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Xiao X, Liu R, Zhang Z, Jalaludin B, Heinrich J, Lao X, Morawska L, Dharmage SC, Knibbs LD, Dong GH, Gao M, Yin C. Using individual approach to examine the association between urban heat island and preterm birth: A nationwide cohort study in China. ENVIRONMENT INTERNATIONAL 2024; 183:108356. [PMID: 38043323 DOI: 10.1016/j.envint.2023.108356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/22/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Evidence suggests that maternal exposure to heat might increase the risk of preterm birth (PTB), but no study has investigated the effect from urban heat island (UHI) at individual level. AIMS Our study aimed to investigate the association between individual UHI exposure and PTB. METHODS We utilized data from the ongoing China Birth Cohort Study (CBCS), encompassing 103,040 birth records up to December 2020. UHI exposure was estimated for each participant using a novel individual assessment method based on temperature data and satellite-derived land cover data. We used generalized linear mixed-effects models to estimate the association between UHI exposure and PTB, adjusting for potential confounders including maternal characteristics and environmental factors. RESULTS Consistent and statistically significant associations between UHI exposure and PTB were observed up to 21 days before birth. A 5 °C increment in UHI exposure was associated with 27 % higher risk (OR = 1.27, 95 % confident interval: 1.20, 1.34) of preterm birth in lagged day 1. Stratified analysis indicated that the associations were more pronounced in participants who were older, had higher pre-pregnancy body mass index level, of higher socioeconomic status and living in greener areas. CONCLUSION Maternal exposure to UHI was associated with increased risk of PTB. These findings have implications for developing targeted interventions for susceptible subgroups of pregnant women. More research is needed to validate our findings of increased risk of preterm birth due to UHI exposure among pregnant women.
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Affiliation(s)
- Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong, China
| | - Ruixia Liu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Zheng Zhang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Bin Jalaludin
- School of Public Health and Community Medicine, The University of New South Wales, Kensington 2052, Australia
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich 80336, Germany
| | - Xiangqian Lao
- Department of Biomedical Sciences, the City University of Hong Kong, Hong Kong, China
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane 4059, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, NSW 2006, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong, China; Center for Ocean Research in Hong Kong and Macau (CORE), Hong Kong, China.
| | - Chenghong Yin
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
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Benitez Fuentes JD, Morgan E, de Luna Aguilar A, Mafra A, Shah R, Giusti F, Vignat J, Znaor A, Musetti C, Yip CH, Van Eycken L, Jedy-Agba E, Piñeros M, Soerjomataram I. Global Stage Distribution of Breast Cancer at Diagnosis: A Systematic Review and Meta-Analysis. JAMA Oncol 2024; 10:71-78. [PMID: 37943547 PMCID: PMC10636649 DOI: 10.1001/jamaoncol.2023.4837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/25/2023] [Indexed: 11/10/2023]
Abstract
Importance Stage at diagnosis is a key prognostic factor for cancer survival. Objective To assess the global distribution of breast cancer stage by country, age group, calendar period, and socioeconomic status using population-based data. Data Sources A systematic search of MEDLINE and Web of Science databases and registry websites and gray literature was conducted for articles or reports published between January 1, 2000, and June 20, 2022. Study Selection Reports on stage at diagnosis for individuals with primary breast cancer (C50) from a population-based cancer registry were included. Data Extraction and Synthesis Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers (J.D.B.F., A.D.A., A.M., R.S., and F.G.). Stage-specific proportions were extracted and cancer registry data quality and risk of bias were assessed. National pooled estimates were calculated for subnational or annual data sets using a hierarchical rule of the most relevant and high-quality data to avoid duplicates. Main Outcomes and Measures The proportion of women with breast cancer by (TNM Classification of Malignant Tumors or the Surveillance, Epidemiology, and End Results Program [SEER]) stage group. Results Data were available for 2.4 million women with breast cancer from 81 countries. Globally, the proportion of cases with distant metastatic breast cancer at diagnosis was high in sub-Saharan Africa, ranging from 5.6% to 30.6% and low in North America ranging from 0.0% to 6.0%. The proportion of patients diagnosed with distant metastatic disease decreased over the past 2 decades from around 3.8% to 35.8% (early 2000s) to 3.2% to 11.6% (2015 onwards), yet stabilization or slight increases were also observed. Older age and lower socioeconomic status had the largest proportion of cases diagnosed with distant metastatic stage ranging from 2.0% to 15.7% among the younger to 4.1% to 33.9% among the oldest age group, and from 1.7% to 8.3% in the least disadvantaged groups to 2.8% to 11.4% in the most disadvantaged groups. Conclusions and Relevance Effective policy and interventions have resulted in decreased proportions of women diagnosed with metastatic breast cancer at diagnosis in high-income countries, yet inequality persists, which needs to be addressed through increased awareness of breast cancer symptoms and early detection. Improving global coverage and quality of population-based cancer registries, including the collection of standardized stage data, is key to monitoring progress.
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Affiliation(s)
- Javier David Benitez Fuentes
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
- Department of Medical Oncology, Hospital Clinico San Carlos, IdISSC, Calle Profesor Martín Lagos, Madrid, Spain
- Velindre Cancer Centre, Cardiff, Wales, United Kingdom
| | - Eileen Morgan
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
| | - Alicia de Luna Aguilar
- Department of Medical Oncology, Hospital Clinico San Carlos, IdISSC, Calle Profesor Martín Lagos, Madrid, Spain
- Velindre Cancer Centre, Cardiff, Wales, United Kingdom
| | - Allini Mafra
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
| | - Richa Shah
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
| | - Francesco Giusti
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
- Belgian Cancer Registry, Brussels, Belgium
| | - Jérôme Vignat
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
| | | | - Cheng-Har Yip
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Ramsay Sime Darby Health Care, Kuala Lumpur, Malaysia
| | - Liesbet Van Eycken
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
- Belgian Cancer Registry, Brussels, Belgium
| | | | - Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon
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3
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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: 7] [Impact Index Per Article: 7.0] [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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Huang J, Chen X, Guo J, Song L, Mu Y, Zhao H, Du C. Apatinib combined with trastuzumab and albumin-bound paclitaxel for treatment of HER2+ breast cancer with brain metastases resistant to anti-HER2 TKIs: A case report. Oncol Lett 2022; 25:56. [PMID: 36644147 PMCID: PMC9827463 DOI: 10.3892/ol.2022.13642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
Although human epidermal growth factor receptor 2 (HER2)-targeted therapy significantly improves the prognosis of patients with HER2-positive breast cancer, most patients with advanced breast cancer eventually progress due to drug resistance. At present, there is no standard treatment after patients become resistant to HER2-targeted therapy. Previous studies have indicated that anti-angiogenesis drugs have potential efficacy in the treatment of advanced breast cancer. The present study reported on a case of a pretreated patient with HER2-positive advanced breast cancer with brain metastases who developed resistance to multiple lines of HER2-targeted treatment. The patient was treated with apatinib combined with trastuzumab and albumin-bound paclitaxel. The patient achieved partial response to the third-line treatment with a progression-free survival of 9 months. After combination treatment, the symptoms of headache and vomiting were relieved and all the brain metastases were significantly reduced. The present case indicated that apatinib may have anti-tumor activity in patients with HER2-positive breast cancer with HER2-targeted drug resistance. The present case provides valuable information and may offer a new possibility for the treatment of patients with breast cancer with brain metastases who progressed after clinical treatment with small-molecule anti-HER2 tyrosine kinase inhibitor drugs.
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Affiliation(s)
- Jiayi Huang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Xiao Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Jinfeng Guo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Lin Song
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Yanxi Mu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Han Zhao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
| | - Caiwen Du
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China,Correspondence to: Professor Caiwen Du, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 113 Baohe Road, Shenzhen, Guangdong 518116, P.R. China, E-mail:
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5
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Zhang S, Wang H, Liu B, Yu J, Gao Y. Socioeconomic status index is an independent determinant of breast cancer screening practices: Evidence from Eastern China. PLoS One 2022; 17:e0279107. [PMID: 36516181 PMCID: PMC9749974 DOI: 10.1371/journal.pone.0279107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Breast cancer is the most prevalent malignancy affecting Chinese women, and early routine screening is incredibly important for its prevention and control. This study aimed to investigate the role of socioeconomic status (SES) in female breast cancer screening practices using the composite SES index. METHODS This cross-sectional study involved 1816 women in Eastern China. Data were collected using an online self-administered questionnaire from January 2020 to May 2021. We used principal component analysis to construct the composite SES index using educational level, annual household income, and occupation. Logistic regression was used to analyze the association between the SES index and breast cancer screening utilization. RESULTS Of the participants, 19.27% reported having performed breast self-examination, 12.89% reported having undergone clinical breast examination, and 3.52% reported having received mammography. The SES has a significant influence on the patronage of female breast cancer screening in Eastern China. The composite SES index was found to have a positive and significant association with breast cancer screening practices. An interaction was found between the SES index and patient characteristics, such as health awareness, marital status, and location of residence. In addition, the SES index had a positive effect on breast cancer-related knowledge. CONCLUSIONS Socioeconomic inequalities existed in Eastern China and were related to breast cancer screening patronage. The composite SES index was identified as a significant determinant of breast cancer screening practices. Our results highlighted the negative impacts of socioeconomic inequities on female breast cancer screening utilization. This suggests that reducing socioeconomic inequalities in breast cancer screening requires more focused interventions and concerted outreach activities for groups with lower education levels, lower income, or lower occupational classes.
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Affiliation(s)
- Shunhua Zhang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- * E-mail:
| | - Hairuo Wang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Binhao Liu
- School of Clinical Medicine, Bengbu Medical College, Bengbu, Anhui, China
| | - Jianwei Yu
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Yizheng Gao
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
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Association of treatment delay and stage with mortality in breast cancer: a nationwide cohort study in Taiwan. Sci Rep 2022; 12:18915. [PMID: 36344740 PMCID: PMC9640724 DOI: 10.1038/s41598-022-23683-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Breast cancer is the fifth leading cause of cancer death globally. In this retrospective study, we investigated the effects of the diagnosis-to-first-treatment interval (DFTI) and other related factors on cancer-specific survival in patients with breast cancer. We included 49,426 patients newly diagnosed as having breast cancer during 2011-2017. The Cox proportional hazards model was used to analyze the hazard ratio (HR) for mortality with various DFTIs; the HRs of the 31-60-, 61-90-, and ≥ 91-day DFTI groups did not differ significantly compared with the reference group (DFTI ≤ 30 days). After stratifying the patients according to initial tumor stage and age, we found that patients aged 55-64 and ≥ 65 years with stage II breast cancer treated ≥ 91 days after diagnosis had a 3.34- and 2.93-fold higher mortality risk (95% confidence intervals [CIs] 1.29-8.69 and 1.06-8.10, respectively). Patients aged ≥ 65 years with stage IV breast cancer treated within 61-90 or ≥ 91 days after diagnosis had a 7.14- and 34.78-fold higher mortality risk (95% CIs 1.28-39.82 and 3.08-393.32, respectively). In conclusion, DFTI is associated with mortality in patients with stage II and IV breast cancer, especially at an older age.
