1
|
Pinchas-Mizrachi R, Jacobson Liptz J, Zalcman BG, Romem A. Disparities in Breast Cancer Mortality Rates in Israel among Urban and Rural Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15785. [PMID: 36497859 PMCID: PMC9737317 DOI: 10.3390/ijerph192315785] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Breast cancer is a leading cause of death. There are a number of risk factors for breast cancer mortality including parity, age, ethnicity, genetic history, and place of residence. This study examined the disparities in breast cancer-related mortality rates among women from urban areas compared to rural areas in Israel. This was a retrospective, follow-up study on mortality from breast cancer among 894,608 Israeli women born between the years of 1940 and 1960. Data was collected from the Israeli Central Bureau of Statistics, the Population Authority, the Education Ministry, and the Health Ministry. Over 80% of women lived in urban areas. A higher incidence of mortality from breast cancer in Israel was found among urban women compared to rural women (1047.8/100,000 compared to 837/100,000, respectively). Even after adjusting for sociodemographic variables, higher mortality rates were found among women from urban areas in Israel compared to women from rural areas in Israel. It is believed that environmental factors can partially explain the geographic variation of breast cancer incidence, and that breast cancer incidence is likely a complex interaction between genetic, environmental, and health factors.
Collapse
Affiliation(s)
| | | | | | - Anat Romem
- Jerusalem College of Technology, Tal Campus, Jerusalem 9548311, Israel
| |
Collapse
|
2
|
Li H, Hou L, Yu Y, Sun X, Liu X, Yu Y, Wu S, He Y, Wu Y, He L, Xue F. Lipids, Anthropometric Measures, Smoking and Physical Activity Mediate the Causal Pathway From Education to Breast Cancer in Women: A Mendelian Randomization Study. J Breast Cancer 2022; 24:504-519. [PMID: 34979597 PMCID: PMC8724372 DOI: 10.4048/jbc.2021.24.e53] [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: 06/24/2021] [Revised: 09/30/2021] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose We aimed to investigate whether obtaining a higher level of education was causally associated with lower breast cancer risk and to identify the causal mechanism linking them. Methods The main data analysis used publicly available summary-level data from 2 large genome-wide association study consortia. Mendelian randomization (MR) analysis used 65 genetic variants derived from the Social Science Genetic Association Consortium as instrumental variables for years of schooling. The outcomes from the Breast Cancer Association Consortium (BCAC) were the overall breast cancer risk (122,977 cases/105,974 controls in women) and the two subtypes: estrogen receptor (ER)-positive breast cancer and ER-negative breast cancer. Fixed and random effects inverse variance weighted methods were used to estimate the causal effects, along with other additional MR methods for sensitivity analyses. Results Results showed that each additional standard deviation of 4.2 years of education was causally associated with a 27% lower risk of ER-negative breast cancer (odds ratio, 0.73; 95% confidence interval, 0.64–0.84; p-value < 0.001). This finding was consistent with the results of the sensitivity analyses. Physical activities can help improve the protective effect of education against breast cancer, with relatively large mediation proportions. Education increases the risk of ER-positive breast cancer due to alterations in high-density lipoprotein level, triglyceride level, height, waist-to-hip ratio, body mass index, and smoking status, with relative medium mediation proportions. Other mediators including low-density lipoprotein, hip circumference, number of cigarettes smoked per day, time spent performing light physical activity, and performing vigorous physical activity for > 10 minutes explain a small part of the causal effect of education on the risk of developing breast cancer, and their mediation proportion is approximately 1%. Conclusion A low level of education is a causal risk factor in the development of breast cancer as it is associated with poor lipid profile, obesity, smoking, and types of physical activity.
