancer is still incurable so far; new specifically targeted and more effective therapies for triple-negative breast cancer (TNBC) are required in the clinic. In this study, our clinical data have established that basal and claudin-low subtypes of breast cancer (TNBC types) express significantly higher levels of Annexin A1 (ANXA1) with poor survival outcomes. Using human cancer cell lines that model the TNBC subtype, we observed a strong positive correlation between expression of ANXA1 and PPARγ. A similar correlation between these two markers was also established in our clinical breast cancer patients' specimens. To establish a link between these two markers in TNBC, we show de novo expression of ANXA1 is induced by activation of PPARγ both in vitro and in vivo and it has a predictive value in determining chemosensitivity to PPARγ ligands. Mechanistically, we show for the first time PPARγ-induced ANXA1 protein directly interacts with receptor interacting protein-1 (RIP1), promoting its deubiquitination and thereby activating the caspase-8-dependent death pathway. We further identified this underlying mechanism also involved a PPARγ-induced ANXA1-dependent autoubiquitination of cIAP1, the direct E3 ligase of RIP1, shifting cIAP1 toward proteosomal degradation. Collectively, our study provides first insight for the suitability of using drug-induced expression of ANXA1 as a new player in RIP1-induced death machinery in TNBCs, presenting itself both as an inclusion criterion for patient selection and surrogate marker for drug response in future PPARγ chemotherapy trials. Mol Cancer Ther; 16(11); 2528-42. ©2017 AACR.
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Affiliation(s)
- Luxi Chen
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,Department of Chemistry and Biochemistry, School of Natural Sciences & Mathematics, The University of Texas at Dallas, Texas
| | - Yi Yuan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Shreya Kar
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Madhu M Kanchi
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Suruchi Arora
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ji E Kim
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Pei F Koh
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Einas Yousef
- Institute for Research in Immunology and Cancer, Universite de Montreal, Montreal, Quebec, Canada.,Department of Histology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Ramar P Samy
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Muthu K Shanmugam
- Department of Pharmacology, National University of Singapore, Singapore
| | - Tuan Z Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Sung W Shin
- Department of Biochemistry, Dong-A University, College of Medicine, Busan, South Korea
| | - Frank Arfuso
- Stem Cell and Cancer Biology Laboratory, School of Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth WA, Australia
| | - Han M Shen
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
| | - Henry Yang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Boon C Goh
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,Department of Haematology-Oncology, National University Health System, Singapore.,National University Cancer Institute, National University Health System, Singapore
| | - Joo I Park
- Department of Biochemistry, Dong-A University, College of Medicine, Busan, South Korea
| | - Louis Gaboury
- Institute for Research in Immunology and Cancer, Universite de Montreal, Montreal, Quebec, Canada
| | - Peter E Lobie
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,National University Cancer Institute, National University Health System, Singapore.,Tsinghua Berkeley Shenzhen Institute and Division of Life Science and Health, Tsinghua University Graduate School, Shenzhen, P.R. China
| | - Gautam Sethi
- Department of Pharmacology, National University of Singapore, Singapore.,School of Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth WA, Australia
| | - Lina H K Lim
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. .,NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore.,NUS Immunology Program, National University of Singapore, Singapore
| | - Alan P Kumar
- Cancer Science Institute of Singapore, National University of Singapore, Singapore. .,Department of Pharmacology, National University of Singapore, Singapore.,National University Cancer Institute, National University Health System, Singapore.,Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth WA, Australia.,Department of Biological Sciences, University of North Texas, Denton, Texas
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17
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Epidemiology and survival outcome of breast cancer in a nationwide study. Oncotarget 2017; 8:16939-16950. [PMID: 28199975 PMCID: PMC5370012 DOI: 10.18632/oncotarget.15207] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/24/2017] [Indexed: 12/17/2022] Open
Abstract
Breast cancer is among the most prevalent cancers in Taiwan. The National Health Insurance database was used to identify patients with breast cancer and estimate the yearly prevalence and incidence of breast cancer between 1997 and 2013. Joinpoint regression analysis was used for the annual percentage change of incidence, prevalence, and survival outcome. Among 12,181,919 female beneficiaries in 2013, the prevalence was 834.37 per 100,000 persons (95% confidence interval, 829.28–839.45) and the incidence was 93.00 per 100,000 person-year (95% confidence interval, 91.27–94.73). The average annual percentage change of the age-standardized breast cancer incidence was 3.5 per 100,000 person-years (3.1–3.8; P < 0.05), suggesting an increase in breast cancer incidence over the study period. The 5-year mortality rate was 4.5% in 1997 and 4.4% in 2008. The 5-year mortality rate among patients with Charlson comorbidity index > 1 was 39.1% (19.2%–59.1%) in 1997 and 21.1% (15.7%-32.0%) in 2008, with an annual percentage change of –0.8 (–1.3 to 2.9), suggesting that the mortality rate was gradually decreasing in patients with comorbidities. In conclusion, 1 in 120 women in Taiwan has breast cancer and the incidence is rising, while the annual percentage change of breast cancer prevalence is decreasing. The mortality rate of breast cancer was essentially stable, but the 1-year, 2-year, and 5-year mortality rates in people with Charlson comorbidity index > 1 were declined.
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18
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Wang F, Tse LA, Chan WC, Kwok CCH, Leung SL, Wu C, Mang OWK, Ngan RKC, Li M, Yu WC, Tsang KH, Law SH, Miao X, Wu C, Zheng Y, Wu F, Yang XR, Yu ITS. Disparities of time trends and birth cohort effects on invasive breast cancer incidence in Shanghai and Hong Kong pre- and post-menopausal women. BMC Cancer 2017; 17:362. [PMID: 28535760 PMCID: PMC5442698 DOI: 10.1186/s12885-017-3359-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 05/15/2017] [Indexed: 12/29/2022] Open
Abstract
Background Breast cancer is the leading cause of cancer morbidity among Shanghai and Hong Kong women, which contributes to 20–25% of new female cancer incidents. This study aimed to describe the temporal trend of breast cancer and interpret the potential effects on the observed secular trends. Methods Cancer incident data were obtained from the cancer registries. Age-standardized incidence rate was computed by the direct method using the World population of 2000. Average annual percentage change (AAPC) in incidence rate was estimated by the Joinpoint regression. Age, period and cohort effects were assessed by using a log-linear model with Poisson regression. Results During 1976–2009, an increasing trend of breast cancer incidence was observed, with an AAPC of 1.73 [95% confidence interval (CI): 1.54–1.92)] for women in Hong Kong and 2.83 (95% CI, 2.26–3.40) in Shanghai. Greater upward trends were revealed in Shanghai women aged 50 years old or above (AAPC = 3.09; 95% CI, 1.48–4.73). Using age at 50 years old as cut-point, strong birth cohort effects were shown in both pre- and post-menopausal women, though a more remarkable effect was suggested in Shanghai post-menopausal women. No evidence for a period effect was indicated. Conclusions Incidence rate of breast cancer has been more speedy in Shanghai post-menopausal women than that of the Hong Kong women over the past 30 years. Decreased birth rate and increasing environmental exposures (e.g., light-at-night) over successive generations may have constituted major impacts on the birth cohort effects, especially for the post-menopausal breast cancer; further analytic studies are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3359-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Feng Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China.