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7
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Huang Y, Wang H, Lyu Z, Dai H, Liu P, Zhu Y, Song F, Chen K. Development and evaluation of the screening performance of a low-cost high-risk screening strategy for breast cancer. Cancer Biol Med 2022; 19:j.issn.2095-3941.2020.0758. [PMID: 34570443 PMCID: PMC9500221 DOI: 10.20892/j.issn.2095-3941.2020.0758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To develop and evaluate the screening performance of a low-cost high-risk screening strategy for breast cancer in low resource areas. METHODS Based on the Multi-modality Independent Screening Trial, 6 questionnaire-based risk factors of breast cancer (age at menarche, age at menopause, age at first live birth, oral contraceptive, obesity, family history of breast cancer) were used to determine the women with high risk of breast cancer. The screening performance of clinical breast examination (CBE), breast ultrasonography (BUS), and mammography (MAM) were calculated and compared to determine the optimal screening method for these high risk women. RESULTS A total of 94 breast cancers were detected among 31,720 asymptomatic Chinese women aged 45-65 years. Due to significantly higher detection rates (DRs) and suitable coverage of the population, high risk women were defined as those with any of 6 risk factors. Among high risk women, the DR for BUS [3.09/1,000 (33/10,694)] was similar to that for MAM [3.18/1,000 (34/10,696)], while it was significantly higher than that for the CBE [1.73/1,000 (19/10,959), P = 0.002]. Compared with MAM, BUS showed significantly higher specificity [98.64% (10,501/10,646) vs. 98.06% (10,443/10,650), P = 0.001], but no significant differences in sensitivity [68.75% (33/48) vs. 73.91% (34/46)], positive prediction values [18.54% (33/178) vs. 14.11% (34/241)], and negative prediction values [99.86% (10,501/10,516) vs. 99.89% (10,443/10,455)]. Further analyses showed no significant difference in the percentages of early stage breast cancer [53.57% (15/28) vs. 50.00% (15/30)], lymph node involvement [22.73% (5/22) vs. 28.00% (7/25)], and tumor size ≥ 2 cm [37.04% (10/27) vs. 29.03% (9/31)] between BUS and MAM. Subgroup analyses stratified by breast densities or age at enrollment showed similar results. CONCLUSIONS The low-cost high-risk screening strategy based on 6 questionnaire-based risk factors was an easy-to-use method to identify women with high risk of breast cancer. Moreover, BUS and MAM had comparable screening performances among high risk women.
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Affiliation(s)
- Yubei Huang
- Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Huan Wang
- Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Zhangyan Lyu
- Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Hongji Dai
- Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Peifang Liu
- Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Ying Zhu
- Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Fengju Song
- Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China
| | - Kexin Chen
- Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Molecular Epidemiology of Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Tianjin 300060, China,Correspondence to: Kexin Chen, E-mail:
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Hassanshahi J, Hajializadeh Z, Niknia S, Mahmoodi M, Kaeidi A. Anti-tumor effects of Thymus Caramanicus Jalas extract in mice through oxidative stress, inflammation and apoptosis. J Pharm Pharmacol 2022; 74:1797-1804. [PMID: 35997166 DOI: 10.1093/jpp/rgac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 07/28/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Breast cancer causes death in women. Thymus Caramanicus Jalas (TCJ) as a polyphenolic plant has an antiproliferative effect. Accordingly, this investigation studied the TCJ extract anti-tumor effects in a breast cancer model. METHODS Twenty-four female BALB/c mice were used in 4 groups including (1) breast cancer (control); (2), (3) and (4) breast cancer + 100, 300 and 500 mg/kg of TCJ extract (once daily for 20-days after breast tumor induction). The breast tumour was induced by 4T1 cell carcinoma injection. Then tumor size and weight were measured. Tumor necrosis factor-α (TNF-α), nuclear factor κ-B (NF-κB), interleukin-6 (IL-6) as inflammatory markers and also Bcl-2, Bax, cytosolic cytochrome-c, apoptosis-inducing factor, and cleaved caspase-3 as biochemical apoptosis markers were evaluated in tumor tissue with western blotting analysis. Also, malondialdehyde (MDA) concentration, hydrogen peroxidase (H2O2), catalase, glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities were exanimated. KEY FINDINGS Treatment with TCJ extract (500 mg/kg) decreased the tumor volume, tumor weight, GPx, SOD, and catalase enzyme activity versus the control group (P < 0.05). Also, TCJ (500 mg/kg) extract increased MDA, H2O2, inflammatory and apoptosis markers versus control (P < 0.05). CONCLUSIONS Current study showed that TCJ can induce anti-tumour effects via promoting inflammation, apoptosis, and oxidative stress in breast tumour tissue.
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Affiliation(s)
- Jalal Hassanshahi
- Physiology-Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Hajializadeh
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Seddigheh Niknia
- Department of Biochemistry, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Mahmoodi
- Department of Clinical Biochemistry, Afzalipoor Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.,Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ayat Kaeidi
- Physiology-Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Wang Y, Wan Z. Spatial autocorrelation and stratified heterogeneity in the evaluation of breast cancer risk inequity and socioeconomic factors analysis in China: Evidence from Nanchang, Jiangxi Province. GEOSPATIAL HEALTH 2022; 17. [PMID: 35579243 DOI: 10.4081/gh.2022.1078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Study of socioeconomic factors can play an important role in the spatial distribution of breast cancer by leading to a better understanding of its spatial pattern and assist breast cancer screening and early diagnosis. Taking Nanchang, a major city in central China, as an example, spatial autocorrelation and stratified heterogeneity were applied using a 10 10 km grid division to analyse breast cancer risk and socioeconomic factors. The research results showed that the median incidence rate of female breast cancer in Nanchang from 2016 to 2018 was 6.6/100,000 with a standard deviation of 12.3/100,000. Areas with higher incidence rates were mainly located in the central urban area and the major county towns. Spatial regression analysis showed that there was a statistically significant correlation between the spatial patterns of breast cancer incidence on the one hand, and on the other socioeconomic factors, such as total gross domestic product (GDP), per capita GDP and density of places of social and economic activities, i.e. points of interest. In addition, the normalized difference vegetation index also played a part in this respect. This research could serve as a reference for regional public health policy formulation and breast cancer screening.
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Affiliation(s)
- Yaqi Wang
- Comprehensive Tumour Internal Department, Jiangxi Provincial Cancer Hospital, Nanchang.
| | - Zhiwei Wan
- School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou.
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Yang Y, Yu J, Bai Y, Liu A, Tian J, Guo L, Huo D, Zhao P, Ji W, Luo B. Self-detection remains a primary means of breast cancer detection in Beijing, China. TRANSLATIONAL BREAST CANCER RESEARCH : A JOURNAL FOCUSING ON TRANSLATIONAL RESEARCH IN BREAST CANCER 2022; 4:27. [PMID: 38751468 PMCID: PMC11093100 DOI: 10.21037/tbcr-22-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/01/2022] [Indexed: 05/18/2024]
Abstract
Background Breast cancer in China is usually identified at a later-stage compared to developed countries, and efforts have been made to improve early detection over the past years. This cross-sectional study aimed to determine the current situation of breast cancer detection and screening in a cohort of Chinese breast cancer patients. Methods Three hundred and ten consecutive female breast cancer patients newly diagnosed and treated in Beijing Tsinghua Changgung Hospital between 2015 and 2021 were recruited. Clinicopathological data were retrieved from the patient's medical records and every individual completed surveys assessing demographics, mode of detection, screening behavior and barriers to screening. Results Among the 310 patients, 72.6% had self-detected diseases (mostly through identification of a breast lump), 24.5% were ultrasound screening-detected, 0.3% were mammographic screening-detected and others were identified through clinical breast examination (CBE) (1.0%) or chest computed tomography (CT)/magnetic resonance imaging (MRI) (1.6%). Detection by screening was associated with earlier stages of breast cancer compared to self-detection, yet, 32.2% of self-detected diseases were at stage 0-I. A total of 166 (53.5%) patients had a screening history, with ultrasonography being mostly used and provided by employers. Leading self-perceived barrier to breast cancer screening was lack of awareness, followed by lack of access. And screening participation was associated with a younger age, higher education, being currently working, residence in urban area, and a high family income. Conclusions Self-detection still remains a major way of breast cancer detection in Beijing, but it is not necessarily associated with a late-stage disease. The suboptimal screening rate with disparity in screening behavior can be mostly attributed to lack of awareness of the public and insufficient screening providers.
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Affiliation(s)
- Yuyan Yang
- School of Medicine, Tsinghua University, Beijing, China
| | - Junping Yu
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yizhou Bai
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Anyang Liu
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jinyi Tian
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lijing Guo
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Dongfang Huo
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Peiliang Zhao
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wuyang Ji
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Bin Luo
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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11
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Mubarik S, Sharma R, Hussain SR, Iqbal M, Nawsherwan, Liu X, Yu C. Breast Cancer Mortality Trends and Predictions to 2030 and Its Attributable Risk Factors in East and South Asian Countries. Front Nutr 2022; 9:847920. [PMID: 35360680 PMCID: PMC8964109 DOI: 10.3389/fnut.2022.847920] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background Amidst the rising breast cancer burden in Asia, we aim to predict the future mortality risk due to breast cancer and identify the risk-attributable deaths for breast cancer among East and South Asian countries. Methods We used country-level data to predict the trends in the next decade relating to female breast cancer mortality by employing data from 1990 to 2019 from the Global Burden of Disease 2019 study. We used the stochastic mortality modeling and prediction techniques to forecast the age-specific and risk-attributable breast cancer mortality trends at the regional and national levels of East and South Asia. Results The number of deaths caused by the breast cancer is predicted to increase in East and South Asian countries in the next decade (2020–2030). Age-standardized death rate (ASDR) of breast cancer is predicted to increase by 7.0% from 9.20/100,000 (95% CI: 6.04–12.12) in 1990 to 9.88/100,000 (95% CI: 7.12–11.4) in 2030 in East Asia, and about 35% increase from 13.4/100,000 (95% CI: 9.21–16.02) in 1990 to 18.1/100,000 (95% CI: 13.23–21.10) in 2030 in South Asia. At the national level, the highest percent change in ASDR between 1990 and 2030 was reported in Pakistan (a 62% increase) and Nepal (a 47% increase). The highest percent change in breast cancer mortality between 2020 and 2030 for females of age group 80–84 years was observed in Pakistan [21.6, (95% CI, 20.6–94.7)], followed by Afghanistan [13.3 (4.0–80.8)], and Nepal [36.6 (11.1–125.7)] as compared to the other countries. In the females of aged 50–80 years, the predicted death rates were associated with high body mass index, high-fasting plasma glucose, and diet high in red meat, across the majority of countries under study. Furthermore, reductions in percent change in mortality rates occurred in several countries with increases in sociodemographic index (SDI), notably across high SDI countries. Conclusion Breast cancer mortality risk varies substantially across East and South Asian countries with higher mortality risk in low/middle SDI countries. Early detection using screening, awareness among females and health workers, and cost-effective and timely treatment of patients with breast cancer is vital in stemming the tide of breast cancer in the next decade.