Collapse
Affiliation(s)
- Hongkai Li
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Lei Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yuanyuan Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Xiaoru Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Xinhui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yifan Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Sijia Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yina He
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yutong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Li He
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Fuzhong Xue
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.,Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
| |
Collapse
|
3
|
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
| |
Collapse
|
4
|
Weisband YL, Torres L, Paltiel O, Sagy YW, Calderon-Margalit R, Manor O. Socioeconomic Disparity Trends in Cancer Screening Among Women After Introduction of National Quality Indicators. Ann Fam Med 2021; 19:396-404. [PMID: 34546946 PMCID: PMC8437575 DOI: 10.1370/afm.2715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Primary care physicians have an important role in encouraging adequate cancer screening. Disparities in cancer screening by socioeconomic status (SES) may affect presentation stage and cancer survival. This study aimed to examine whether breast, colorectal, and cervical cancer screening rates in women differed by SES and age, and whether screening rates and SES disparities changed after introduction of a primary care-based national quality indicator program. METHODS This repeated cross-sectional study spanning 2002-2017 included all female Israeli residents in age ranges appropriate for each cancer screening assessed. SES was measured both as an individual-level variable based on exemption from copayments and as an area-level variable using census data. RESULTS In 2017, the most recent year in the study period, screening rates among 1,529,233 women were highest for breast cancer (70.5%), followed by colorectal cancer (64.3%) and cervical cancer (49.6%). Women in the highest area-level SES were more likely to undergo cervical cancer screening compared with those in the lowest (odds ratio = 3.56; 99.9% CI, 3.47-3.65). Temporal trends showed that after introduction of quality indicators for breast and colorectal cancer screening in 2004 and 2005, respectively, rates of screening for these cancers increased, with greater reductions in disparities for the former. The quality indicator for cervical cancer screening was introduced in 2015, and no substantial changes have occurred yet for this screening. CONCLUSIONS We found increased uptake and reduced socioeconomic disparities after introduction of cancer screening indicators. Recent introduction of a cervical cancer screening indicator may increase participation and reduce disparities, as has occurred for breast and colorectal cancer screening. These findings related to Israel's quality indicators program highlight the importance of primary care clinicians in increasing cancer screening rates to improve outcomes and reduce disparities.
Collapse
Affiliation(s)
| | - Luz Torres
- Research Department, Cardioinfantil Foundation-Cardiology Institute, Bogotá, Colombia
| | - Ora Paltiel
- Braun School of Public Health, Hebrew University-Hadassah, Jerusalem, Israel
| | - Yael Wolff Sagy
- Braun School of Public Health, Hebrew University-Hadassah, Jerusalem, Israel
| | | | - Orly Manor
- Braun School of Public Health, Hebrew University-Hadassah, Jerusalem, Israel
| |
Collapse
|
5
|
Pader J, Basmadjian RB, O'Sullivan DE, Mealey NE, Ruan Y, Friedenreich C, Murphy R, Wang E, Quan ML, Brenner DR. Examining the etiology of early-onset breast cancer in the Canadian Partnership for Tomorrow's Health (CanPath). Cancer Causes Control 2021; 32:1117-1128. [PMID: 34173131 DOI: 10.1007/s10552-021-01460-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 06/11/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Breast cancer incidence among younger women (under age 50) has increased over the past 25 years, yet little is known about the etiology among this age group. The objective of this study was to investigate relationships between modifiable and non-modifiable risk factors and early-onset breast cancer among three prospective Canadian cohorts. METHODS A matched case-control study was conducted using data from Alberta's Tomorrow Project, BC Generations Project, and the Ontario Health Study. Participants diagnosed with breast cancer before age 50 were identified through provincial registries and matched to three control participants of similar age and follow-up. Conditional logistic regression was used to examine the association between factors and risk of early-onset breast cancer. RESULTS In total, 609 cases and 1,827 controls were included. A body mass index ≥ 30 kg/m2 was associated with a lower risk of early-onset breast cancer (OR 0.65; 95% CI 0.47-0.90), while a waist circumference ≥ 88 cm was associated with an increased risk (OR 1.58; 95% CI 1.18-2.11). A reduced risk was found for women with ≥ 2 pregnancies (OR 0.76; 95% CI 0.59-0.99) and a first-degree family history of breast cancer was associated with an increased risk (OR 1.95; 95% CI 1.47-2.57). CONCLUSIONS In this study, measures of adiposity, pregnancy history, and familial history of breast cancer are important risk factors for early-onset breast cancer. Evidence was insufficient to conclude if smoking, alcohol intake, fruit and vegetable consumption, and physical activity are meaningful risk factors. The results of this study could inform targeted primary and secondary prevention for early-onset breast cancer.