| | - Wing-Cheong Chan
- Department of Surgery, North District Hospital, Sheung Shui, Hong Kong SAR, China
| | - Carol Chi-Hei Kwok
- Department of Oncology, Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Siu-Lan Leung
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China
| | - Cherry Wu
- Department of Pathology, North District Hospital, Sheung Shui, Hong Kong SAR, China
| | - Oscar Wai-Kong Mang
- Hong Kong Cancer Registry, Hospital Authority, Yau Ma Tei, Hong Kong SAR, China
| | | | - Mengjie Li
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Wai-Cho Yu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Koon-Ho Tsang
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong SAR, China
| | - Sze-Hong Law
- Department of Surgery, Yan Chai Hospital, Tsuen Wan, Hong Kong SAR, China
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics, Tongji School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Chunxiao Wu
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Ying Zheng
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Fan Wu
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Xiaohong R Yang
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ignatius Tak-Sun Yu
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
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Saridi M, Kapogeorgou E, Rekleiti M, Geitona M, Souliotis K. Knowledge and attitudes of women regarding gynaecological cancer prevention in an urban area of Greece in financial crisis. Scand J Caring Sci 2017; 31:710-717. [PMID: 28233331 DOI: 10.1111/scs.12385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/17/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Preventive gynaecological examinations (PGEs) are the main means of monitoring gynaecological cancers across the developed world. The purpose of this study was to investigate the perceptions and attitudes of women of a regional municipality of Greece, regarding preventive gynaecological examinations amid economic crisis. MATERIAL AND METHODS The study included 360 women aged 20-70 years, who lived in an urban area of Greece. A specialised, valid and anonymous questionnaire that included questions about perceptions and attitudes regarding preventive gynaecological examinations was used. The data analysis was performed using the statistical package spss 21. RESULTS It was found that women who lived in less developed areas had had lower educational levels and higher abstinence rates from medical examinations. The main source of information about sexually transmitted diseases was their social circle (48%), but the gynaecologist is the one preferred (54.8) to inform about preventive gynaecological examinations. Thirty per cent of the participants had never have a mammogram, while 33.9% of the sample did not show the same result, although considered the Pap test necessary. The main cause of women's abstention of preventive gynaecological examinations is the financial crisis. CONCLUSIONS The current financial crisis has negatively affected the women's ability to afford gynaecological examinations. Therefore, it is necessary to inform the population about the necessity of preventive gynaecological examinations starting from school age and at the same time, health information and promotion campaigns should be launched at a national level.
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Affiliation(s)
- Maria Saridi
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| | - Eleni Kapogeorgou
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| | - Maria Rekleiti
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece.,Department of Nursing, University of Peloponnese, Sparta, Greece
| | - Maria Geitona
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| | - Kyriakos Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
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Lee M, Mariapun S, Rajaram N, Teo SH, Yip CH. Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country. BMC Public Health 2017; 17:127. [PMID: 28129762 PMCID: PMC5273834 DOI: 10.1186/s12889-017-4015-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 01/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. METHODS From October 2011 to June 2015, 1,778 asymptomatic women, aged 40-74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. RESULTS The mean age for screening was 50.8 years and seven cancers (0.39%) were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist's experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. DISCUSSION The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2-4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening are likely premenopausal and hence have denser breasts. Radiologists who reported more than 360 mammograms were more confident in reporting a mammogram as normal without adjunct ultrasonography compared to those who reported less than 180 mammograms. CONCLUSION Our subsidised opportunistic mammographic screening programme is able to provide equivalent cancer detection rates but the high recall for adjunct ultrasonography would make screening less cost-effective.
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Affiliation(s)
| | | | | | - Soo-Hwang Teo
- Cancer Research Malaysia, Subang Jaya, Malaysia.,University of Malaya, Kuala Lumpur, Malaysia
| | - Cheng-Har Yip
- University of Malaya, Kuala Lumpur, Malaysia. .,Subang Jaya Medical Centre, No 1, Jalan SS12/1A, 47500, Subang Jaya, Malaysia.
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Huang Z, Wen W, Zheng Y, Gao YT, Wu C, Bao P, Wang C, Gu K, Peng P, Gong Y, Zhang M, Xiang Y, Zhong W, Jin F, Xiang YB, Shu XO, Beeghly-Fadiel A. Breast cancer incidence and mortality: trends over 40 years among women in Shanghai, China. Ann Oncol 2016; 27:1129-1134. [PMID: 27013394 PMCID: PMC4880061 DOI: 10.1093/annonc/mdw069] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/02/2015] [Accepted: 02/07/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Breast cancer incidence rates are increasing among Asian women, likely due to the changes in risk factors caused by globalization. Trends in breast cancer rates among Chinese women may differ from other Asian regions due to the implementation of a nationwide family planning program and resulting changes in women's reproductive practices. Appraisal of cancer trends can direct cancer control and public health planning, but relevant studies in China are scarce due to a lack of long-term data. We sought to evaluate secular time trends in breast cancer incidence and mortality using 40 years of cancer registry data for women in urban Shanghai. MATERIALS AND METHODS Data on invasive breast cancer incidence and mortality were collected by the Shanghai Cancer Registry. Age-standardized rates (ASRs) for incidence and mortality were calculated using the Segi/Doll 1960 world standard population. Age, period, and birth cohort effects were evaluated using age-period-cohort (APC) Poisson regression models. Overall linear trends, interpreted as the estimated annual percentage change (EAPC), were derived from the net drift in age-drift models. RESULTS A total of 53 885 breast cancer cases and 17 235 breast cancer-specific deaths were documented among women in urban Shanghai between 1 January 1973 and 31 December 2012. Breast cancer incidence and mortality ASRs increased by 141.2% and 26.6%, respectively. Significant age, cohort, and period effects were identified in both incidence and mortality APC models; cohort effects were pronounced. Overall, a substantial increase in breast cancer incidence (EAPC = 2.96%/year) and a moderate increase in breast cancer mortality (EAPC = 0.87%/year) was observed. A notable downward trend in mortality was identified among younger women born after 1960. CONCLUSIONS Forty years of cancer registry data document a tremendous increase in incidence and a slight increase in mortality for breast cancer among women in Shanghai. Effective, appropriate, and affordable breast cancer prevention and control strategies are urgently needed in China.
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Affiliation(s)
- Z Huang
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - W Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA
| | - Y Zheng
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China.
| | - Y T Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai
| | - C Wu
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - P Bao
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - C Wang
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - K Gu
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - P Peng
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Y Gong
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - M Zhang
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Y Xiang
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - W Zhong
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - F Jin
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai
| | - Y B Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai
| | - X O Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA
| | - A Beeghly-Fadiel
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA
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Secular Trends of Breast Cancer in China, South Korea, Japan and the United States: Application of the Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15409-18. [PMID: 26690183 PMCID: PMC4690929 DOI: 10.3390/ijerph121214993] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/29/2015] [Accepted: 11/30/2015] [Indexed: 11/29/2022]
Abstract
To describe the temporal trends of breast cancer mortality in East Asia and to better understand the causes of these trends, we analyzed the independent effects of chronological age, time period and birth cohort on breast cancer mortality trends using age-period-cohort (APC) analysis. We chose three main countries in East Asia, namely China, South Korea, and Japan, which have reported death status to the WHO Mortality Database, and used the United States as a comparison population. Our study shows that in general, breast cancer mortality rates in females increased in all three East Asian countries throughout the study period. By APC analysis, we confirmed that there is, in fact, a difference in age-specific mortality rate patterns between the Eastern and the Western countries, which is presumably caused by the two-disease model. While the cause of the decrease from approximately the 1950s generation is still in question, we believe that increasing general awareness and improvements in the health-care system have made a significant contribution to it. Although the age and cohort effects are relatively strong, the period effect may be a more critical factor in the mortality trend, mainly reflecting the increase in exposures to carcinogens and behavioral risk factors.