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12
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Choe SA, Roh M, Kim HR, Lee S, Ki M, Paek D, Son M. Income Disparity in Breast Cancer Incidence and Stage at Presentation: A National Population Study of South Korea. J Breast Cancer 2022; 25:415-424. [DOI: 10.4048/jbc.2022.25.e38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Seung-Ah Choe
- Division of Life Science, Korea University, Seoul, Korea
- Department of Preventive Medicine, Korea University, Seoul, Korea
| | - Minji Roh
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Hye Ri Kim
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Soohyeon Lee
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Myung Ki
- Department of Preventive Medicine, Korea University, Seoul, Korea
| | - Domyung Paek
- Wonjin Institute for Occupational and Environmental Health, Green Hospital, Seoul, Korea
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Mia Son
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
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13
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Disparities in stage at diagnosis for five common cancers in China: a multicentre, hospital-based, observational study. THE LANCET PUBLIC HEALTH 2021; 6:e877-e887. [DOI: 10.1016/s2468-2667(21)00157-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/04/2021] [Accepted: 06/16/2021] [Indexed: 12/14/2022] Open
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14
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Hu N, Si Y, Yue J, Sun T, Wang X, Jia Z, Gao S, Li Q, Shao Y, Wang J, Luo Y, Ma F, Xu B, Yuan P. Anlotinib has good efficacy and low toxicity: a phase II study of anlotinib in pre-treated HER-2 negative metastatic breast cancer. Cancer Biol Med 2021; 18:j.issn.2095-3941.2020.0463. [PMID: 33710812 PMCID: PMC8330540 DOI: 10.20892/j.issn.2095-3941.2020.0463] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/15/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Anlotinib is a novel tyrosine kinase inhibitor blocking angiogenesis. This study was performed to assess the efficacy and safety of anlotinib in patients with metastatic breast cancer. METHODS Patients with HER2-negative breast cancer, who were pre-treated with anthracycline or taxanes in a neoadjuvant, adjuvant, or metastatic setting, and had treatment failure after at least one prior chemotherapy regimen in the metastatic setting were enrolled. Anlotinib was administered at 12 mg daily for 14 days in a 21-day cycle until disease progression or unacceptable toxicity occurred. Simultaneously, 5-10 mL of venous blood was collected to perform circulating tumor DNA (ctDNA) testing every 2 treatment cycles. The primary endpoint was the objective response rate (ORR). Secondary endpoints included the disease control rate (DCR), progression-free survival (PFS), overall survival, safety, and biomarkers. RESULTS Twenty-six eligible patients were enrolled, with a median age of 56 (30-75) years. The median follow-up time was 10.5 months. The ORR was 15.4%, the DCR was 80.8%, and the median PFS was 5.22 months (95% confidence interval 2.86-6.24). Fourteen (53.8%) patients survived for more than 10 months. The changes in the detectable ctDNA variant allele frequency were consistent with the tumor response. The most common treatment-related adverse events were hypertension (57.7%), thyroidstimulating hormone elevation (34.6%), and hand-foot syndrome (23.1%). CONCLUSIONS Anlotinib showed objective efficacy with tolerable toxicity in heavily pre-treated, metastatic HER2-negative breast cancer. The dynamic changes in the ctDNA variant allele fraction may be predictive of the tumor response.
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Affiliation(s)
- Nanlin Hu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yiran Si
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jian Yue
- Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Tingting Sun
- Nanjing Geneseeq Technology Inc., Nanjing 210032, China
| | - Xue Wang
- Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhuqing Jia
- Cancer Hospital of Huanxing Chaoyang District Beijing, Beijing 100021, China
| | - Songlin Gao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qiao Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yang Shao
- Nanjing Geneseeq Technology Inc., Nanjing 210032, China
| | - Jiayu Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yang Luo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Peng Yuan
- Department of VIP Medical Services, 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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15
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Hu N, Zhu A, Si Y, Yue J, Wang X, Wang J, Ma F, Xu B, Yuan P. A Phase II, Single-Arm Study of Apatinib and Oral Etoposide in Heavily Pre-Treated Metastatic Breast Cancer. Front Oncol 2021; 10:565384. [PMID: 33659204 PMCID: PMC7917213 DOI: 10.3389/fonc.2020.565384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction We performed this clinical trial to evaluate the efficacy and safety of apatinib and oral etoposide in patients with HER2-negative locally advanced or metastatic breast cancer (MBC). Methods Patients with HER2-negative MBC previously treated with anthracycline and taxanes and failed ≥1 prior chemotherapy regimens were recruited. The starting dose of apatinib was 500 and 425 mg in patients with ECOG scores of 0-1 and 2, respectively. The etoposide capsules were given at 50 mg/m2 on days 1 to 10 for 21 days. The primary end point was objective response rate (ORR). Secondary end points included progression-free survival (PFS), disease control rate (DCR), overall survival (OS), and safety. Results Thirty-one eligible patients were enrolled. The median follow-up time was 11 months. The median PFS for all patients was 6.9 months [95% confidence interval (CI) 6.0-7.9], and 6.9 months (95% CI 5.3-8.6) and 6.6 months (95% CI 1.4-11.7) for patients with apatinib 425 and 500mg once daily, respectively. The ORR was 35.5% (11/31). The DCR was 87.1% (27/31). The median OS was 20.4 months (95% CI 11.4-29.3). The median PFS of patients who had hypertension and proteinuria was longer than that for those without hypertension and proteinuria. The most common grade 3/4 treatment-related AEs were hypertension (12/31, 38.7%), fatigue (3/31, 9.7%), thrombocytopenia (3/31, 9.7%). Conclusion Apatinib combined with etoposide capsules is effective and tolerable in heavily pretreated, metastatic HER2-negative breast cancer patients. A lower apatinib dose provide equivalent efficacy and reduced toxicity. Clinical Trial Registration https://clinicaltrials.gov/, identifier NCT03535961.
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Affiliation(s)
- Nanlin Hu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anjie Zhu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Breast Oncology, Peking University Cancer Hospital/Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China
| | - Yiran Si
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Yue
- Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue Wang
- Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiayu Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peng Yuan
- Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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16
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Wan Z, Wang Y, Deng C. Application of GIS Spatial Analysis and Scanning Statistics in the Gynecological Cancer Clustering Pattern and Risk Screening: A Case Study in Northern Jiangxi Province, China. Risk Manag Healthc Policy 2020; 13:1079-1093. [PMID: 32982504 PMCID: PMC7493024 DOI: 10.2147/rmhp.s261221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/28/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The incidence of gynecological cancer is high in China, and the effects of related treatments and preventive measures need to be improved. METHODS This study uses GIS spatial analysis methods and a scanning statistical analysis to study the major gynecological cancers in northern Jiangxi Province from 2016 to 2018. RESULTS The incidence and spatial pattern of cervical cancer, ovarian cancer, and uterine cancer had agglomeration characteristics and changes during the study period. The gynecological cancer had a spatial autocorrelation and agglomeration in its spatial pattern. The Moran's Index of the overall gynecological cancer incidence rate was 0.289 (p = 0.005). Ripley's L(d) function showed that the agglomeration radius was between 51.40 and 52.82 km. The results of the kernel density estimation showed that the cases of gynecological cancer were concentrated in the central and northeastern areas of the study area. The overall county-level incidence of gynecological cancer varied from 0.26 to 11.14 per 100,000. The results of the gravity center analysis showed that the spatial distribution of the gravity center point of gynecological cancer had moved toward the east during the past three years. The results of a hotspot analysis showed that there were five hotspot areas that had gynecological cancers. The most likely clusters of gynecological cancer at the county level in northern Jiangxi Province were distributed in the adjacent areas of Jiujiang, Yichun, and Nanchang, with a relative risk of 1.85. CONCLUSION The research shows that GIS can display the distribution of cancer cases and can use spatial analysis methods and scanning statistical techniques to obtain key areas of cancer incidence. These results can provide data and key areas for the formulation of regional public health policies and provide recommendations for cancer screening and the rational allocation of health resources.
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Affiliation(s)
- Zhiwei Wan
- School of Geography and Environment, Jiangxi Normal University, Nanchang330022, People’s Republic of China
| | - Yaqi Wang
- Jiangxi Provincial Cancer Center, Jiangxi Provincial Cancer Hospital, Nanchang330029, People’s Republic of China
| | - Chunhong Deng
- Jiangxi Provincial Cancer Center, Jiangxi Provincial Cancer Hospital, Nanchang330029, People’s Republic of China
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17
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Hao Y, Xu B, Yan Q, Zhou M, Hou C, Wu L, Zhong X, Li J. Long-term excess body fat in adulthood and the risk of pre- and postmenopausal breast cancer in Chinese women. Breast Cancer Res Treat 2020; 182:195-206. [PMID: 32415498 DOI: 10.1007/s10549-020-05685-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/11/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE This study aimed to investigate the association between long-term excess body fat and breast cancer risk by studying adult weight gain together with the subsequent weight fluctuations. METHODS Weight gain measure in three different time periods in adulthood of 1500 participants was collected in a case-control study of Western China. Logistic regression models were used to estimate odds ratios and 95% CIs. RESULTS The increased risk of postmenopausal BC was associated with adult weight gain at 5 years and at 10 years before enrollment (OR 1.24, 95% CI 1.03-1.49 per 5 kg increase; OR 1.40, 95% CI 1.14-1.70 per 5 kg increase) but was not associated with adult weight gain at enrollment (OR 0.97, 95% CI 0.81-1.16 per 5 kg increase). Only a positive association was observed in premenopausal women who had gained > 5.0 kg at 10 years before enrollment (OR 1.61, 95% CI 1.10-2.35). Women who had gained > 5.0 kg at 10 years before enrollment and continued to gain during the subsequent 5 years had the highest postmenopausal BC risk (OR 3.34, 95% CI 1.58-7.08). CONCLUSION Adult weight gain at 5 years and 10 years before enrollment are more closely associated with postmenopausal BC risk than adult weight gain at enrollment in Western China. Controlling body weight as early as possible throughout adulthood to keep weight gain not more than 5.0 kg is particularly necessary for Chinese women.
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Affiliation(s)
- Yu Hao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16 Ren Min Nan Lu, Chengdu, 610041, Sichuan, China
| | - Bin Xu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16 Ren Min Nan Lu, Chengdu, 610041, Sichuan, China
| | - Qiming Yan
- Chengdu Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Min Zhou
- Department of Maternal and Child Health, Chengdu Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Can Hou
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16 Ren Min Nan Lu, Chengdu, 610041, Sichuan, China
| | - Lin Wu
- Department of Maternal and Child Health, Chengdu Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Xiaorong Zhong
- Department of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiayuan Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16 Ren Min Nan Lu, Chengdu, 610041, Sichuan, China.
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18
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Lili X, Zhiyu L, Yinglan W, Aihua W, Hongyun L, Ting L, Yingxia W, Guanghui Y, Xianghua C, Junqun F, Donghua X, Fanjuan K. Analysis of breast cancer cases according to county-level poverty status in 3.5 million rural women who participated in a breast cancer screening program of Hunan province, China from 2016 to 2018. Medicine (Baltimore) 2020; 99:e19954. [PMID: 32332679 PMCID: PMC7440191 DOI: 10.1097/md.0000000000019954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The Hunan provincial government has implemented a free breast cancer screening program for rural women aged 35 to 64 years from 2016, under a 2015 policy aimed at of poverty eradication and improving women's health in China. However, there has been no population study of the breast cancer screening program in China to date, especially considering exploring differences related to the area's poverty status. We explored differences in risk factors, clinical examination results, and clinicopathological features among breast cancer patients in poor compared with non-poor counties in rural areas of Hunan province from 2016 to 2018 using χ and Fisher's exact test, and multivariate logistic regression analysis. A total of 3,151,679 women from rural areas participated in the screening program, and the breast cancer prevalence was 37.09/10. Breast cancer prevalence was lower in poor (29.68/10) than in non-poor counties (43.13/10). There were differences between breast cancers in poor and non-poor counties in terms of cysts, margins, internal echo, blood flow in solid masses in the right breast on ultrasound examination, lump structure in mammograms, and clinicopathological staging and grading in pathological examinations. Breast cancer in poor counties was more likely to be diagnosed at later stages as determined by ultrasound, mammography, and pathological examinations. Furthermore, indexes of the breast screening program including early detection, prevalence, pathological examination, and mammography examination were lower in poor compared with non-poor counties. Multivariate logistic regression analysis showed that education, ethnicity, reproductive history and the year 2017 were associated with an increased risk of breast cancer in poor counties (odds ratio >1, P < .05). In conclusion, women in poor areas were more likely to be diagnosed with breast cancer at a later stage compared with women in non-poor areas. Women in poor areas of Hunan province should therefore have better access to diagnostic and clinical services to help rectify this situation.