Collapse
Affiliation(s)
- Joy Pader
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Robert B Basmadjian
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dylan E O'Sullivan
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nicole E Mealey
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Christine Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rachel Murphy
- Department of Epidemiology, Biostatistics and Public Health Practice, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Edwin Wang
- Department of Biochemistry & Molecular Biology, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - May Lynn Quan
- Department of Surgery, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Oncology and Community Health Sciences, University of Calgary, Heritage Medical Research Building, 3300 Hospital Dr NW, Room 382B, Calgary, AB, T2N 4Z6, Canada.
| |
Collapse
|
6
|
Takamatsu K, Ideno Y, Kikuchi M, Yasui T, Maruoka N, Nagai K, Hayashi K. Validity of self-reported diagnoses of gynaecological and breast cancers in a prospective cohort study: the Japan Nurses' Health Study. BMJ Open 2021; 11:e045491. [PMID: 34145012 PMCID: PMC8215237 DOI: 10.1136/bmjopen-2020-045491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To validate the self-reported diagnoses of gynaecological and breast cancers in a nationwide prospective cohort study of nursing professionals: the Japan Nurses' Health Study (JNHS). DESIGN AND SETTING Retrospective analysis of the JNHS. PARTICIPANTS AND MEASURES Data were reviewed for 15 717 subjects. The mean age at baseline was 41.6±8.3 years (median: 41), and the mean follow-up period was 10.5±3.8 years (median: 12). Participants are regularly mailed a follow-up questionnaire once every 2 years. Respondents who self-reported a positive cancer diagnosis were sent an additional confirmation questionnaire and contacted the diagnosing facility to confirm the diagnosis based on medical records. A review panel of experts verified the disease status. Regular follow-up, confirmation questionnaires and expert review were validated for their positive predictive value (PPV) and negative predictive value (NPV). RESULTS New incidences were verified in 37, 47, 26 and 300 cervical, endometrial, ovarian and breast cancer cases, respectively. The estimated incidence rates were 22.0, 25.4, 13.8 and 160.4 per 100 000 person-years. These were comparable with those of national data from regional cancer registries in Japan. For regular follow-up, the corresponding PPVs for cervical, endometrial, ovarian and breast cancer were 16.9%, 54.2%, 45.1% and 81.4%, and the NPVs were 100%, 99.9%, 99.9% and 99.9%, respectively. Adding the confirmation questionnaire improved the PPVs to 31.5%, 88.9%, 76.7% and 99.9%; the NPVs were uniformly 99.9%. Expert review yielded PPVs and NPVs that were all ~100%. CONCLUSIONS Gynaecological cancer cannot be accurately assessed by self-reporting alone. Additionally, the external validity of cancer incidence in this cohort was confirmed.
Collapse
Affiliation(s)
- Kiyoshi Takamatsu
- Department of Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Yuki Ideno
- Center for Mathematics and Data Science, Gunma University, Maebashi, Japan
| | - Mami Kikuchi
- Center of Regional Medical Research and Education, Gunma University Hospital, Meabashi, Japan
| | - Toshiyuki Yasui
- Department of Reproductive and Menopausal Medicine, University of Tokushima Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Naho Maruoka
- Department of International/Community Health Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kazue Nagai
- Department of International/Community Health Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kunihiko Hayashi
- Department of International/Community Health Laboratory Sciences, Gunma University Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| |
Collapse
|
7
|
Brandão M, Guisseve A, Damasceno A, Bata G, Silva-Matos C, Alberto M, Ferro J, Garcia C, Zaqueu C, Lorenzoni C, Leitão D, Soares O, Gudo-Morais A, Schmitt F, Morais S, Tulsidás S, Carrilho C, Lunet N. Risk Factors for Breast Cancer, Overall and by Tumor Subtype, among Women from Mozambique, Sub-Saharan Africa. Cancer Epidemiol Biomarkers Prev 2021; 30:1250-1259. [PMID: 33849971 DOI: 10.1158/1055-9965.epi-20-1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer incidence is rising in Africa, but there are scare data regarding risk factors in this region. We assessed the relation between risk factors and the occurrence of breast cancer, overall and by tumor subtype in women from Mozambique. METHODS The associations between education, number of births, height, weight, body mass index (BMI), and breast cancer risk among 138 cases (participants from the Moza-BC cohort) and 638 controls from the general population (from a World Health Organization stepwise approach to surveillance survey), recruited during 2014 to 2017, were investigated. Adjusted ORs (aOR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression. RESULTS Multiparity (≥6 vs. 0-1 live births) was a protective factor for the development of hormone receptor (HR)-positive (aOR = 0.22; 95% CI, 0.08-0.64) and HR-positive/HER2-negative tumors (aOR = 0.20; 95% CI, 0.06-0.68), whereas a higher educational level (≥8 vs. 0 schooling years) increased breast cancer risk across all subtypes (overall aOR = 1.98; 95% CI, 1.04-3.80). Higher weight and BMI were associated with a higher breast cancer risk among postmenopausal women (per 1-kg increase: aOR = 1.05; 95% CI, 1.02-1.08; per 1-kg/m2 increase: aOR = 1.11; 95% CI, 1.04-1.18, respectively), but were protective in premenopausal women (aOR = 0.98; 95% CI, 0.96-0.99; aOR = 0.95; 95% CI, 0.91-0.99, respectively), regardless of subtype. Higher height increased the risk of HR-negative tumors in postmenopause (per 10-cm increase: aOR = 2.81; 95% CI, 1.41-6.03). CONCLUSION These results demonstrate the etiological heterogeneity of breast cancer among native African women, namely regarding the differential effect of multiparity, education, and body parameters in breast cancer risk. IMPACT As the prevalence of obesity grows, these findings are important to inform public health policies on cancer prevention, by highlighting obesity as a modifiable risk factor for breast cancer among African women.