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Lim D, Ha M, Song I. Trends in major cancer mortality in Korea, 1983–2012, with a joinpoint analysis. Cancer Epidemiol 2015; 39:939-46. [DOI: 10.1016/j.canep.2015.10.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022]
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Song QK, Wang XL, Zhou XN, Yang HB, Li YC, Wu JP, Ren J, Lyerly HK. Breast Cancer Challenges and Screening in China: Lessons From Current Registry Data and Population Screening Studies. Oncologist 2015; 20:773-9. [PMID: 26001390 DOI: 10.1634/theoncologist.2014-0351] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/02/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND As one of its responses to the increasing global burden of breast cancer (BC), China has deployed a national registration and BC screening campaign. The present report describes these programs and the initial results of these national BC control strategies, highlighting the challenges to be considered. MATERIALS AND METHODS The primary BC incidence and prevalence data were obtained from the Chinese National Central Cancer Registry. MapInfo software was used to map the geographic distribution and variation. The time trends were estimated by the annual percentage of change from 2003 to 2009. The description of the screening plans and preliminary results were provided by the Ministry of Health. RESULTS Chinese cancer registries were primarily developed and activated in the East and Coastal regions of China, with only 12.5% of the registries located in West China. Geographic variation was noted, with the incidence of BC higher in North China than in South China and in urban areas compared with rural areas. Of great interest, these registries reported that the overall BC incidence has been increasing in China, with an earlier age of onset compared with Western countries and a peak incidence rate at age 50. In response to this increasing incidence and early age of onset, BC screening programs assessed 1.46 million women aged 35-59 years, using clinical breast examinations and ultrasound as primary screening tools between 2009 and 2011. The diagnostic rate for this screening program was only 48.0/10(5) with 440 cases of early stage BC. Early stage BC was detected in nearly 70% of screened patients. Subsequently, a second-generation screening program was conducted that included older women aged 35-64 years and an additional 6 million women were screened. CONCLUSION The cancer registration system in China has been uneven, with a greater focus on East rather than West China. The data from these registries demonstrate regional variation, an increasing BC incidence, and an early age of onset. The 2009 to 2011 BC screening program targeting women aged 35-59 years had a low detection rate that resulted in a second-generation screening program that extended the cohort size and ages screened to 35-64 years. IMPLICATIONS FOR PRACTICE Cancer registration has been active in China for decades; however, a national survey of registries has not been routinely reported. This study used MapInfo to describe the reported data and found asymmetric registration activities, geographic variations in breast cancer (BC) burdens, and an increasing incidence with a peak at age 50. The initial Chinese BC screening programs focused on a relatively young population of women aged 35-59 years and had a low detection rate, but 69.7% of patients had early stage BC. Older women were included in the second-generation screening programs, and an additional 6 million women were screened. Consideration of regional variations and age is necessary to optimize the efficiency and utility of BC screening in China, with the ultimate goal to reduce BC mortality.
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Affiliation(s)
- Qing-Kun Song
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Xiao-Li Wang
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Xin-Na Zhou
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Hua-Bing Yang
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Yu-Chen Li
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Jiang-Ping Wu
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Jun Ren
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
| | - Herbert Kim Lyerly
- Beijing Key Laboratory of Therapeutic Cancer Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing, People's Republic of China; Duke University Medical Center, Durham, North Carolina, USA
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25
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Choi Y, Kim Y, Park SK, Shin HR, Yoo KY. Age-Period-Cohort Analysis of Female Breast Cancer Mortality in Korea. Cancer Res Treat 2015; 48:11-9. [PMID: 25989803 PMCID: PMC4720099 DOI: 10.4143/crt.2015.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/13/2015] [Indexed: 11/21/2022] Open
Abstract
Purpose Despite the low mortality rate of breast cancer among women in Korea, the breast cancer mortality rate has increased. The aim of this study was to examine trends in breast cancer mortality from 1983 to 2012 in Korea, assessing the importance of age, period, and birth cohort as risk factors. Materials and Methods Data on the annual number of deaths due to female breast cancer and on female population statistics from 1983 to 2012 were obtained from Statistics Korea. A log-linear Poisson age-period-cohort model was used to estimate age, period, and cohort effects. Results The increasing breast cancer mortality can be explained predominantly by a birth cohort effect: the risk of breast cancer death showed a steady increase until the 1968 birth cohort, and decreased thereafter. There was a sharp increase in the magnitude of the age effect up to 60 years old, then a moderate increase in the effect during the sixties, followed by another sharp increase from 70 years old. The period effect on breast cancer mortality seems negligible based on its adjusted relative risk, even though it was statistically significant after adjusting for age and cohort effects. Conclusion In this study, the mortality pattern of breast cancer in Korea can be explained predominantly by a birth cohort effect. Hence, the overall mortality rate of breast cancer may increase for a while, and show a gradual decrease in the future, which will start from the younger age group.
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Affiliation(s)
- Yunhee Choi
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yeonju Kim
- Independent Researcher, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea ; Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Hai-Rim Shin
- Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
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26
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Takagi A, Kano M, Kaga C. Possibility of breast cancer prevention: use of soy isoflavones and fermented soy beverage produced using probiotics. Int J Mol Sci 2015; 16:10907-20. [PMID: 25984609 PMCID: PMC4463682 DOI: 10.3390/ijms160510907] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 04/10/2015] [Accepted: 04/24/2015] [Indexed: 11/21/2022] Open
Abstract
The various beneficial effects of soybeans, which are rich in phytochemicals, have received much attention because of increasing health awareness. Soy milk that has been fermented using lactic acid bacteria has been used to prepare cheese-like products, tofu (bean-curd), and yogurt-type products. However, the distinct odor of soybeans has limited the acceptance of such foods, particularly in Western countries. In Japan, while tofu and soy milk have long been habitually consumed, the development of novel, palatable food products has not been easy. The unpleasant odor of soy milk and the absorption efficiency for isoflavones can be improved using a recently developed fermented soy milk beverage. Cancer has been the leading cause of death, and breast cancer is the most common malignancy among women. The most common type of breast cancer is estrogen-dependent, and the anti-estrogenic effects of isoflavones are known. The present review focuses on the characteristics of soy milk fermented using probiotics, an epidemiological study examining the incidence of breast cancer and soy isoflavone consumption, and a non-clinical study examining breast cancer prevention using fermented soy milk beverage.
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Affiliation(s)
- Akimitsu Takagi
- Pharmaceutical Research Laboratory, Yakult Central Institute, Tokyo 186-8650, Japan.
| | - Mitsuyoshi Kano
- Food Research Laboratory, Yakult Central Institute, Tokyo 186-8650, Japan.
| | - Chiaki Kaga
- Food Research Laboratory, Yakult Central Institute, Tokyo 186-8650, Japan.
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Tsuchida J, Nagahashi M, Rashid OM, Takabe K, Wakai T. At what age should screening mammography be recommended for Asian women? Cancer Med 2015; 4:1136-44. [PMID: 25914223 PMCID: PMC4529351 DOI: 10.1002/cam4.468] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/15/2015] [Accepted: 03/29/2015] [Indexed: 01/15/2023] Open
Abstract
Although regular screening mammography has been suggested to be associated with improvements in the relative survival of breast cancer in recent years, the appropriate age to start screening mammography remains controversial. In November 2009, the United States Preventive Service Task Force published updated guidelines for breast cancer, which no longer support routine screening mammography for women aged 40–49 years, but instead, defer the choice of screening in that age group to the patient and physician. The age to begin screening differs between guidelines, including those from the Task Force, the American Cancer Society and the World Health Organization. It remains unclear how this discrepancy impacts patient survival, especially among certain subpopulations. Although the biological characteristics of breast cancer and peak age of incidence differ among different ethnic populations, there have been few reports that evaluate the starting age for screening mammography based on ethnicity. Here, we discuss the benefits and harm of screening mammography in the fifth decade, and re-evaluate the starting age for screening mammography taking ethnicity into account, focusing on the Asian population. Breast cancer incidence peaked in the fifth decade in Asian women, which has been thought to be due to a combination of biological and environmental factors. Previous reports suggest that Asian women in their 40s may receive more benefit and less harm from screening mammography than the age-matched non-Asian US population. Therefore, starting screening mammography at age 40 may be beneficial for women of Asian ethnicity in well-resourced countries, such as Japanese women who reside in Japan.