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Affiliation(s)
| | - Liu Zhiyu
- Department of Information Management
| | | | | | | | | | | | | | - Chen Xianghua
- Department of Healthcare, Hunan Province Maternal and Children Health Care Hospital, 53 Xiang Chun Road, Changsha, Hunan
| | - Fang Junqun
- Department of Healthcare, Hunan Province Maternal and Children Health Care Hospital, 53 Xiang Chun Road, Changsha, Hunan
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19
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Pang Y, Kartsonaki C, Guo Y, Chen Y, Yang L, Bian Z, Bragg F, Millwood IY, Lv J, Yu C, Chen J, Li L, Holmes MV, Chen Z. Socioeconomic Status in Relation to Risks of Major Gastrointestinal Cancers in Chinese Adults: A Prospective Study of 0.5 Million People. Cancer Epidemiol Biomarkers Prev 2020; 29:823-831. [PMID: 31988070 DOI: 10.1158/1055-9965.epi-19-0585] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/22/2019] [Accepted: 01/14/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Low socioeconomic status (SES) is associated with higher risk of certain gastrointestinal (e.g., colorectal, pancreatic, and liver) cancers in Western populations. Evidence is very limited in China, where correlates and determinants of SES differ from those in the West. METHODS The prospective China Kadoorie Biobank recruited 512,715 adults (59% women, mean age 51 years) from 10 (5 urban, 5 rural) regions. During 10 years of follow-up, 27,940 incident cancers (including 3,061 colorectal, 805 pancreatic, and 2,904 liver) were recorded among 510,131 participants without prior cancer at baseline. Cox regression was used to estimate adjusted HRs for specific cancers associated with area-level (e.g., per capita gross domestic product, disposable income) and individual-level (e.g., education, household income) SES. RESULTS Area-level SES and household income showed positive associations with incident colorectal and pancreatic cancers and inverse associations with liver cancer (P trend < 0.05). Education showed no association with colorectal cancer but inverse associations with pancreatic and liver cancers, with adjusted HRs comparing university to no formal schooling being 1.05 [95% confidence interval (CI), 0.85-1.29], 0.49 (95% CI, 0.28-0.85), and 0.61 (95% CI, 0.47-0.81), respectively. Potential risk factors (e.g., smoking, alcohol) partly explained the inverse associations of education with pancreatic and liver cancers (17.6% and 60.4%), respectively. CONCLUSIONS Among Chinese adults, the associations of SES with gastrointestinal cancers differed by cancer type and SES indicator. Potential risk factors partially explained the inverse associations of education with pancreatic and liver cancers. IMPACT The different associations between SES with gastrointestinal cancers may inform cancer prevention strategies.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.,Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Christiana Kartsonaki
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. .,Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.,Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.,Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Fiona Bragg
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Iona Y Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.,Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Junshi Chen
- National Center for Food Safety Risk Assessment, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Michael V Holmes
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.,Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, United Kingdom
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.,Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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20
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Huang Y, Tong Z, Chen K, Wang Y, Liu P, Gu L, Liu J, Yu J, Song F, Zhao W, Shi Y, Li H, Xiao H, Hao X. Interpretation of breast cancer screening guideline for Chinese women. Cancer Biol Med 2019; 16:825-835. [PMID: 31908899 PMCID: PMC6936244 DOI: 10.20892/j.issn.2095-3941.2019.0322] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/26/2019] [Indexed: 12/19/2022] Open
Abstract
Breast cancer is the most common malignant tumor in Chinese women. Early screening is the best way to improve the rates of early diagnosis and survival of breast cancer patients. The peak onset age for breast cancer in Chinese women is considerably younger than those in European and American women. It is imperative to develop breast cancer screening guideline that is suitable for Chinese women. By summarizing the current evidence on breast cancer screening in Chinese women, and referring to the latest guidelines and consensus on breast cancer screening in Europe, the United States, and East Asia, the China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) have formulated population-based guideline for breast cancer screening in Chinese women. The guideline provides recommendations on breast cancer screening for Chinese women at average or high risk of breast cancer according to the following three aspects: age of screening, screening methods, and screening interval. This article provides more detailed information to support the recommendations in this guideline and to provide more direction for current breast cancer screening practices in China.
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Affiliation(s)
| | | | - Kexin Chen
- Department of Epidemiology and Statistics
| | - Ying Wang
- Department of Epidemiology and Statistics
- China Anti-Cancer Association, Tianjin 300060, China
| | | | - Lin Gu
- The 2 Surgery Department of Breast Oncology
| | | | - Jinpu Yu
- Cancer Molecular Diagnostics Core
| | | | - Wenhua Zhao
- Department of Epidemiology and Statistics
- China Anti-Cancer Association, Tianjin 300060, China
| | - Yehui Shi
- Medicine Department of Breast Oncology
| | - Hui Li
- Department of Gastrointestinal Cancer Biology
| | - Huaiyuan Xiao
- Department of Research and Education, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China
| | - Xishan Hao
- Department of Epidemiology and Statistics
- China Anti-Cancer Association, Tianjin 300060, China
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21
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The Structure and Parameterization of the Breast Cancer Transition Model Among Chinese Women. Value Health Reg Issues 2019; 21:29-38. [PMID: 31634794 DOI: 10.1016/j.vhri.2019.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/29/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Markov model simulation based on the natural history of disease is commonly employed for the comparative research of health interventions. The present study aims to simulate the natural progression of breast cancer and parameterize the initial and transition probabilities of multiple states of breast cancer development among Chinese women. METHODS The age-specific incidence, mortality, and clinical stage distribution of breast cancer; and relapse rate of each clinical stage were collected from China's cancer registry yearbooks and clinical epidemiological studies to simulate the process from full health to breast cancer to death among Chinese women aged 30 to 80 through a Markov cohort study. The validity analysis was conducted to evaluate the accuracy of the model estimation. RESULTS A Markov transition model with 7 states (no breast cancer, clinical stages 0-IV breast cancer, and death) was constructed for Chinese women. The age-specific incidence, mortality, and clinical stage distribution of breast cancer estimated by the initial and transition probabilities among different Markov states were highly consistent with the registered data and observed studies. CONCLUSION A breast cancer transition model for Chinese women has been established with validity. It could be a point of reference for further economic evaluations and breast cancer screening policy formulation.
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de Lemos LLP, Carvalho de Souza M, Pena Moreira D, Ribeiro Fernandes Almeida PH, Godman B, Verguet S, Guerra AA, Leal Cherchiglia M. Stage at diagnosis and stage-specific survival of breast cancer in Latin America and the Caribbean: A systematic review and meta-analysis. PLoS One 2019; 14:e0224012. [PMID: 31618268 PMCID: PMC6799865 DOI: 10.1371/journal.pone.0224012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 10/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Female breast cancer is the most common cancer in Latin American and Caribbean (LAC) countries and is the leading cause of cancer deaths. The high mortality-to-incidence ratio in the regions is associated with mainly the high proportion of advanced stage diagnosis, and also to inadequate access to health care. In this study we aimed to systematically review the proportion of advanced stage (III-IV) at diagnosis (pas) and the five-year stage-specific survival estimates of breast cancer in LAC countries. METHODS We searched MEDLINE, Embase, and LILACS (Latin American and Caribbean Health Science Literature) to identify studies, in any language, indexed before Nov 5, 2018. We also conducted manual search by reviewing citations of papers found. pas was summarized by random effects model meta-analysis, and meta-regression analysis to identify sources of variation. Stage-specific survival probabilities were described as provided by study authors, as it was not possible to conduct meta-analysis. PROSPERO CRD42017052493. RESULTS For pas we included 63 studies, 13 of which population-based, from 22 countries comprising 221,255 women diagnosed from 1966 to 2017. The distribution of patients by stage varied greatly in LAC (pas 40.8%, 95%CI 37.0% to 44.6%; I2 = 99%; p<0.0001). The heterogeneity was not explained by any variable included in the meta-regression. There was no difference in pas among the Caribbean (pas 43.0%, 95%CI 33.1% to 53.6%), Central America (pas 47.0%, 95%CI 40.4% to 53.8%) and South America (pas 37.7%, 95%CI 33.1% to 42.5%) regions. For 5-year stage-specific survival we included 37 studies, comprising 28,988 women from ten countries. Seven of these studies were included also for pas. Since we were unable to adjust for age, comparability between countries and regions was hampered, and as expected, the results varied widely from study to study. CONCLUSIONS LAC countries should look to address concerns with early detection and diagnosis of breast cancer, and wherever viable implement screening programs and to provide timely treatment.
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Affiliation(s)
- Lívia Lovato Pires de Lemos
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- SUS Collaborating Centre for Technology Assessment and Excellence in Health, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Mirian Carvalho de Souza
- Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniela Pena Moreira
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Henrique Ribeiro Fernandes Almeida
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, Scotland
- Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Karolinska Institutet, Huddinge, Sweden
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Augusto Afonso Guerra
- SUS Collaborating Centre for Technology Assessment and Excellence in Health, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariangela Leal Cherchiglia
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Sun L, Sadique Z, Dos-Santos-Silva I, Yang L, Legood R. Cost-effectiveness of breast cancer screening programme for women in rural China. Int J Cancer 2018; 144:2596-2604. [PMID: 30367451 DOI: 10.1002/ijc.31956] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/05/2018] [Accepted: 10/19/2018] [Indexed: 12/20/2022]
Abstract
In low and middle-income countries mammographic breast cancer screening is prohibitively expensive and a cheaper alternative option is to use ultrasound as the primary screening test. In 2009, China launched a breast cancer screening programme for rural women aged 35-64 years with clinical breast examination coupled with ultrasound as the primary tool. Our study aimed to analyse the cost-effectiveness of breast screening compared to no screening among Chinese rural women. We developed a Markov model to estimate the lifetime costs and effects for rural women aged 35 years from a societal perspective. Asymptomatic women in the intervention arm were screened every 3 years before age 64 years. Breast cancer in the non-screening arm can only be diagnosed on presentation of symptoms. Parameter uncertainty was explored using one-way and probabilistic sensitivity analyses. Compared to no screening, breast cancer screening cost $186.7 more and led to a loss of 0.20 quality-adjusted life years (QALYs). Breast screening was more expensive and did harm to health among rural women with an incremental cost-effectiveness ratio (ICER) of $-916/QALY. The sensitivity analysis identified utility loss from false positives as the factor that most influenced the results, but this did not affect the conclusions. In a rural setting with such low breast cancer incidence, screening for asymptomatic disease is not cost-effective with current screening tools. Priority should be given to ensure that symptomatic women have proper access to diagnosis and treatment at an early stage as this will lead to mortality reductions without the usual screening harms.
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Affiliation(s)
- Li Sun
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.,School of Public Health, Peking University, Beijing, China
| | - Zia Sadique
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Isabel Dos-Santos-Silva
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Li Yang
- School of Public Health, Peking University, Beijing, China
| | - Rosa Legood
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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24
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Quinlan A, O’Brien KK, Galvin R, Hardy C, McDonnell R, Joyce D, McDowell RD, Aherne E, Keogh C, O’Sullivan K, Fahey T. Quantifying patient preferences for symptomatic breast clinic referral: a decision analysis study. BMJ Open 2018; 8:e017286. [PMID: 29858402 PMCID: PMC5988058 DOI: 10.1136/bmjopen-2017-017286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Decision analysis study that incorporates patient preferences and probability estimates to investigate the impact of women's preferences for referral or an alternative strategy of watchful waiting if faced with symptoms that could be due to breast cancer. SETTING Community-based study. PARTICIPANTS Asymptomatic women aged 30-60 years. INTERVENTIONS Participants were presented with 11 health scenarios that represent the possible consequences of symptomatic breast problems. Participants were asked the risk of death that they were willing to take in order to avoid the health scenario using the standard gamble utility method. This process was repeated for all 11 health scenarios. Formal decision analysis for the preferred individual decision was then estimated for each participant. PRIMARY OUTCOME MEASURE The preferred diagnostic strategy was either watchful waiting or referral to a breast clinic. Sensitivity analysis was used to examine how each varied according to changes in the probabilities of the health scenarios. RESULTS A total of 35 participants completed the interviews, with a median age 41 years (IQR 35-47 years). The majority of the study sample was employed (n=32, 91.4%), with a third-level (university) education (n=32, 91.4%) and with knowledge of someone with breast cancer (n=30, 85.7%). When individual preferences were accounted for, 25 (71.4%) patients preferred watchful waiting to referral for triple assessment as their preferred initial diagnostic strategy. Sensitivity analysis shows that referral for triple assessment becomes the dominant strategy at the upper probability estimate (18%) of breast cancer in the community. CONCLUSIONS Watchful waiting is an acceptable strategy for most women who present to their general practitioner (GP) with breast symptoms. These findings suggest that current referral guidelines should take more explicit account of women's preferences in relation to their GPs initial management strategy.