Collapse
Affiliation(s)
- Mariana Brandão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo, Brussels, Belgium
| | - Assucena Guisseve
- Department of Pathology, Faculty of Medicine, University Eduardo Mondlane, Avenida Salvador Allende, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Albertino Damasceno
- Cardiology Department, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Genoveva Bata
- Oncology Department, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Carla Silva-Matos
- Unidade de Gestão do Fundo Global - Direcção de Planificação e Cooperação, Ministério da Saúde, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Matos Alberto
- Department of Pathology, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Josefo Ferro
- Department of Pathology, Beira Central Hospital, Avenida Mártires da Revolução, Beira, Mozambique
| | - Carlos Garcia
- Department of Pathology, Beira Central Hospital, Avenida Mártires da Revolução, Beira, Mozambique
| | - Clésio Zaqueu
- Department of Pathology, Nampula Central Hospital, Avenida Samora Machel, Nampula, Mozambique
| | - Cesaltina Lorenzoni
- Department of Pathology, Faculty of Medicine, University Eduardo Mondlane, Avenida Salvador Allende, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Dina Leitão
- Pathology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Departmento de Patologia e Oncologia, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, Porto, Portugal
| | - Otília Soares
- Oncology Department, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Alberto Gudo-Morais
- Oncology Department, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique.,Radiotherapy Unit, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Fernando Schmitt
- Departmento de Patologia e Oncologia, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, Porto, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Satish Tulsidás
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Oncology Department, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Carla Carrilho
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal. .,Department of Pathology, Faculty of Medicine, University Eduardo Mondlane, Avenida Salvador Allende, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| |
Collapse
|
8
|
Abstract
OBJECTIVE We aimed to examine the association between education level and breast cancer incidence by a meta-analysis of cohort studies. METHODS Relevant studies were identified by searching PubMed, Web of Science, and Scopus databases on June 10, 2018. Reference lists from the obtained articles were also reviewed. We included cohort studies reporting relative risks with 95% CIs for the association between education level and breast cancer incidence. Either a fixed- or random-effects model was used to calculate the pooled risk estimates. RESULTS We identified 18 cohort studies with more than 10 million women. Compared with women with a lower education level, women with a higher education level had a significantly higher risk of developing breast cancer (pooled relative risk 1.22 [95% CI, 1.14-1.30]). The results did not differ by study area or reference group. The association remained in studies that adjusted for age at first birth and parity, but was attenuated and no longer significant when the analysis was restricted to studies that adjusted for alcohol use, to studies that adjusted for age at menopause, or to studies that adjusted for hormone therapy. CONCLUSIONS A higher education level may be associated with an increased risk of developing breast cancer, in which alcohol use, age at menopause, and hormone therapy may, at least partially, play a mediating role.