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Affiliation(s)
- Junko Tsuchida
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-Ku, Niigata, 951-8510, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-Ku, Niigata, 951-8510, Japan.,Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-Ku, Niigata, 951-8510, Japan
| | - Omar M Rashid
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, SRB 4.24012, Tampa, Florida, 33612
| | - Kazuaki Takabe
- Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University School of Medicine and the Massey Cancer Center, 1200 E. Broad Street, Richmond, Virginia, 23219
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-Ku, Niigata, 951-8510, Japan
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Kim Y, Yoo KY, Goodman MT. Differences in Incidence, Mortality and Survival of Breast Cancer by Regions and Countries in Asia and Contributing Factors. Asian Pac J Cancer Prev 2015; 16:2857-70. [DOI: 10.7314/apjcp.2015.16.7.2857] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Randomized study of orally administered fluorinated pyrimidines (capecitabine versus S-1) in women with metastatic or recurrent breast cancer: Japan Breast Cancer Research Network 05 Trial. Cancer Chemother Pharmacol 2015; 75:1183-9. [PMID: 25862350 DOI: 10.1007/s00280-015-2738-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/24/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE Capecitabine and S-1 are orally administered fluorinated pyrimidines with high-level activity against metastatic breast cancer (MBC). This randomized, multicenter, phase II study compared the activities and safeties of the oral fluoropyrimidines, capecitabine and S-1, in breast cancer patients. METHODS Patients with MBC were randomly assigned to receive capecitabine 825 g/m(2) twice daily on days 1-21 every 4 weeks or S-1 40-60 mg twice daily, according to body surface area, on days 1-28 every 6 weeks. The primary endpoint was progression-free survival (PFS). RESULTS A total of 142 patients were enrolled and randomized to either capecitabine (N = 73) or S-1 (N = 69). Median PFS (progression-free survival) was 1.2 years for capecitabine and 1.3 years for S-1, with a hazard ratio (S-1/capecitabine) of 0.85 (95 % confidence interval [CI] 0.52-1.38) (P = 0.48 by log-rank). The confirmed objective response rates were 24.0 % for capecitabine and 23.1 % for S-1 (P = 0.938). The most common treatment-related adverse events were grade 1-2 in intensity. Thrombocytopenia (S-1: 9.2 %, capecitabine: 1.4 %; P = 0.040) and nausea (S-1: 26.2 %, capecitabine: 14.1 %; P = 0.079) were more frequent in the S-1 group, while hand-foot syndrome occurred more often in the capecitabine group (S-1: 10.8 %, capecitabine: 25.4 %; P = 0.029). CONCLUSIONS The results of the current study demonstrate that both S-1 and capecitabine are effective and well-tolerated treatments in patients with MBC, while their adverse events were different. They are both convenient, orally administered drugs, making them attractive agents for use in outpatient treatment.
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Gonzaga CMR, Freitas-Junior R, Curado MP, Sousa ALL, Souza-Neto JA, Souza MR. Temporal trends in female breast cancer mortality in Brazil and correlations with social inequalities: ecological time-series study. BMC Public Health 2015; 15:96. [PMID: 25886146 PMCID: PMC4331144 DOI: 10.1186/s12889-015-1445-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 01/20/2015] [Indexed: 11/17/2022] Open
Abstract
Background Breast cancer is the most common cause of death from cancer in women in less developed regions. Therefore, the objective of this study was to provide data on the temporal trends in female breast cancer mortality between 1990 and 2011 and to evaluate its association with the social inequalities present in Brazil. Methods Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service database for the 1990–2011 period. Age-standardized mortality rates were calculated (20–39, 40–49, 50–69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using joinpoint regression model and linear regression. The Social Exclusion Index and the Human Development Index were used to classify the 27 Brazilian states. Pearson’s correlation was used to describe the association between the Social Exclusion Index and the Human DeveIopment and the variations in mortality rates in each state. Results Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.3; 95% CI: −0.1 – 0.7) between 1994 and 2011. Considering the Brazilian states, significant decreases in mortality rates were found in Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95 %CI: 5.8 – 16.9), Piauí (APC = 9.8; 95% CI: 7.6 – 12.1) and Paraíba (APC = 9.3; 95% CI: 6.0 – 12.8). There was a statistically significant correlation between Social Exclusion Index and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between Human Development Index and mortality between 2001 and 2011. Conclusions Female breast cancer mortality rates are stable in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting better healthcare.
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Affiliation(s)
| | - Ruffo Freitas-Junior
- Department of Obstetrics and Gynecology, Federal University of Goiás (UFG), Goiânia, Brazil. .,, Alameda das Rosas, 533, Setor Oeste, 74110-060, Goiânia, GO, Brazil.
| | - Maria-Paula Curado
- Health Sciences, Federal University of Goiás (UFG), Goiânia, Brazil. .,Hospital Araújo Jorge, Goiás Anticancer Association (ACCG), Goiânia, Brazil. .,International Prevention Research Institute (IPRI), Lyon, France.
| | | | | | - Marta Rovery Souza
- Institute of Tropical Pathology and Public Health, Federal University of Goiás (UFG), Goiânia, Brazil.
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Ethnic differences in mammographic densities: an Asian cross-sectional study. PLoS One 2015; 10:e0117568. [PMID: 25659139 PMCID: PMC4320072 DOI: 10.1371/journal.pone.0117568] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 12/28/2014] [Indexed: 11/19/2022] Open
Abstract
Background Mammographic density is a strong risk factor for breast cancer and is highly variable, but, to date, few studies have examined density in Asian women, particularly those in low and middle-income Asian countries where genetic and lifestyle determinants may be significantly different. Methods A total of 1,240 women who attended an opportunistic mammogram screening programme were eligible for analysis. Mammographic density was estimated using a fully-automated thresholding method and differences across ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women. Results Percent density was significantly higher in Chinese women (28.5%; 95% CI 27.0%, 30.0%) compared to Malay (24.2%; 95% CI 22.5%, 26.0%) and Indian (24.3%; 95% CI 22.8%, 25.7%) women (p<0.001), after adjustment for age, BMI, menopausal status, parity and age at first full term pregnancy. Correspondingly, adjusted nondense area was significantly lower in Chinese (72.2cm2; 95% CI 67.9cm2, 76.5cm2) women compared to Malay (92.1cm2; 95% CI 86.9cm2, 97.2cm2) and Indian (97.7cm2; 95% CI 93.4cm2, 101.9cm2) women (p<0.001), but dense area did not differ across the three ethnic groups. Conclusions Our study shows that higher percent density and lower nondense area reflect the higher incidence of breast cancer in Chinese compared to Malay and Indian women in Malaysia. Known lifestyle determinants of mammographic density do not fully account for the ethnic variations observed in mammographic density in this Asian cohort.