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Affiliation(s)
- Aisling Quinlan
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kirsty K O’Brien
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rose Galvin
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Colin Hardy
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ronan McDonnell
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Doireann Joyce
- Department of Surgery, National University of Ireland Galway, Galway, Ireland
| | - Ronald D McDowell
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Emma Aherne
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Claire Keogh
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Katriona O’Sullivan
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tom Fahey
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
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Wen D, Wen X, Yang Y, Chen Y, Wei L, He Y, Shan B. Urban rural disparity in female breast cancer incidence rate in China and the increasing trend in parallel with socioeconomic development and urbanization in a rural setting. Thorac Cancer 2018; 9:262-272. [PMID: 29280294 PMCID: PMC5792727 DOI: 10.1111/1759-7714.12575] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 11/15/2017] [Accepted: 11/15/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Worldwide breast cancer incidence correlates with socioeconomic status and increases in parallel with westernization, however urban-rural disparity and trends have not been adequately investigated in China. METHODS The age standardized rate (ASR) of female breast cancer by population-based cancer registration was compared between urban Shijiazhuang city and rural Shexian County in relation to socioeconomic status. The increasing trend of breast cancer in Shexian County from 2000-2015 was examined using Joinpoint analysis and the correlation with gross domestic product (GDP) per capita was analyzed. RESULTS In 2012, the ASR of female breast cancer in Shijiazhuang was more than three times higher than in Shexian County (45.5/1 00 000 vs.13.8/1 00 000; P < 0.01) when the GDP per capita was 2.6 times higher (US$6964.80 vs. US$2700). In parallel with rapid socioeconomic development and urbanization, the biennial ASR of female breast cancer in Shexian county has increased significantly from 2.8/1 00 000 in 2000-2001 to 17.3/1 00 000 in 2014-2015, with an average biennial percent change of +10.2% (P < 0.01). The Pearson correlation between ASR and GDP was significantly positive (r = 0.94, P < 0.01). CONCLUSION The incidence of breast cancer in women in China is increasing along with lifestyle westernization and changing reproductive patterns associated with socioeconomic development and urbanization. Urgent prevention measures, including the development of a healthy diet, giving birth at a younger age, an increase in breastfeeding, limiting menopause estrogen therapy, and control of alcohol consumption, are required.
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Affiliation(s)
- Denggui Wen
- Cancer CenterFourth Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Xiaoduo Wen
- Cancer CenterFourth Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Yi Yang
- Department of Medical ImagingFourth Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Yuetong Chen
- Cancer CenterFourth Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Lizhen Wei
- Cancer CenterFourth Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Yutong He
- Cancer CenterFourth Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Baoen Shan
- Cancer CenterFourth Hospital of Hebei Medical UniversityShijiazhuangChina
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26
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Li Y, Shi J, Yu S, Wang L, Liu J, Ren J, Gao S, Hui Z, Li J, Wu N, Yang B, Liu S, Qin M, Wang D, Liao X, Xing X, Du L, Yang L, Liu Y, Zhang Y, Zhang K, Qiao Y, He J, Dai M, Yao H. Effect of socioeconomic status on stage at diagnosis of lung cancer in a hospital-based multicenter retrospective clinical epidemiological study in China, 2005-2014. Cancer Med 2017; 6:2440-2452. [PMID: 28941012 PMCID: PMC5633542 DOI: 10.1002/cam4.1170] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/22/2017] [Accepted: 07/31/2017] [Indexed: 12/03/2022] Open
Abstract
There is inconsistent evidence of associations between socioeconomic status (SES) and lung cancer stage in non-Chinese populations up to now. We set out to determine how SES affects stage at diagnosis at both individual and area levels, from a hospital-based multicenter 10-year (2005-2014) retrospective clinical epidemiological study of 7184 primary lung cancer patients in mainland China. Individual-level SES data were measured based on two indicators from case report forms of the study: an individual's education and occupation. Seven census indicator variables were used as surrogates for the area-level SES with principal component analysis (PCA). Multivariate analysis was undertaken using binary logistic regressions and multinomial logit model to describe the association and explore the effect across tertiles on stage after adjusting for demographic variables. There was a significant stepwise gradient of effect across different stages in the highest tertile of area-level SES, comparing with the lowest tertile of area-level SES (ORs, 0.77, 0.67, and 0.29 for stage II, III, and IV). Patients with higher education were less likely to have stage IV lung cancer, comparing with the illiterate group (ORs, 0.52, 0.63, 0.71, 0.64 for primary school, middle school, high school, college degree or above subgroup, respectively). Findings suggest that the most socioeconomically deprived areas may be associated with a higher risk of advanced-stage lung cancer, and increasing educational level may be correlated with a lower risk to be diagnosed at advanced stage in both men and women.
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Affiliation(s)
- Yuanqiu Li
- Office of EpidemiologyChinese Center for Disease Control and PreventionBeijingChina
| | - Jufang Shi
- Program Office for Cancer Screening in Urban ChinaNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Shicheng Yu
- Office of EpidemiologyChinese Center for Disease Control and PreventionBeijingChina
| | - Le Wang
- Program Office for Cancer Screening in Urban ChinaNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jianjun Liu
- Chinese Center for Disease Control and PreventionBeijingChina
| | - Jiansong Ren
- Program Office for Cancer Screening in Urban ChinaNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Shugeng Gao
- Department of Thoracic SurgeryNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Zhouguang Hui
- Department of Radiation OncologyNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Junling Li
- Department of Medical OncologyNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ning Wu
- Department of Diagnostic RadiologyNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Boyan Yang
- Department of General MedicineNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Shangmei Liu
- Department of PathologyNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Mingfang Qin
- Division for Chronic Non‐communicable Disease Prevention and ControlYunnan Center for Disease Control and PreventionKunmingChina
| | - Debin Wang
- School of Health Services ManagementAnhui Medical UniversityHefeiChina
| | - Xianzhen Liao
- Hunan Office for Cancer Control and ResearchHunan Cancer HospitalChangshaChina
| | - Xiaojing Xing
- Liaoning Office for Cancer Control and ResearchLiaoning Cancer Hospital & InstituteShenyangChina
| | - Lingbin Du
- Zhejiang Office for Cancer Control and ResearchZhejiang Cancer HospitalHangzhouChina
| | - Li Yang
- School of Public HealthGuangxi Medical UniversityNanningChina
| | - Yuqin Liu
- Cancer Epidemiology Research CenterGansu Provincial Cancer HospitalLanzhouChina
| | - Yongzhen Zhang
- Department of EpidemiologyShanxi Provincial Cancer HospitalTaiyuanChina
| | - Kai Zhang
- Program Office for Cancer Screening in Urban ChinaNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Cancer Department of Physical ExaminationNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Youlin Qiao
- Department of EpidemiologyNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jie He
- Program Office for Cancer Screening in Urban ChinaNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Department of Thoracic SurgeryNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Min Dai
- Program Office for Cancer Screening in Urban ChinaNational Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Hongyan Yao
- Office of EpidemiologyChinese Center for Disease Control and PreventionBeijingChina
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Liu Y, Zhang J, Huang R, Feng WL, Kong YN, Xu F, Zhao L, Song QK, Li J, Zhang BN, Fan JH, Qiao YL, Xie XM, Zheng S, He JJ, Wang K. Influence of occupation and education level on breast cancer stage at diagnosis, and treatment options in China: A nationwide, multicenter 10-year epidemiological study. Medicine (Baltimore) 2017; 96:e6641. [PMID: 28403116 PMCID: PMC5403113 DOI: 10.1097/md.0000000000006641] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The objective of this study was to evaluate the impact of occupation and education level of Chinese female breast cancer patients on their cancer staging at diagnosis, clinical and pathological features, rate of implementation, and selection of treatment.The medical charts of 4211 confirmed female breast cancer cases diagnosed between 1999 and 2008, from 7 breast cancer centers spread across the whole of China, were reviewed. Data including information on the patient's sociodemographic status, clinical and pathological characteristics, implementation of clinical examination and treatment modalities were analyzed. In parallel, the associations between different occupations and level of educational attainment were analyzed in relation to tumor stage through TNM staging, clinical and pathological characteristics, implementation of clinical examination, and treatment patterns. Multivariate logistic regression was used to identify whether the occupation and education level of patients are independent factors of TNM staging at diagnosis.There were significant differences among different occupation groups and the education level of patients in regards to pathological characteristics and treatment choice. Both the occupation and education level of patients were independent factors of TNM staging at diagnosis. For patients within the lower-income occupation or lower educational attainment group, the tumor stage was later, the rates of implementation of relevant investigations were lower, as were the rates of radiotherapy, chemotherapy, and endocrine therapy.This study suggests that strategies should work toward developing more accurate and effective breast cancer prevention and treatment strategies aimed specifically at patients with lower educational attainment levels and at specific occupation groups.
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Affiliation(s)
- Yang Liu
- Department of Breast Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an
| | - Jian Zhang
- Department of Breast Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an
| | - Rong Huang
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan
| | - Wei-Liang Feng
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou
| | - Ya-Nan Kong
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou
| | - Feng Xu
- Department of Breast-thyroid Surgery, Xiangya Second Hospital, Central South University, Changsha
| | - Lin Zhao
- Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang
| | - Qing-Kun Song
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Jing Li
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Bao-Ning Zhang
- Center of Breast Disease, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing
| | - Xiao-Ming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou
| | - Shan Zheng
- Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Jian-Jun He
- Department of Breast Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an
| | - Ke Wang
- Department of Breast Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an
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28
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Preliminary effectiveness of breast cancer screening among 1.22 million Chinese females and different cancer patterns between urban and rural women. Sci Rep 2016; 6:39459. [PMID: 27995968 PMCID: PMC5171648 DOI: 10.1038/srep39459] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 11/14/2016] [Indexed: 11/30/2022] Open
Abstract
To determine the preliminary effectiveness of breast cancer screening among Chinese females, 1226714 women aged 35–69 years first received clinical breast examinations. Urban women with suspected cancer received mammography followed by breast ultrasound (BUS), while rural suspected women underwent BUS followed by mammography. After one-year follow-up, 223 and 431 breast cancers were detected among urban and rural women (respectively), with overall detection rates of 0.56/1000 and 0.52/1000. Higher detection rates were significantly associated with older age at screening for both urban and rural women; additionally, urban women were at significantly higher risk if they had no job, no insurance, or were obese; additional risk factors specific to rural women included Han nationality, higher income, being unmarried, and having a family history of cancer (all P values < 0.05). Among screening-detected breast cancers in urban vs. rural women, 46.2% and 38.8% (respectively) were early stage, 62.5% and 66.3% were ≤2 centimeters, 38.0% and 47.3% included lymph-node involvement, and 14.0% and 6.0% were identified as carcinoma in situ. All abovementioned cancer characteristics were significantly better than clinic-detected cancers (all P values < 0.001). In conclusion, several important differences were found between urban and rural women in screening effectiveness and patterns of cancer distribution.