Collapse
|
9
|
Statler AB, Wei W, Gupta A, Blake CN, Hobbs BP, Nahleh ZA. Elucidating Determinants of Survival Disparities Among a Real-world Cohort of Metastatic Breast Cancer Patients: A National Cancer Database Analysis. Clin Breast Cancer 2020; 20:e625-e650. [PMID: 32434711 DOI: 10.1016/j.clbc.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Disparities in breast cancer survival by race/ethnicity and socioeconomic status have been reported. However, it is unclear if these findings are reproducible among subpopulations. This study aimed to assess if socially oriented factors are predictive of overall survival (OS) among patients with hormone receptor-positive (HR+), human epidermal growth factor 2-positive (HER2+) metastatic breast cancer (MBC). PATIENTS AND METHODS We analyzed patients with MBC included in the National Cancer Database diagnosed with HR+ and HER2+ disease treated between 2010 and 2015. Multivariate analyses describe the association between non-clinical prognostic factors and OS. A matched analysis, which balanced prognostic factors between whites and African Americans (AA), was also conducted. RESULTS Of the 6200 patients analyzed, the majority were 50 years or older, white, and treated with hormonal therapy. Disparities in OS were observed; multivariate analysis revealed diminished survival was associated with low income (< $38K vs. ≥ $63K, hazard ratio [HR], 1.30; P < .001), having government insurance (government vs. private, HR, 1.55; P < .001), living closer to one's treatment facility (< 4 miles vs. ≥ 18 miles, HR, 1.16; P = .04), and being AA (AA vs. white, HR, 1.20; P = .006). The mortality disparity attributed to race was insignificant in the matched analysis (AA vs. white, HR, 1.13; 95% confidence interval, 0.98-1.30; P = .09). CONCLUSIONS This study confirms that the known sociodemographic disparities in OS among patients with MBC are similar within the HR+/HER2+ subpopulation. The discordance of outcomes between matched and unmatched analysis demonstrate that there is a highly vulnerable subgroup of AAs. Further investigation is required to determine if the identified associations are independently causal of poor prognosis.
Collapse
Affiliation(s)
- Abby B Statler
- Cancer Biostatistics, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Wei Wei
- Quantitative Health Sciences, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Annie Gupta
- Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL
| | - Cassann N Blake
- Department of General Surgery, Cleveland Clinic Florida, Weston, FL
| | - Brian P Hobbs
- Quantitative Health Sciences, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Zeina A Nahleh
- Department of Hematology/Oncology, Maroone Cancer Center, Cleveland Clinic Florida, Weston, FL.
| |
Collapse
|
10
|
Simhi M, Yoselis A, Sarid O, Cwikel J. Hidden Figures: Are Ultra-Orthodox Jewish Women Really so Different When it Comes to Health Care? JOURNAL OF RELIGION AND HEALTH 2020; 59:1398-1420. [PMID: 31218549 DOI: 10.1007/s10943-019-00862-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Incorporating the needs of at-risk populations into national health care initiatives is essential. Israel has identified ultra-Orthodox Jewish, or Haredi, women, as at risk of increased morbidity and mortality, yet actual data on this insular community are lacking. We reviewed published research on Israeli Haredi women's health status, behaviors and health care access and examined methodologies. Of 273 articles identified, 14 publications and four government reports were included. More research is needed on this community, essential not only to Israeli health care policy, but to that of the USA and the UK, who share the largest percentages of Haredi Jews.
Collapse
Affiliation(s)
- Meital Simhi
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel.