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Cho J, Jung SY, Lee JE, Shim EJ, Kim NH, Kim Z, Sohn G, Youn HJ, Kim KS, Kim H, Lee JW, Lee MH. A review of breast cancer survivorship issues from survivors' perspectives. J Breast Cancer 2014; 17:189-99. [PMID: 25320616 PMCID: PMC4197348 DOI: 10.4048/jbc.2014.17.3.189] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/26/2014] [Indexed: 11/30/2022] Open
Abstract
Despite the fact that more breast cancer survivors are currently enjoying longer lifespans, there remains limited knowledge about the factors and issues that are of greatest significance for these survivors, particularly from their perspectives. This review was based on the concept that the topics addressed should focus on the perspectives of current survivors and should be extended to future modalities, which physicians will be able to use to gain a better understanding of the hidden needs of these patients. We intended to choose and review dimensions other than the pathology and the disease process that could have been overlooked during treatment. The eight topics upon which we focused included: delay of treatment and survival outcome; sexual well-being; concerns about childbearing; tailored follow-up; presence of a family history of breast cancer; diet and physical activity for survivors and their families; qualitative approach toward understanding of breast cancer survivorship, and; mobile health care for breast cancer survivors. Through this review, we aimed to examine the present clinical basis of the central issues noted from the survivors' perspectives and suggest a direction for future survivorship-related research.
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Affiliation(s)
- Jihyoung Cho
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - So-Youn Jung
- Breast Cancer Center, National Cancer Center, Goyang, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University School of Medicine, Busan, Korea
| | - Nam Hyoung Kim
- Department of Advertising and Branding, Kaywon University of Art and Design, Uiwang, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Guiyun Sohn
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jo Youn
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Ku Sang Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hanna Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Jong Won Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea
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Tsunematsu M, Kawasaki H, Masuoka Y, Kakehashi M. Factors affecting breast cancer screening behavior in Japan--assessment using the health belief model and conjoint analysis. Asian Pac J Cancer Prev 2014; 14:6041-8. [PMID: 24289622 DOI: 10.7314/apjcp.2013.14.10.6041] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Japanese women in their 40s or older have been encouraged to attend breast cancer screening. However, the breast cancer screening rate in Japan is not as high as in Europe and the United States. The aim of this study was to identify psychological and personal characteristics of women concerning their participation in breast cancer screening using the Health Belief Model (HBM). In addition, the attributes of screening more easily accepted by participants were analyzed by conjoint analysis. MATERIALS AND METHODS In this cross sectional study of 3,200 age 20-69 women, data were collected by an anonymous questionnaire. Questions were based on HBM and personal characteristics, and included attitudes on hypothetical screening attributes. Data of women aged 40-69 were analyzed by logistic regression and conjoint analysis to clarify the factors affecting their participation in breast cancer screening. RESULTS Among responses collected from 1,280 women of age 20-69, the replies of 993 women of age 40-69 were used in the analysis. Regarding the psychological characteristics based on HBM, the odds ratios were significantly higher in "importance of cancer screening" (95%CI: 1.21-2.47) and "benefits of cancer screening" (95%CI: 1.09-2.49), whereas the odds ratio was significantly lower in "barriers to participation before cancer screening" (95%CI: 0.27-0.51). Conjoint analysis revealed that the respondents, overall, preferred screening to be low cost and by female staff members. Furthermore, it was also clarified that attributes of screening dominant in decision-making were influenced by the employment status and the type of medical insurance of the women. CONCLUSIONS In order to increase participation in breast cancer screening, it is necessary to disseminate accurate knowledge on cancer screening and to reduce barriers to participation. In addition, the attributes of screening more easily accepted were inexpensive, provided by female staff, executed in a hospital and finished in a short time.
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Affiliation(s)
- Miwako Tsunematsu
- Department of Health Informatics, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan E-mail :
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Abstract
INTRODUCTION AND AIMS To provide a current perspective on nutrition and physical activity influence on breast cancer. METHODS AND RESULTS A comprehensive literature review was conducted and selective presentation of findings follows. While some observational studies have associated higher dietary fat intake with higher breast cancer incidence, two full-scale randomized, clinical trials of dietary fat intake reduction programs were negative. However, a lifestyle intervention targeting fat intake reduction in the Women's Intervention Nutrition Study (WINS), resulted in weight loss and also reduced breast cancer recurrences in women with early stage disease. Observational studies evaluating specific nutrient intakes and dietary supplements have provided mixed results. Several observational studies find women with early stage breast cancer with lower 25-hydroxyvitamin D levels at higher recurrence risk, a finding requiring cautious interpretation. The lifestyle factor most strongly and consistently associated with both breast cancer incidence and breast cancer recurrence risk is physical activity. A meta-analyses of observational studies supports the concept that moderate recreational physical activity (about 3-4 h walking per week) may reduce breast cancer incidence and that women with early stage breast cancer who increased or maintain their physical activity may have lower recurrence risk as well. Feasibility of achieving increased physical activity and weight loss in women with early-stage breast cancer has been established. Two full-scale randomized clinical trials are evaluating weight loss/maintenance and increased physical activity in relation to recurrence risk in women with early-stage, resected breast cancer. DISCUSSION/CONCLUSIONS Dietary intake may influence breast cancer but influence is difficult to separate from influence of body weight. A consistent body of observational study evidence suggests higher physical activity has favorable influence on breast cancer incidence and outcome. While awaiting definitive evidence from ongoing randomized trials, breast cancer patients can reasonably be counseled to avoid weight gain and reduce body weight if overweight or obese and increase or maintain a moderate level of physical activity.
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Affiliation(s)
- Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Building J-3, Torrance, CA 90502, USA.
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Hong-Li C, Xiao-Chun W, Jiang-Bin W, Jing-Bo Z, Yao W. Quality of life in patients with breast cancer and their rehabilitation needs. Pak J Med Sci 2014; 30:126-30. [PMID: 24639845 PMCID: PMC3955556 DOI: 10.12669/pjms.301.3952] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 10/24/2013] [Accepted: 10/26/2013] [Indexed: 11/30/2022] Open
Abstract
Objective: We conducted a cross sectional study to investigate the quality of life (QOL) in breast cancer patients after treatment for one year and identify factors which may facilitate improvements in health care for breast cancer. Methods: A total of 154 patients of breast cancer were collected from The First Affiliated Hospital of Harerbin Medical University during May 2008 and May 2010, and they were divided into three groups. The quality of life was assessed by Functional assessment of cancer therapy- breast (FACT-B) version 4, and a semi-structured interview was used to investigate the information and rehabilitation needs of the breast cancer patients. Results: Group II had the best social well-being, functional well-being and Total FACT-G among the three groups. Group III had the best physical well-being, emotional well-being, breast specific subscales, total FACT-B and TOI among the three groups. Higher PWB scores were significantly correlation with lower tumor stage; increased SWB scores were significantly correlated with education and occupation, and lower EWB scores were correlated with younger aged women and higher tumor stage (< 40 years). The semi-structured investigation showed all of them want to receive tumor markers detection and PET scan to prevent recurrence. 56% of these patients were worried about symptoms. 42% of the patients reported they had restriction in sexual relationship, and 57% wanted to improve their body image and reconstruction surgery. Conclusions: Breast cancer patients should be followed up for their quality of life and provided effective therapy for their physical and psychological problems.