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Li T, Mello-Thoms C, Brennan PC. Descriptive epidemiology of breast cancer in China: incidence, mortality, survival and prevalence. Breast Cancer Res Treat 2016; 159:395-406. [PMID: 27562585 DOI: 10.1007/s10549-016-3947-0] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/13/2016] [Indexed: 01/24/2023]
Abstract
Breast cancer is the most common neoplasm diagnosed amongst women worldwide and is the leading cause of female cancer death. However, breast cancer in China is not comprehensively understood compared with Westernised countries, although the 5-year prevalence statistics indicate that approximately 11 % of worldwide breast cancer occurs in China and that the incidence has increased rapidly in recent decades. This paper reviews the descriptive epidemiology of Chinese breast cancer in terms of incidence, mortality, survival and prevalence, and explores relevant factors such as age of manifestation and geographic locations. The statistics are compared with data from the Westernised world with particular emphasis on the United States and Australia. Potential causal agents responsible for differences in breast cancer epidemiology between Chinese and other populations are also explored. The need to minimise variability and discrepancies in methods of data acquisition, analysis and presentation is highlighted.
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Affiliation(s)
- Tong Li
- Medical Image Optimisation and Perception Group (MIOPeG), Department of Medical Imaging & Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Claudia Mello-Thoms
- Medical Image Optimisation and Perception Group (MIOPeG), Department of Medical Imaging & Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East Street, Lidcombe, NSW, 2141, Australia
| | - Patrick C Brennan
- Medical Image Optimisation and Perception Group (MIOPeG), Department of Medical Imaging & Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East Street, Lidcombe, NSW, 2141, Australia
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Seneviratne S, Lawrenson R, Harvey V, Ramsaroop R, Elwood M, Scott N, Sarfati D, Campbell I. Stage of breast cancer at diagnosis in New Zealand: impacts of socio-demographic factors, breast cancer screening and biology. BMC Cancer 2016; 16:129. [PMID: 26896237 PMCID: PMC4761194 DOI: 10.1186/s12885-016-2177-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/15/2016] [Indexed: 01/07/2023] Open
Abstract
Background Examination of factors associated with late stage diagnosis of breast cancer is useful to identify areas which are amenable to intervention. This study analyses trends in cancer stage at diagnosis and impact of socio-demographic, cancer biological and screening characteristics on cancer stage in a population-based series of women with invasive breast cancer in New Zealand. Methods All women diagnosed with invasive breast cancer between 2000 and 2013 were identified from two regional breast cancer registries. Factors associated with advanced (stages III and IV) and metastatic (stage IV) cancer at diagnosis were analysed in univariate and multivariate models adjusting for covariates. Results Of the 12390 women included in this study 2448 (19.7 %) were advanced and 575 (4.6 %) were metastatic at diagnosis. Māori (OR = 1.86, 1.39-2.49) and Pacific (OR = 2.81, 2.03-3.87) compared with NZ European ethnicity, other urban (OR = 2.00, 1.37-2.92) compared with main urban residency and non-screen (OR = 6.03, 4.41-8.24) compared with screen detection were significantly associated with metastatic cancer at diagnosis in multivariate analysis. A steady increase in the rate of metastatic cancer was seen which has increased from 3.8 % during 2000-2003 to 5.0 % during 2010-2013 period (p = 0.042). Conclusions Providing equitable high quality primary care and increasing mammographic screening coverage needs to be looked at as possible avenues to reduce late-stage cancer at diagnosis and to reduce ethnic, socioeconomic and geographical disparities in stage of breast cancer at diagnosis in New Zealand.
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Affiliation(s)
- Sanjeewa Seneviratne
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand. .,Department of Surgery, University of Colombo, Colombo, Sri Lanka.
| | - Ross Lawrenson
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
| | - Vernon Harvey
- Auckland District Health Board, Auckland, New Zealand.
| | | | - Mark Elwood
- School of Population Health, University of Auckland, Auckland, New Zealand.
| | - Nina Scott
- Māori Health Services, Waikato District Health Board, Hamilton, New Zealand.
| | | | - Ian Campbell
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
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Fan L, Goss PE, Strasser-Weippl K. Current Status and Future Projections of Breast Cancer in Asia. Breast Care (Basel) 2015; 10:372-8. [PMID: 26989355 PMCID: PMC4789872 DOI: 10.1159/000441818] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Asia is the world's largest continent comprising about 3/5 of the human population. Breast cancer is the most common type of cancer and the second leading cause of cancer-related deaths among women in Asia, accounting for 39% of all breast cancers diagnosed worldwide. The incidence of breast cancer in Asia varies widely across the continent and is still lower than in Western countries, but the proportional contribution of Asia to the global breast cancer rates is increasing rapidly in parallel to the socioeconomic development. However, the mortality-to-incidence ratios are much higher for Asia than for Western countries. Most Asian countries are low- and middle-income countries (LMICs) where breast cancer presents at a younger age and a later stage, and where patients are more likely to die from the disease than those in Western countries. Moreover, diagnostic workup, treatment and palliative services are inadequate in most Asian LMICs. In this review, we present an overview of the breast cancer risk factors and epidemiology, control measures, and cancer care among Asian countries.
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Affiliation(s)
- Lei Fan
- Breast Cancer Institute, Cancer Hospital, Department of Oncology, Shanghai Medical College, Institutes of Biomedical Science, Fudan University, Shanghai, China
| | - Paul E. Goss
- Global Cancer Institute, Boston, MA, USA
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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32
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Jia M, Zheng R, Zhang S, Zeng H, Zou X, Chen W. Female breast cancer incidence and mortality in 2011, China. J Thorac Dis 2015; 7:1221-6. [PMID: 26380738 DOI: 10.3978/j.issn.2072-1439.2015.05.15] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/17/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Breast cancer is the most common cancer diagnosis in women. During the past 30 years, mortality of breast cancer in Chinese women showing a gradual upward trend, it has become the crucial death reasons of female. METHODS In 2014, there were 234 population-based cancer registries submitting their data of 2011 to the National Central Cancer Registry (NCCR) of China and 177 cancer registries' data were selected after quality evaluation. The selected cancer registries were classified as urban areas and rural areas, in each level. The crude incidence and mortality rates of female breast cancer were calculated by age-groups. Age-standardized rates were described by China and World standard population. And the national population data of China was used to combine with the cancer registries' data to estimate the female breast cancer burden in 2011 in China. RESULTS The estimated number of female breast cancer cases was 248,620. The crude incidence rate, age-standardized rate by China and World population were 37.86 per 100,000, 28.51 per 100,000 and 26.65 per 100,000, respectively. The estimated number of female breast cancer death in 2011 of China was about 60,473. The crude, age-standardized mortalities by China population and World population were 9.21 per 100,000, 6.57 per 100,000 and 6.38 per 100,000, respectively. The incidence and mortality rates were both higher in urban areas than rural areas. Trend of age-specific incidence rates in urban and rural was similar, reaching peak at 55-59 years old. The trend of age-specific mortality rates was very similar before 60 between urban and rural areas, but after that, the urban areas curve was rapidly mounting as the age growing and much higher than rural. CONCLUSIONS Breast cancer is still a major health burden for Chinese women especially in urban areas. Prevention strategies such as weight control, high-quality screening, diagnosis and treatment may help control the disease.
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Affiliation(s)
- Manman Jia
- National Central Cancer Registry, National Cancer Center, Beijing 100021, China
| | - Rongshou Zheng
- National Central Cancer Registry, National Cancer Center, Beijing 100021, China
| | - Siwei Zhang
- National Central Cancer Registry, National Cancer Center, Beijing 100021, China
| | - Hongmei Zeng
- National Central Cancer Registry, National Cancer Center, Beijing 100021, China
| | - Xiaonong Zou
- National Central Cancer Registry, National Cancer Center, Beijing 100021, China
| | - Wanqing Chen
- National Central Cancer Registry, National Cancer Center, Beijing 100021, China
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Sivasubramaniam PG, Zhang BL, Zhang Q, Smith JS, Zhang B, Tang ZH, Chen GJ, Xie XM, Xu XZ, Yang HJ, He JJ, Li H, Li JY, Fan JH, Qiao YL. Breast Cancer Disparities: A Multicenter Comparison of Tumor Diagnosis, Characteristics, and Surgical Treatment in China and the U.S. Oncologist 2015; 20:1044-50. [PMID: 26240131 DOI: 10.1634/theoncologist.2014-0290] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 06/03/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Incidence of and mortality rates for breast cancer continue to rise in the People's Republic of China. The purpose of this study was to analyze differences in characteristics of breast malignancies between China and the U.S. METHODS Data from 384,262 breast cancer patients registered in the U.S. Surveillance, Epidemiology, and End Results (SEER) program from 2000 to 2010 were compared with 4,211 Chinese breast cancer patients registered in a Chinese database from 1999 to 2008. Outcomes included age, race, histology, tumor and node staging, laterality, surgical treatment method, and reconstruction. The Pearson chi-square and Fisher's exact tests were used to compare rates. RESULTS Infiltrating ductal carcinoma was the most common type of malignancy in the U.S. and China. The mean number of positive lymph nodes was higher in China (2.59 vs. 1.31, p < .001). Stage at diagnosis was higher in China (stage IIA vs. I, p < .001). Mean size of tumor at diagnosis was higher in China (32.63 vs. 21.57 mm). Mean age at diagnosis was lower in China (48.28 vs. 61.29 years, p < .001). Moreover, 2.0% of U.S. women underwent radical mastectomy compared with 12.5% in China, and 0.02% in China underwent reconstructive surgery. CONCLUSION Chinese women were diagnosed at younger ages with higher stage and larger tumors and underwent more aggressive surgical treatment. Prospective trials should be conducted to address screening, surgical, and tumor discrepancies between China and the U.S. IMPLICATIONS FOR PRACTICE Breast cancer patients in China are diagnosed at later stages than those in America, which might contribute to different clinical management and lower 5-year survival rate. This phenomenon suggests that an earlier detection and treatment program should be widely implemented in China. By comparing the characteristics of Chinese and Chinese-American patients, we found significant differences in tumor size, lymph nodes metastasis, and age at diagnosis. These consequences indicated that patients with similar genetic backgrounds may have different prognoses due to the influence of environment and social economic determinates.
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Affiliation(s)
- Priya G Sivasubramaniam
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Bai-Lin Zhang
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qian Zhang
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jennifer S Smith
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Bin Zhang
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Zhong-Hua Tang
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Guo-Ji Chen
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiao-Ming Xie
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiao-Zhou Xu
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Hong-Jian Yang
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jian-Jun He
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Hui Li
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jia-Yuan Li
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jin-Hu Fan
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - You-Lin Qiao
- Fogarty Global Health Fellowship Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Departments of Epidemiology and Breast Cancer, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Wang N, Cao F, Liu F, Jia Y, Wang J, Bao C, Wang X, Song Q, Tan B, Cheng Y. The effect of socioeconomic status on health-care delay and treatment of esophageal cancer. J Transl Med 2015. [PMID: 26205792 PMCID: PMC4511992 DOI: 10.1186/s12967-015-0579-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Socioeconomic status (SES) has been focused on as a key determinant of the incidence of cancer, cancer stage at diagnosis as well as treatment choices in western countries. However, to the authors’ knowledge, little work has been done concerning the relationship of SES and esophageal cancer in China. Methods Patients diagnosed with primary esophageal cancer from January to December 2007 in Qilu hospital were included. Socioeconomic status was determined by a questionnaire including religion, years of schooling and high education, place of residence, occupation, annual household income, and insurance. Results A total of 238 cases were collected in this study. Linear-by-linear association testing revealed that health-care delay was significantly associated with SES (P = 0.009). Multivariable logistic regression analysis revealed that increased health-care delay (>2 months) was more frequently observed in patients with lower SES (OR 2.271; 95% CI 1.069–4.853). Patients diagnosed at TNM I and II were more frequently in higher SES groups (P = 0.017). The association test was statistically significant for undergoing surgical resection only (P = 0.015) and chemotherapy (P = 0.015). Multivariable logistic regression analysis revealed that surgical resection only was less performed in higher SES group compared with lower SES group (OR 0.372; 95% CI 0.188–0.734). For chemotherapy, higher SES patients had a three-fold higher likelihood compared with lower SES group (OR 3.042; 95% CI 1.335–6.928). Conclusion Socioeconomic status was found to be associated with health-care delay, tumor stage and treatment modalities in esophageal cancer. Electronic supplementary material The online version of this article (doi:10.1186/s12967-015-0579-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nana Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Fangli Cao
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China. .,Department of Oncology, Liaocheng People's Hospital, Liaocheng, People's Republic of China.
| | - Fang Liu
- Department of Image, Shandong Medical College, Jinan, People's Republic of China.
| | - Yibin Jia
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Jianbo Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Cihang Bao
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Xintong Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Qingxu Song
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Bingxu Tan
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, People's Republic of China.