| | - Aviva Yoselis
- Health Advize, POB 383, 90651, Mitzpe Yericho, Israel
| | - Orly Sarid
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel
| | - Julie Cwikel
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel
| |
Collapse
|
11
|
Hamdi-Cherif M, Serraino D, Bouad S, Dib A, Boudaoud K, Atoui S, Mergherm I, Toffolutti F, Bidoli E, Kara L, Ayat A, Habia G, Makhloufi K, Bouchaibi I, Kettaf S, Chenafi S, Dilmi D, Bouhafs K, Ablaoui B, Chaouche H, Belbedj L, Nadjem A, Lakab N, Virdone S, Panato C. Sociodemographic and Reproductive Risk Factors for Breast Cancer: A Case-Control Study in the Setif Province, Northern Algeria. Asian Pac J Cancer Prev 2020; 21:457-464. [PMID: 32102524 PMCID: PMC7332138 DOI: 10.31557/apjcp.2020.21.2.457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The age-standardized rate of breast cancer (BC) increased nearly nine-fold in the last 30 years in Setif, Algeria. A case-control study was carried out to investigate the role of sociodemographic characteristics and reproductive factors in the etiology of BC in this young Arab/Berber population of Setif. Methods: Cases were 612 women with incident BC admitted to major teaching and general hospitals of Setif during 2012–2017. Controls were 615 women admitted for acute, non-neoplastic conditions to the same hospital network of cases. Information was elicited using a standardized questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed after allowance for age and education. Results: Significant associations with BC risk emerged for family history of BC (OR= 4.15 for yes vs. no; 95%CI: 2.22-7.77), for the generation of oral contraceptive used (OR=1.57 for II-generation vs. III-generation; 95%CI:1.01-2.44), and education (OR=0.63 for >11 years vs. no schooling; 95%CI: 0.46-0.86). Conversely, parity and body mass index were not associated with BC risk, whereas a late age at menarche was linked with a non statistically significant BC risk (OR=1.20 for >15 vs. <13 years; 95%CI:0.86-1.66). These results were consistent in strata of menopausal status. Conclusion(s): Some of the expected risk factors (e.g., low education levels and type of oral contraceptives) were associated with elevated BC risks also in Setif, and these findings offer further support to primary preventive efforts already carried on in Algeria. Conversely, no association emerged for other well established risk factors (e.g., body mass index).
Collapse
Affiliation(s)
| | - Diego Serraino
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy.,Friuli Venezia Giulia Cancer Registry, IRCCS Oncological Reference Center, Aviano, Italy
| | - Souad Bouad
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Adlane Dib
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Khadidja Boudaoud
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Saida Atoui
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Imene Mergherm
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| | - Lamia Kara
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Asma Ayat
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Ghania Habia
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Kenza Makhloufi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Imane Bouchaibi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Sabah Kettaf
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Samiha Chenafi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Douniazad Dilmi
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Karima Bouhafs
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Bahadinne Ablaoui
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Hadjira Chaouche
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Loubna Belbedj
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Asma Nadjem
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Nawel Lakab
- Faculty of Medicine and Cancer Registry, University of Setif, Setif, Algeria
| | - Saverio Virdone
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Oncological Reference Center (CRO), IRCCS, Aviano, Italy
| |
Collapse
|
12
|
Ji P, Gong Y, Jiang CC, Hu X, Di GH, Shao ZM. Association between socioeconomic factors at diagnosis and survival in breast cancer: A population-based study. Cancer Med 2020; 9:1922-1936. [PMID: 31960597 PMCID: PMC7050085 DOI: 10.1002/cam4.2842] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/17/2019] [Accepted: 12/30/2019] [Indexed: 12/12/2022] Open
Abstract
Background The associations between socioeconomic statuses and survival outcomes of breast cancer remain unclear. No model has included both histological and socioeconomic factors to predict the survival of breast cancer. This study was designed to develop nomograms to predict breast cancer–specific survival (BCSS) and overall survival (OS) with consideration of socioeconomic factors for breast cancer patients. Materials and methods We included a total of 207 749 female patients, diagnosed with malignant breast cancer between 2007 and 2012 from the Surveillance, Epidemiology, and End Results database. BCSS and OS were evaluated with Gray's test and log‐rank tests, respectively. Marital statuses, insurance statuses, residence, median household income, poverty rate, unemployment rate, and education level were included as socioeconomic factors in univariate and multivariate Cox regression analyses. Clinicopathological factors and socioeconomic factors were integrated to construct nomograms. Calibration plots and concordance indexes (C‐indexes) were used to evaluate the accuracy and discrimination of the models. Results Four and three socioeconomic factors were involved in constructing the nomograms for 3‐, 5‐, and 7‐year BCSS and OS, respectively. The C‐indexes of the final nomograms were higher than those of the TNM staging system for predicting BCSS (0.835 vs 0.782; P < .001) and OS (0.773 vs 0.676; P < .001). The performance of the nomograms for predicting OS was significantly lower when excluding socioeconomic factors (P < .001). Conclusion These findings may highlight the importance of developing health‐related policies and the necessity of targeted social support‐based interventions for high‐risk patients.