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Affiliation(s)
- Chen Hong-Li
- Chen Hong-li, Nursing Department, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Wang Xiao-Chun
- Wang Xiao-chun, Nursing Department, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Wang Jiang-Bin
- Wang Jiang-bin, Nursing Department, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Zhang Jing-Bo
- Zhang Jing-bo, The Stomach and Spleen Portal Hypertension Surgery, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
| | - Wang Yao
- Wang Yao, Nurse Practitioner, Experimental Surgery, The First Affiliated Hospital of Harerbin Medical University, Harerbin, China
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Obermair A, Youlden DR, Baade PD, Janda M. The impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy on survival in patients with a history of breast cancer--a population-based data linkage study. Int J Cancer 2013; 134:2211-22. [PMID: 24127248 DOI: 10.1002/ijc.28537] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/27/2013] [Indexed: 11/12/2022]
Abstract
Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy (BSO) is recommended in breast cancer susceptibility gene (BRCA)-positive women, whereas in women from the general population, hysterectomy plus BSO may increase the risk of overall mortality. The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population-base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (n = 21,067). We fitted flexible parametric breast cancer-specific and overall survival models with 95% confidence intervals (also known as Royston-Parmar models) to assess the impact of risk-reducing surgery (removal of uterus, one or both ovaries). We also stratified analyses by age 20-49 and 50-79 years, respectively. Overall, 1,426 women (7%) underwent risk-reducing surgery (13% of premenopausal women and 3% of postmenopausal women). No women who had risk-reducing surgery compared to 171 who did not have risk-reducing surgery developed a gynaecological cancer. Overall, 3,165 (15%) women died, including 2,195 (10%) from breast cancer. Hysterectomy plus BSO was associated with significantly reduced risk of death overall [adjusted hazard ration (HR), 0.69; 95% confidence interval (CI), 0.53-0.89; p = 0.005]. Risk reduction was greater among premenopausal women, whose risk of death halved (HR, 0.45; 95% CI, 0.25-0.79; p < 0.006). This was largely driven by reduction in breast cancer-specific mortality (HR, 0.43; 95% CI, 0.24-0.79; p < 0.006). This population-based study found that risk-reducing surgery halved the mortality risk for premenopausal breast cancer patients. Replication of our results in independent cohorts and subsequently randomised trials are needed to confirm these findings.
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Affiliation(s)
- Andreas Obermair
- Queensland Centre for Gynaecological Cancer School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
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Kaga C, Takagi A, Kano M, Kado S, Kato I, Sakai M, Miyazaki K, Nanno M, Ishikawa F, Ohashi Y, Toi M. Lactobacillus casei Shirota enhances the preventive efficacy of soymilk in chemically induced breast cancer. Cancer Sci 2013; 104:1508-14. [PMID: 23992486 DOI: 10.1111/cas.12268] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 08/08/2013] [Accepted: 08/09/2013] [Indexed: 01/01/2023] Open
Abstract
Soy foods are known to be effective for breast cancer prevention. The habitual consumption of soy isoflavones in combination with the probiotic Lactobacillus casei Shirota (LcS) was shown to decrease the risk of breast cancer occurrence in our previous population-based case-controlled study among Japanese women. The present study aimed to elucidate the cooperative prevention mechanism of soymilk and LcS using an animal carcinogenic model. Female Sprague-Dawley rats received a high-fat, AIN-76A diet containing soymilk, LcS, both soymilk and LcS, or none and were orally exposed to 2-amino-1-methyl-6-penylimidazo[4,5-b]pyridine at a dose of 85 mg/kg bodyweight eight times for 2 weeks. The development of palpable mammary tumors was monitored for 17 weeks. Tumor tissues were immunohistochemically examined for estrogen receptor (ER)-α, Ki-67 and CD34. Compared with the control group, the incidence and multiplicity of mammary tumors were reduced by soymilk alone and soymilk in combination with LcS, while tumor volume was decreased by LcS alone and LcS in combination with soymilk. An immunohistochemical analysis revealed that soymilk in combination with LcS more effectively reduced the numbers of ER-α-positive and Ki-67-positive cells in tumors than soymilk alone and that both soymilk and LcS inhibited tumor angiogenesis. These results demonstrated that soymilk prevents the development of mammary tumors and that LcS suppresses tumor growth, potentially enhancing the preventive efficacy of soymilk. The habitual consumption of LcS in combination with soymilk might be a beneficial dietary style for breast cancer prevention.
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Affiliation(s)
- Chiaki Kaga
- Yakult Central Institute for Microbiological Research, Tokyo, Japan
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Moore MA. Overview of Cancer Registration Research in the Asian Pacific from 2008-2013. Asian Pac J Cancer Prev 2013; 14:4461-84. [DOI: 10.7314/apjcp.2013.14.8.4461] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ilic M, Vlajinac H, Marinkovic J, Vasiljevic S. Joinpoint Regression Analysis of Female Breast Cancer Mortality in Serbia 1991–2010. Women Health 2013; 53:439-50. [DOI: 10.1080/03630242.2013.806388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Choi E, Park H, Lee J, Kim G. Anticancer, antiobesity, and anti-inflammatory activity of Artemisia species in vitro. J TRADIT CHIN MED 2013; 33:92-7. [PMID: 23596819 DOI: 10.1016/s0254-6272(13)60107-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate the anticancer, anti-inflammatory, and antiobesity activity of methanol extracts of eight distinct species: Artemisia Stolonifera (AST), Artemisia Selengensis (ASE), Artemisia Japonica, Artemisia Montana, Artemisia Capillaris (ACA), Artemisia Sylvatica (ASY), Artemisia Keiskeana (AKE), and Artemisia Scoparia (ASC) in vitro. METHODS Antiproliferative activity was investigated in human breast cancer estrogen receptor-a positive T47D and negative HS578T cell lines exposed to the extracts at various concentrations (5-200 mg/ mL) for 24, 48, and 72 h. For evaluating the anti-inflammatory activity of the extracts, inhibition of nitrite synthesis was investigated in lipopolysaccharide (LPS)-stimulated cultures of macrophages cells exposed to 10, 50, 100, and 200 mg/mL for 24 h. The antiobesity activity of the extracts was determined as triglyceride content and by a lipolysis assay in differentiated 3T3-L1 cells exposed to the extracts for 72 h at the same concentrations described above. RESULTS All extracts showed similar antiproliferative activity in a dose- and time-dependent manner in HS578T cells. Although extracts at lower concentrations and shorter times stimulated growth of T47D cells, the antiproliferative effects of the extracts on T47D cells at higher concentrations (> 100 mg/ mL) for 72 h were significantly greater than those of HS578T cells. In case of anti-inflammatory activity, some extracts (AST, ASE, ACA, and AKE) significantly reduced nitric oxide production at higher concentrations in the presence of LPS compared with that in control cells. Antiobesity activity was showed with reducing lipid accumulation significantly (> 50%) at concentrations above 100 mg/mL in most extracts (except AST and ACA). Additionally, AKE and ASC increased lipolysis by 11%-24% compared with that in the control. CONCLUSION Artemisia spp. demonstrates potential as bioactive food supplements.
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Affiliation(s)
- Eunjeong Choi
- Plant Resources Research Institute, Duksung Women's University, Seoul 139-716, South Korea
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Performance of breast cancer screening methods and modality among Chinese women: a report from a society-based breast screening program (SBSP) in Shanghai. SPRINGERPLUS 2013; 2:276. [PMID: 23961381 PMCID: PMC3724976 DOI: 10.1186/2193-1801-2-276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 05/08/2013] [Indexed: 12/12/2022]
Abstract
To evaluate the screening performance of individual and combined use of clinical breast examination, ultrasonography and mammography in Chinese women, we conducted a biennial breast cancer screening program among 14,464 women aged 35 to 74 years old who lived in Qibao County, Minhang district of Shanghai, China, between May 2008 and Sept 2012. All participants were submitted to clinical breast examination, and then women with positive results and all women at age of 45-69 years old were preformed breast ultrasonography and mammography. The examination results were compared against pathological findings as the gold standard of reference. A total of 66 women were diagnosed with breast cancer in the two rounds of the screening, yielding an incident rate of 194 per 100,000 person-years. The sensitivity of clinical breast examination, ultrasonography and mammography alone were 61.4%, 53.7% and 67.3%, respectively. While mammography performed better in elder age groups and hormone receptor positive disease groups, ultrasonography had a higher sensitivity in younger age group and did not differ in sensitivity by estrogen receptor or progesterone receptor status. Combined use of the two imaging examinations increased the sensitivity in almost all age groups, but had a higher sensitivity in hormone receptor positive cancers than in those negative. Our results suggest that the Qibao modality is an effective strategy for breast cancer screening among Chinese women, especially for early detection of elder and hormone receptor positive breast cancer.