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Wang B, Wang X, Zou Y. Association between hormone receptors and HER-2/neu is age-related. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:8472-9. [PMID: 26339420 PMCID: PMC4555748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/26/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To investigate the association between hormone receptors and HER-2/neu in different age groups of women with breast cancers. METHODS A total of 1036 women with breast cancers were recruited. All the patients were divided into nine groups. The expression of hormone receptors and HER-2/neu was studied by IHC, while FISH test was used to determine HER-2/neu status in cases scored IHC 2+. The association between hormone receptors and HER-2/neu in different age groups was evaluated using the χ(2) test. Multivariate analysis was used to find out the independent factors predicting HER-2/neu amplification. Significant findings: The expression of ER and PR was inversely correlated with HER-2/neu status in women aged >40 years. By multivariate analysis, as far as the overall groups were concerned, PR, lymph node status and tumor grade were independently associated with HER-2/neu; Considering the younger age group (≤ 40), the only predictor for HER-2/neu was the tumor grade; Considering the older age group (>40), tumor grade, PR status, tumor size and lymph node status were associated with HER-2/neu overexpression. CONCLUSIONS Our data suggest that the association between ER, PR and HER-2/neu is age-related. The negative relationship is only applied for women aged >40 years.
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Affiliation(s)
- Bo Wang
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China
| | - Xiaoling Wang
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China
| | - Yinying Zou
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China
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Zhou Y, Tian L, Zhang YC, Guo BF, Zhou QW. Apoptotic effects of psiRNA-STAT3 on 4T1 breast cancer cells in vitro. Asian Pac J Cancer Prev 2015; 15:6977-82. [PMID: 25169471 DOI: 10.7314/apjcp.2014.15.16.6977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effect of a Lipofectamine2000 (Life2000) Transfection Reagent transfected psiRNA-STAT3 plasmid on 4T1 breast cancer cells. MATERIALS AND METHODS MTT was used to detect the cell proliferation of breast cancer 4T1 cells at different periods (0h, 6h, 8h, 10h); the cell cycle was assessed by flow cytometry; variation of apoptosis and mitochondrial membrane potential was observed under a fluorescence microscope; immunohistochemical staining was used to determine the expression of caspase-3 and cyclin-D1 protein. RESULTS An obvious effect of inhibition to 4T1 cancer cells could be observed at 8h after the psiRNA-STAT3 was transfected. Typical alterations of apoptotic morphological features were visible in the psiRNA-STAT3 treatment group. Mitochondrial membrane potential decreased significantly, the number of cells was increased in G0/G1 phase, and the number of cells was decreased in S phase, and the data were statistically significant (p<0.05), compared with the Scramble and Mock groups. Expression of caspase-3 protein was increased significantly, while that of cyclin D1 was significantly decreased. CONCLUSIONS Life2000 transfected psiRNA-STAT3 plasmid can inhibit 4T1 tumor cell proliferation and promote apoptosis of 4T1 tumor cells, which process depends on the regulation of expression of cyclin D1 and caspase-3 protein.
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Affiliation(s)
- Yue Zhou
- School of Pharmacy, 2Department of Breast Surgery , The Second Clinical Hospital, 3Department of Plastic Surgery, the China- Japan Union Hospital, 4Department of Biology and Medical Engineering, Institute of Regenerative Medicine, Jilin University, Changchun, China E-mail : ,
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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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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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Dialla PO, Arveux P, Ouedraogo S, Pornet C, Bertaut A, Roignot P, Janoray P, Poillot ML, Quipourt V, Dabakuyo-Yonli TS. Age-related socio-economic and geographic disparities in breast cancer stage at diagnosis: a population-based study. Eur J Public Health 2015; 25:966-72. [PMID: 25829506 DOI: 10.1093/eurpub/ckv049] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to determine the impact of socio-economic and geographic disparities on disease stage at diagnosis according to age in breast cancer (BC) patients. Secondary purpose was to describe survival METHODS All women with primary invasive BC, diagnosed from 1998 to 2009 in the department of Côte d'Or were retrospectively selected using data from the Côte d'Or BC registry. European transnational ecological deprivation index (French European Deprivation Index) was used to measure the socio-economic environment. Relationships between socio-geographic deprivation and disease stage at diagnosis according to age were assessed by a multilevel ordered logistic regression model. Relative survival rates (RSRs) were given at 5 years according to tumour and patients characteristics. RESULTS In total, 4364 women were included. In multivariable analysis, socio-economic deprivation was associated with disease stage at diagnosis. Women aged between 50 and 74 years and living in deprived areas were more often diagnosed with advanced tumour stages (stages II/III vs. I or stages IV vs. II/III) with odds ratio = 1.27 (1.01-1.60). RSRs were lowest in women living in the most deprived area compared with those living in most affluent area with RSR = 88.4% (85.9-90.4) and 92.6% (90.5-94.2), respectively. CONCLUSIONS Socio-economic factors affected tumour stage at diagnosis and survival. Living in a deprived area was linked to advanced-stage BC at diagnosis only in women aged 50-74 years. This is probably due to the socio-economic disparities in participation in organized BC screening programmes. Furthermore, living in deprived area was associated with a poor survival rate.
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Affiliation(s)
- Pegdwende O Dialla
- 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France
| | - Patrick Arveux
- 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France
| | - Samiratou Ouedraogo
- 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France
| | - Carole Pornet
- 3 Department of Epidemiological Research and Evaluation, CHU de Caen, France 4 EA3936, Medical School, Université de Caen Basse-Normandie, Caen, France 5 U1086 Inserm, Cancers and Preventions, Medical School, Université de Caen Basse-Normandie, Avenue de la Côte de Nacre, Caen, France
| | - Aurélie Bertaut
- 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France
| | | | | | - Marie-Laure Poillot
- 1 Breast and Gynaecologic Cancer Registry of Côte d'Or, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France 2 EA 4184, Medical School University of Burgundy, Dijon, France
| | - Valérie Quipourt
- 8 Coordination Unit in Geriatric oncology in Burgundy, Hôpital de jour Gériatrique, Hôpital de Champmaillot, Dijon, France
| | - Tienhan S Dabakuyo-Yonli
- 2 EA 4184, Medical School University of Burgundy, Dijon, France 9 Biostatistics and Quality of Life Unit, Department of Medical Information Centre Georges François Leclerc comprehensive cancer centre, Dijon, France
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Wang K, Ren Y, Huang R, He JJ, Feng WL, Kong YN, Xu F, Zhao L, Song QK, Li J, Zhang BN, Fan JH, Xie XM, Zheng S, Qiao YL. Application of intraoperative frozen section examination in the management of female breast cancer in China: a nationwide, multicenter 10-year epidemiological study. World J Surg Oncol 2014; 12:225. [PMID: 25034137 PMCID: PMC4105393 DOI: 10.1186/1477-7819-12-225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 07/04/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Intraoperative frozen section examination (IFSE) during breast cancer surgery can partly reflect the status of surgical treatment since the surgical method used directly determines the purpose of IFSE use in disease management. This study aims to investigate the application of, changing trends in, and factors influencing IFSE in the management of female breast cancer in China. METHODS We collected the sociodemographic and clinical data of 4,211 breast cancer patients between 1999 and 2008 and statistically analyzed these data using χ2 or Fisher's exact tests. RESULTS A total of 2,283 (54.22%) patients with breast cancer underwent IFSE. During the 10-year study period, IFSE use was associated with an increase in the number of sentinel lymph node biopsies (SLNB) and breast-conserving surgeries (BS) performed, with significant regional differences noted in this trend (P < 0.05). Patients' education, occupation, age, tumor size estimated by preoperative palpation, and the use of imaging examinations affected the purpose of IFSE use (P < 0.05). CONCLUSIONS Our results show that the purpose of IFSE in the surgical treatment of breast cancer in China is gradually approaching that in developed countries. We believe that policymakers must address the differences in breast cancer treatment based on the socioeconomic status of patients. Lastly, the use of IFSE for determining tumor characteristics should be avoided as far as possible, and patient education and breast cancer screening programs tailored to the Chinese population should be established. Our findings may guide the formulation of breast cancer control strategies in China and other low-income countries.
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Affiliation(s)
- Ke Wang
- Department of Oncosurgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong Universtiy, 277 Yanta West Road, Xi’an 710061, P.R. China
| | - Yu Ren
- Department of Oncosurgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong Universtiy, 277 Yanta West Road, Xi’an 710061, P.R. China
| | - Rong Huang
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jian-Jun He
- Department of Oncosurgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong Universtiy, 277 Yanta West Road, Xi’an 710061, P.R. China
| | - Wei-Liang Feng
- Department of Breast Surgery, Zhejiang Cancer Hospital, No. 38 Banshanqiao Guanji Road, Hangzhou 310022, P.R. China
| | - Ya-Nan Kong
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East, Guangzhou 510060, P.R. China
| | - Feng Xu
- Department of Breast-thyroid Surgery, Xiangya Second Hospital, Central South University, No. 139 Renminzhonglu, Changsha 410011, P.R. China
| | - Lin Zhao
- Department of Breast Surgery, Liaoning Cancer Hospital, No. 44 Xiaoyanhe Road, Dadong District, Shenyang 110041, P.R. China
| | - Qing-Kun Song
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
| | - Jing Li
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
| | - Bao-Ning Zhang
- Center of Breast Disease, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
| | - Xiao-Ming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East, Guangzhou 510060, P.R. China
| | - Shan Zheng
- Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, P.R. China
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Hashemi SHB, Karimi S, Mahboobi H. Lifestyle changes for prevention of breast cancer. Electron Physician 2014; 6:894-905. [PMID: 25763165 PMCID: PMC4324293 DOI: 10.14661/2014.894-905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 05/17/2014] [Accepted: 06/10/2014] [Indexed: 12/29/2022] Open
Abstract
Breast cancer is the second most common cause of death from cancer among women. Lifestyle changes are shown to be important in the prevention of breast cancer. Diet, physical activity, smoking, alcohol use, and vitamin and mineral use are key factors influencing the risk of breast cancer among women. Because these factors are related to each other, it is difficult to assess their individual roles in breast cancer. Some of these factors are alterable, meaning that women can decrease their risk for breast cancer by changing their behavior. Breast cancer is associated with a high rate of mortality and morbidity among women. Therefore, it is logical to try to find ways to decrease the risk of developing breast cancer. Lifestyle changes seem to be an easy, effective, and economical way to help prevention breast cancer. In women with a confirmed breast cancer diagnosis who are under radiotherapy treatment after undergoing a mastectomy, lifestyle changes are still very important. Some factors, such as smoking cessation and prevention of weight gain, may improve the long-term survival chances of these patients. Therefore, ways to increase women’s knowledge about the role of lifestyle changes in the prevention of breast cancer and in the survival of patients with diagnosed breast cancer should be considered and studied.