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Yamamoto D, Iwase S, Tsubota Y, Sueoka N, Yamamoto C, Kitamura K, Odagiri H, Nagumo Y. Bevacizumab in the treatment of five patients with breast cancer and brain metastases: Japan Breast Cancer Research Network-07 trial. Onco Targets Ther 2012; 5:185-9. [PMID: 23049262 PMCID: PMC3459838 DOI: 10.2147/ott.s36515] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Brain metastases from breast cancer occur in 20%-40% of patients, and the frequency has increased over time. New radiosensitizers and cytotoxic or cytostatic agents, and innovative techniques of drug delivery are still under investigation. METHODS Five patients with brain metastases who did not respond to whole-brain radiotherapy and then received bevacizumab combined with paclitaxel were identified using our database of records between 2011 and 2012. The clinicopathological data and outcomes for these patients were then reviewed. RESULTS The median time to disease progression was 86 days. Of five patients, two (40%) achieved a partial response, two had stable disease, and one had progressive disease. In addition, one patient with brain metastases had ptosis and diplopia due to metastases of the right extraocular muscles. However, not only the brain metastases, but also the ptosis and diplopia began to disappear after 1 month of treatment. The most common treatment-related adverse events (all grades) were hypertension (60%), neuropathy (40%), and proteinuria (20%). No grade 3 toxicity was seen. No intracranial hemorrhage was observed. CONCLUSION We present five patients with breast cancer and brain metastases, with benefits from systemic chemotherapy when combined with bevacizumab.
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Affiliation(s)
- Daigo Yamamoto
- Department of Surgery, Kansai Medical University, Hirakata, Osaka ; Department of Internal Medicine, Seiko Hospital, Neyagawa, Osaka
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Overexpression of metadherin/MTDH is associated with an aggressive phenotype and a poor prognosis in invasive breast cancer. Breast Cancer 2012; 21:341-9. [PMID: 22903204 DOI: 10.1007/s12282-012-0398-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 07/27/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Metadherin (MTDH) plays functional roles in the tumorigenesis and tumor progression of various cancers. This study investigated the associations between MTDH and the clinicopathological features in primary breast carcinomas to clarify the role of MTDH in the phenotypes and prognosis of breast cancer. METHODS A total of 195 primary invasive breast cancer samples were evaluated. The MTDH DNA copy number and MTDH mRNA expression were analyzed by quantitative genomic polymerase chain reaction (PCR) and quantitative reverse transcriptase PCR. MTDH protein expression was analyzed by immunohistochemistry. RESULTS A positive correlation was found between the expression of MTDH protein and mRNA expression and the MTDH DNA copy number. MTDH overexpression was significantly associated with a high nuclear grade, negative estrogen receptor (ER) and progesterone receptor (PR) expression, high Ki67 index, poor disease-free survival (P = 0.0001), poor distant metastasis-free survival (P = 0.009), and poor overall survival (P = 0.0101). MTDH overexpression showed a particularly negative impact on the prognosis in node-negative patients. A multivariate analysis showed MTDH overexpression to be independently associated with a poor disease-free survival rate [HR 3.45, 95 % confidence interval (CI) 1.69-6.84, P = 0.0010] and a poor distant metastasis-free survival rate (HR 2.39, 95 % CI 1.08-5.01, P = 0.0319). CONCLUSION MTDH overexpression contributes to an aggressive phenotype, thus leading to a poor prognosis for primary invasive breast cancer.
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Chen WW, Shao YY, Shau WY, Lin ZZ, Lu YS, Chen HM, Kuo RNC, Cheng AL, Lai MS. The impact of diabetes mellitus on prognosis of early breast cancer in Asia. Oncologist 2012; 17:485-91. [PMID: 22467665 DOI: 10.1634/theoncologist.2011-0412] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) has been implicated in influencing the survival duration of patients with breast cancer. However, less is known about the impact of DM and other comorbidities on the breast cancer-specific survival (BCS) and overall survival (OS) outcomes of Asian patients with early-stage breast cancer. PATIENTS AND METHODS The characteristics of female patients with newly diagnosed, early-stage breast cancer were collected from the Taiwan Cancer Registry database for 2003-2004. DM status and other comorbidities were retrieved from Taiwan's National Health Insurance database. The BCS and OS times of patients according to DM status were estimated via the Kaplan-Meier method. Cox's proportional hazard model was used to estimate adjusted hazard ratios (HRs) for the effects of DM, comorbidities, and other risk factors on mortality. RESULTS In total, 4,390 patients were identified and 341 (7.7%) presented with DM. The 5-year BCS and OS rates were significantly greater in DM patients than in non-DM patients (BCS, 85% versus 91%; OS, 79% versus 90%). Furthermore, after adjusting for clinicopathologic variables and comorbidities, DM remained an independent predictor of shorter BCS (adjusted HR, 1.53) and OS (adjusted HR, 1.71) times. Subgroup analyses also demonstrated a consistent prognostic influence of DM across different groups. CONCLUSION In Asian patients with early-stage breast cancer, DM is an independent predictor of lower BCS and OS rates, even after adjusting for other comorbidities. The integration of DM care as part of the continuum of care for early-stage breast cancer should be emphasized.
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Affiliation(s)
- Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
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Youlden DR, Cramb SM, Dunn NAM, Muller JM, Pyke CM, Baade PD. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol 2012; 36:237-48. [PMID: 22459198 DOI: 10.1016/j.canep.2012.02.007] [Citation(s) in RCA: 463] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 02/22/2012] [Accepted: 02/26/2012] [Indexed: 01/01/2023]
Abstract
BACKGROUND This paper presents the latest international descriptive epidemiological data for invasive breast cancer amongst women, including incidence, survival and mortality, as well as information on mammographic screening programmes. RESULTS Almost 1.4 million women were diagnosed with breast cancer worldwide in 2008 and approximately 459,000 deaths were recorded. Incidence rates were much higher in more developed countries compared to less developed countries (71.7/100,000 and 29.3/100,000 respectively, adjusted to the World 2000 Standard Population) whereas the corresponding mortality rates were 17.1/100,000 and 11.8/100,000. Five-year relative survival estimates range from 12% in parts of Africa to almost 90% in the United States, Australia and Canada, with the differential linked to a combination of early detection, access to treatment services and cultural barriers. Observed improvements in breast cancer survival in more developed parts of the world over recent decades have been attributed to the introduction of population-based screening using mammography and the systemic use of adjuvant therapies. CONCLUSION The future worldwide breast cancer burden will be strongly influenced by large predicted rises in incidence throughout parts of Asia due to an increasingly "westernised" lifestyle. Efforts are underway to reduce the global disparities in survival for women with breast cancer using cost-effective interventions.
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Affiliation(s)
- Danny R Youlden
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Spring Hill, Qld 4004, Australia.