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Affiliation(s)
| | - Samieh Karimi
- Hormozgan fertility and infertility research center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hamidreza Mahboobi
- Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ; B.A of psychology, Payam Noor University (PNU), Tehran, Iran
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Youlden DR, Cramb SM, Yip CH, Baade PD. Incidence and mortality of female breast cancer in the Asia-Pacific region. Cancer Biol Med 2014; 11:101-15. [PMID: 25009752 PMCID: PMC4069805 DOI: 10.7497/j.issn.2095-3941.2014.02.005] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/11/2014] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region. METHODS Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases (such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models. RESULTS Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths (9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. CONCLUSION It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancer-related mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes.
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Affiliation(s)
- Danny R Youlden
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Susanna M Cramb
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Cheng Har Yip
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Peter D Baade
- 1 Cancer Council Queensland, Brisbane 4006, Australia ; 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane 4000, Australia ; 3 Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia ; 4 Griffith Health Institute, Griffith University, Gold Coast 4222, Australia ; 5 School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
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Li J, Huang Y, Zhang BN, Fan JH, Huang R, Zhang P, Wang SL, Zheng S, Zhang B, Yang HJ, Xie XM, Tang ZH, Li H, He JJ, Hsieh E, Qiao YL, Li JY. Body mass index and breast cancer defined by biological receptor status in pre-menopausal and post-menopausal women: a multicenter study in China. PLoS One 2014; 9:e87224. [PMID: 24489874 PMCID: PMC3906138 DOI: 10.1371/journal.pone.0087224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 12/27/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Few studies have investigated the association between body mass index (BMI) and breast cancer with consideration to estrogen/progesterone/human epidermal growth factor type 2 receptor status (ER/PR/HER2) in the breast tissue among Chinese pre- and post-menopausal women. METHODS Four thousand two hundred and eleven breast cancer patients were selected randomly from seven geographic regions of China from 1999 to 2008. Demographic data, risk factors, pathologic features, and biological receptor status of cases were collected from the medical charts. Chi-square test, fisher exact test, rank-correlation analysis, and multivariate logistic regression model were adopted to explore whether BMI differed according to biological receptor status in pre- and post-menopausal women. RESULTS Three thousand two hundred and eighty one eligible cases with BMI data were included. No statistically significant differences in demographic characteristics were found between the cases with BMI data and those without. In the rank-correlation analysis, the rates of PR+ and HER2+ were positively correlated with increasing BMI among post-menopausal women (rs BMI, PR+=0.867, P=0.001; rs BMI, HER2+ =0.636, P=0.048), but the ER+ rates did not vary by increasing BMI. Controlling for confounding factors, multivariate logistic regression models with BMI<24 kg/m(2) as the reference group were performed and found that BMI ≥ 24 kg/m(2) was only positively correlated with PR+ status among post-menopausal breast cancer cases (adjusted OR=1.420, 95% CI: 1.116-1.808, Wald=8.116, P=0.004). CONCLUSIONS Post-menopausal women with high BMI (≥ 24 kg/m(2)) have a higher proportion of PR+ breast cancer. In addition to effects mediated via the estrogen metabolism pathway, high BMI might increase the risk of breast cancer by other routes, which should be examined further in future etiological mechanism studies.
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Affiliation(s)
- Jing Li
- Department of Environmental Health and Occupational Medicine, West China School of Public Health & No.4 West China Teaching Hospital, Sichuan University, Chengdu, China
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuan Huang
- Department of Epidemiology and Biostatistics, West China School of Public Health & No.4 West China Teaching Hospital, Sichuan University, Chengdu, China
| | - Bao-Ning Zhang
- Center of Breast Disease, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Rong Huang
- Department of Epidemiology and Biostatistics, West China School of Public Health & No.4 West China Teaching Hospital, Sichuan University, Chengdu, China
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Pin Zhang
- Department of Medical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shan Zheng
- Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bin Zhang
- Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, China
| | - Hong-Jian Yang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Xiao-Ming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Zhong-Hua Tang
- Department of Breast-thyroid Surgery, Xiangya Second Hospital, Central South University, Changsha, China
| | - Hui Li
- Department of Breast Surgery, the Second People’s Hospital of Sichuan Province, Chengdu, China
| | - Jian-Jun He
- Department of Oncosurgery, the First Affiliated Hospital of Medical College, Xi’an JiaoTong University, Xi’an, China
| | - Evelyn Hsieh
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jia-Yuan Li
- Department of Epidemiology and Biostatistics, West China School of Public Health & No.4 West China Teaching Hospital, Sichuan University, Chengdu, China
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Pan XF, Fei MD, Zhang KY, Fan ZL, Fu FH, Fan JH. Psychopathological Profile of Women with Breast Cancer Based on the Symptom Checklist-90-R. Asian Pac J Cancer Prev 2013; 14:6579-84. [DOI: 10.7314/apjcp.2013.14.11.6579] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lee H, Li JY, Fan JH, Li J, Huang R, Zhang BN, Zhang B, Yang HJ, Xie XM, Tang ZH, Li H, He JJ, Wang Q, Huang Y, Qiao YL, Pang Y. Risk factors for breast cancer among Chinese women: a 10-year nationwide multicenter cross-sectional study. J Epidemiol 2013; 24:67-76. [PMID: 24270059 PMCID: PMC3872527 DOI: 10.2188/jea.je20120217] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background The characteristics of established risk factors for breast cancer may vary among countries. A better understanding of local characteristics of risk factors may help in devising effective prevention strategies for breast cancer. Methods Information on exposures to risk factors was collected from the medical charts of 4211 women with breast cancer diagnosed during 1999–2008. The distributions of these exposures among regions, and by menopausal status and birth period, were compared with the χ2 test. Crude associations between the selected factors and breast cancer were estimated using the cases in the present study and a representative control population, which was selected from qualified published studies. Results As compared with cases from less developed regions, those from more developed regions were significantly more likely to be nulliparous, had fewer childbirths (P < 0.05), and were less likely to have breastfed (P = 0.08). As compared with premenopausal cases, postmenopausal cases were more likely to be overweight and to have breastfed and had more childbirths (P < 0.05). The number of live births and rate of breastfeeding decreased in relation to birth period (P for trends <0.001). Overweight, late menopause, and family history of breast cancer were significantly associated with breast cancer among Chinese women. Conclusions Breast cancer incidence was associated with nulliparity and history of breastfeeding. Population attributable risks should be assessed, especially for more developed areas and young women. The effects of body mass index, age at menopause, and family history of breast cancer should be given priority during assessment of breast cancer risk among Chinese women.
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Affiliation(s)
- Hui Lee
- West China School of Public Health, Sichuan University
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Income and outcome in myelodysplastic syndrome: The prognostic impact of SES in a single-payer system. Leuk Res 2013; 37:1495-501. [DOI: 10.1016/j.leukres.2013.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/29/2013] [Accepted: 08/30/2013] [Indexed: 11/18/2022]
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Traditional dietary pattern of South America is linked to breast cancer: an ongoing case-control study in Argentina. Eur J Nutr 2013; 53:557-66. [PMID: 23907208 DOI: 10.1007/s00394-013-0564-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 07/15/2013] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Several studies have shown the effect of dietary patterns on breast cancer risk, but none has been conducted in Argentina. The aim of this study was to extract dietary patterns from Food Frequency Questioner, to estimate their effect on breast cancer occurrence while taking into account aggregation factors (family history of breast cancer) and to explore the sensitivity of the estimates to changes in the assumptions. METHODS A principal component exploratory factor analysis was applied to identify dietary patterns, which were then included as covariates in a multilevel logistic regression. Family history of BC was considered as a clustering variable. A multiple probabilistic sensitivity analysis was also performed. RESULTS The study included 100 cases and 294 controls. Four dietary patterns were identified. Traditional (fat meats, bakery products, and vegetable oil and mayonnaise) (OR III tertile vs I 3.13, 95% CI 2.58-3.78), Rural (processed meat) (OR III tertile vs I 2.02, 95% CI 1.21-3.37) and Starchy (refined grains) (OR III tertile vs I 1.82, 95 % CI 1.18-2.79) dietary patterns were positively associated with BC risk, whereas the Prudent pattern (fruit and non-starchy vegetables) (OR III tertile vs I 0.56, 95% CI 0.41-0.77) showed a protective effect. For Traditional pattern, the median bias-adjusted ORs (3.52) were higher than the conventional (2.76). CONCLUSIONS While the Prudent pattern was associated with a reduced risk of BC, Traditional, Rural and Starchy patterns showed a promoting effect. Despite the threats to validity, the nature of associations was not strongly affected.
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Lopez R, Agullo P, Lakshmanaswamy R. Links between obesity, diabetes and ethnic disparities in breast cancer among Hispanic populations. Obes Rev 2013; 14:679-91. [PMID: 23611507 DOI: 10.1111/obr.12030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 01/25/2013] [Accepted: 02/18/2013] [Indexed: 12/27/2022]
Abstract
Breast cancer is the most prevalent malignancy in women worldwide and is a growing concern due to rising incidence and ongoing ethnic disparities in both incidence and mortality. A number of factors likely contribute to these trends including rising rates of obesity and diabetes across the globe and differences in genetic predisposition. Here, we emphasize Hispanic populations and summarize what is currently known about obesity, diabetes and individual genetic predisposition as they relate to ethnic disparities in breast cancer incidence and mortality. In addition, we discuss potential contributions to breast cancer aetiology from molecular mechanisms associated with obesity and diabetes including dyslipidemia, hyperglycaemia, hyperinsulinaemia, endocrine dysfunction and inflammation. We propose that unique differences in diet and lifestyle coupled with individual genetic predisposition and endocrine/immune dysfunction explain most of the ethnic disparities seen in breast cancer incidence and mortality.
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Affiliation(s)
- R Lopez
- Center of Excellence in Cancer Research, Center of Excellence in Diabetes Research, Department of Biomedical Sciences MSB1, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX 79905, USA
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Henry KA, Sherman R, Farber S, Cockburn M, Goldberg DW, Stroup AM. The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 US States. Health Place 2013; 21:110-21. [PMID: 23454732 DOI: 10.1016/j.healthplace.2013.01.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 01/23/2013] [Accepted: 01/25/2013] [Indexed: 10/27/2022]
Abstract
This study evaluated independent and joint effects of census tract (CT) poverty and geographic access to mammography on stage at diagnosis for breast cancer. The study included 161,619 women 40+ years old diagnosed with breast cancer between 2004 -2006 in ten participating US states. Multilevel logistic regression was used to estimate the odds of late-stage breast cancer diagnosis for the entire study population and by state. Poverty was independently associated with late-stage in the overall population (poverty rates >20% OR=1.30, 95% CI=1.26- 1.35) and for 9 of the 10 states. Geographic access was not associated with late-stage diagnosis after adjusting for CT poverty. State-specific analysis provided little evidence that geographic access was associated with breast cancer stage at diagnosis, and after adjusting for poverty, geographic access mattered in only 1 state. Overall, compared to women with private insurance, the adjusted odds ratios for late stage at diagnosis among women with either no insurance, Medicaid, or Medicare were 1.80 (95% CI = 1.65, 1.96), 1.75 (95% CI = 1.68, 1.84), and 1.05 (95% CI 1.01, 1.08), respectively. Although geographic access to mammography was not a significant predictor of late-stage breast cancer diagnosis, women in high poverty areas or uninsured are at greatest risk of being diagnosed with late-stage breast cancer regardless of geographic location and may benefit from targeted interventions.
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Affiliation(s)
- Kevin A Henry
- Department of Geography and Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, UT 84112, USA.
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