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Forouzanfar MH, Foreman KJ, Delossantos AM, Lozano R, Lopez AD, Murray CJL, Naghavi M. Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. Lancet 2011; 378:1461-84. [PMID: 21924486 DOI: 10.1016/s0140-6736(11)61351-2] [Citation(s) in RCA: 635] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Breast and cervical cancer are important causes of mortality in women aged ≥15 years. We undertook annual age-specific assessments of breast and cervical cancer in 187 countries. METHODS We systematically collected cancer registry data on mortality and incidence, vital registration, and verbal autopsy data for the period 1980-2010. We modelled the mortality-to-incidence (MI) ratio using a hierarchical model. Vital registration and verbal autopsy were supplemented with incidence multiplied by the MI ratio to yield a comprehensive database of mortality rates. We used Gaussian process regression to develop estimates of mortality with uncertainty by age, sex, country, and year. We used out-of-sample predictive validity to select the final model. Estimates of incidence with uncertainty were also generated with mortality and MI ratios. FINDINGS Global breast cancer incidence increased from 641,000 (95% uncertainty intervals 610,000-750,000) cases in 1980 to 1,643,000 (1,421,000-1,782,000) cases in 2010, an annual rate of increase of 3·1%. Global cervical cancer incidence increased from 378,000 (256,000-489,000) cases per year in 1980 to 454,000 (318,000-620,000) cases per year in 2010-a 0·6% annual rate of increase. Breast cancer killed 425,000 (359,000-453,000) women in 2010, of whom 68,000 (62,000-74,000) were aged 15-49 years in developing countries. Cervical cancer death rates have been decreasing but the disease still killed 200,000 (139,000-276,000) women in 2010, of whom 46,000 (33,000-64,000) were aged 15-49 years in developing countries. We recorded pronounced variation in the trend in breast cancer mortality across regions and countries. INTERPRETATION More policy attention is needed to strengthen established health-system responses to reduce breast and cervical cancer, especially in developing countries. FUNDING Susan G Komen for the Cure and the Bill & Melinda Gates Foundation.
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Sankaranarayanan R, Ramadas K, Thara S, Muwonge R, Prabhakar J, Augustine P, Venugopal M, Anju G, Mathew BS. Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst 2011; 103:1476-80. [PMID: 21862730 DOI: 10.1093/jnci/djr304] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A cluster randomized controlled trial was initiated in the Trivandrum district (Kerala, India) on January 1, 2006, to evaluate whether three rounds of triennial clinical breast examination (CBE) can reduce the incidence rate of advanced disease incidence and breast cancer mortality. A total of 275 clusters that included 115,652 healthy women, aged 30-69 years, were randomly allocated to intervention (CBE; 133 clusters; 55,844 women) or control (no screening; 142 clusters; 59,808 women) groups. Performance characteristics (sensitivity, specificity, false-positive rate, and positive predictive value) of CBE were evaluated. An intention-to-treat analysis was performed for comparison of incidence rates between the intervention and control groups. Preliminary results for incidence are based on follow-up until May 31, 2009, when the first round of screening was completed. Of the 50,366 women who underwent CBE, 30 breast cancers were detected among 2880 women with suspicious findings in CBE screening that warranted further investigations. Sensitivity, specificity, false-positive rate, and positive predictive value of CBE were 51.7% (95% confidence interval [CI] = 38.2% to 65.0%), 94.3% (95% CI = 94.1% to 94.5%), 5.7% (95% CI = 5.5% to 5.9%), and 1.0% (95% CI = 0.7% to 1.5%), respectively. The age-standardized incidence rates for early-stage (stage IIA or lower) breast cancer were 18.8 and 8.1 per 100,000 women and for advanced-stage (stage IIB or higher) breast cancer were 19.6 and 21.7 per 100,000 women, in the intervention and control groups, respectively.
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Affiliation(s)
- Rengaswamy Sankaranarayanan
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France.
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Kwong A, Mang OWK, Wong CHN, Chau WW, Law SCK. Breast cancer in Hong Kong, Southern China: the first population-based analysis of epidemiological characteristics, stage-specific, cancer-specific, and disease-free survival in breast cancer patients: 1997-2001. Ann Surg Oncol 2011; 18:3072-8. [PMID: 21847700 PMCID: PMC3180563 DOI: 10.1245/s10434-011-1960-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Indexed: 12/21/2022]
Abstract
Background Cancer registries have been set up worldwide to provide information for cancer health planning. There are known variations in breast cancer incidence and mortality worldwide. However, breast cancer incidence, pathological characteristics, and survival data is still under-reported in Asian countries. This is the first comprehensive population-based breast cancer study performed using population database of the Hong Kong Cancer Registry. Methods A retrospective review of medical records of 8,961 subjects who were diagnosed with breast cancer between January 1, 1997 to December 31, 2001 and followed up to December 31, 2007. Descriptive statistics were employed to analyze the epidemiological and clinical data. Estimates of overall, disease-free, and cancer-specific survival at 5 years were estimated by the Kaplan–Meier method and stage-specific relative survival rates were calculated. Results A total of 7,630 breast cancer patients’ medical records and dataset were available during this period, and 7,449 subjects were eligible for the final analysis. Median follow-up was 84 months. A total of 47.4% were diagnosed with breast cancer at age 49 years and younger; 22.2%, 46.9%, 10.8%, and 4.1% presented at stages I, II, III, and IV, respectively. A total of 53.5% had ER-positive cancer, and 20.3% had HER2-positive cancers; 13.4% had triple-negative cancers. The relative, cancer-specific, and disease-free survival rates at 5 years were 84%, 85.2%, and 81.2%, respectively. Discussion We performed the first comprehensive population-based breast cancer epidemiology study in Southern China using the Hong Kong Cancer Registry database. This provides a baseline study cohort for comparative studies with other Asian countries and Chinese who have migrated to the West.
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Affiliation(s)
- Ava Kwong
- Division of Breast Surgery, Department of Surgery, Queen Mary and Tung Wah Hospital, The University of Hong Kong, Hong Kong, China.
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Iwasaki M, Tsugane S. Risk factors for breast cancer: epidemiological evidence from Japanese studies. Cancer Sci 2011; 102:1607-14. [PMID: 21624009 DOI: 10.1111/j.1349-7006.2011.01996.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although our understanding of the etiology of breast cancer has improved, many well-known risk factors are not modifiable and present knowledge has proved insufficient to allow the disease to be overcome. Indeed, incidence and mortality among Japanese women have increased over the past three decades. Here, we review epidemiological evidence from our cohort and case-control studies among Japanese women in comparison with other published findings. Our studies confirm the important role of established factors derived primarily from Western populations, such as menstrual and reproductive factors, anthropometric factors, physical activity, and alcohol intake, in the development of breast cancer. In addition, we provide further evidence to better understand the role of traditional Japanese foods in the etiology of breast cancer. Our cohort study found that a higher intake of isoflavone and higher levels of plasma genistein, but not daidzein, were associated with a decreased risk of breast cancer. Our case-control studies reveal a dose-response pattern for these compounds; specifically, decreased risk as women move from "no" to "moderate" intake and leveling off thereafter. In addition, gene-environment interactions have been revealed in the effects of isoflavones. The evidence reviewed suggests that isoflavone has a protective effect against breast cancer in Asian populations. Conversely, our cohort study did not observe an inverse association between breast cancer risk and the intake of green tea and/or the plasma level of tea polyphenols, but we did find an association between increased risk and active and passive smoking. In conclusion, based on current knowledge, primary prevention according to individual lifestyle modification should focus on alcohol intake, weight control, physical activity, and tobacco smoking.
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Affiliation(s)
- Motoki Iwasaki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
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