Collapse
Affiliation(s)
- Peng Ji
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yue Gong
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chang-Chuan Jiang
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mt Sina St. Luke's and Mt Sinai West Hospital, New York, NY, USA
| | - Xin Hu
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Gen-Hong Di
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Zhi-Ming Shao
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Institutes of Biomedical Science, Fudan University, Shanghai, China
| |
Collapse
|
13
|
TAHERI M, TAVAKOL M, AKBARI ME, ALMASI-HASHIANI A, ABBASI M. Relationship of Socio Economic Status, Income, and Education with the Survival Rate of Breast Cancer: A Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1428-1438. [PMID: 32292725 PMCID: PMC7145923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite our awareness of the significant effect of Social Determinant of Health (SDoH) such as Socio Economic Status (SES), income and education on breast cancer survival, there was a serious lack of information about the effect of different level of these factors on breast cancer survival. So far, no meta-analysis has been conducted with this aim, but this gap was addressed by this meta-analysis. METHODS Main electronic databases such as PubMed, Web of Science, and Scopus were investigated up to January 2019. Epidemiological studies focusing on the association between SDoH and breast cancer were singled out. Q-test and I2 statistic were used to study the heterogeneity across studies. Begg's and Egger's tests were applied to explore the likelihood of the publication bias. The results were reported as hazard ratio (HR) with 95% confidence intervals (CI) through a random-effects model. RESULTS We identified 7,653 references and included 25 studies involving 1,497,881 participants. The HR estimate of breast cancer survival was 0.82 (0.67, 0.98) among high level of SES, 0.82 (0.70, 0.94) among high level of income and 0.72 (0.66, 0.78) among academic level of education. CONCLUSION The SES, income, and education were associated with breast cancer survival, although the association was not very strong. However, there was a significant association between the levels of these factors and breast cancer survival.
Collapse
Affiliation(s)
- Majid TAHERI
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad TAVAKOL
- Department of Sociology, School of Social Sciences, University of Tehran, Tehran, Iran
| | | | - Amir ALMASI-HASHIANI
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran,Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Mahmoud ABBASI
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding Author:
| |
Collapse
|
14
|
The Effects of Exercise on Adolescent Physical Development, Brain Development and Adult Health in Underserved Populations. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
15
|
Cho S, Shin A, Song D, Park JK, Kim Y, Choi JY, Kang D, Lee JK. Validity of self-reported cancer history in the health examinees (HEXA) study: A comparison of self-report and cancer registry records. Cancer Epidemiol 2017; 50:16-21. [PMID: 28763723 DOI: 10.1016/j.canep.2017.07.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/18/2017] [Accepted: 07/22/2017] [Indexed: 01/31/2023]
Abstract
PURPOSE To assess the validity of the cohort study participants' self-reported cancer history via data linkage to a cancer registry database. METHODS We included 143,965 participants from the Health Examinees (HEXA) study recruited between 2004 and 2013 who gave informed consent for record linkage to the Korean Central Cancer Registry (KCCR). The sensitivity and the positive predictive value of self-reported histories of cancer were calculated and 95% confidence intervals were estimated. RESULTS A total of 4,860 participants who had at least one record in the KCCR were included in the calculation of sensitivity. In addition, 3,671 participants who reported a cancer history at enrollment were included in the calculation of positive predictive value. The overall sensitivity of self-reported cancer history was 72.0%. Breast cancer history among women showed the highest sensitivity (81.2%), whereas the lowest sensitivity was observed for liver cancer (53.7%) and cervical cancer (52.1%). The overall positive predictive value was 81.9%. The highest positive predictive value was observed for thyroid cancer (96.1%) and prostate cancer (96.1%), and the lowest was observed for cervical cancer (43.7%). CONCLUSION The accuracy of self-reported cancer history varied by cancer site and may not be sufficient to ascertain cancer incidence, especially for cervical and bladder cancers.
Collapse
Affiliation(s)
- Sooyoung Cho
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Daesub Song
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Center for Disease Control and Prevention, Osong, Republic of Korea
| | - Jae Kyung Park
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Center for Disease Control and Prevention, Osong, Republic of Korea
| | - Yeonjung Kim
- Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Center for Disease Control and Prevention, Osong, Republic of Korea
| | - Ji-Yeob Choi
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Jong-Koo Lee
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Seoul Center for Infectious Disease Control, Seoul, Republic of Korea
| |
Collapse
|
16
|
Lou Z, Fei X, Christakos G, Yan J, Wu J. Improving Spatiotemporal Breast Cancer Assessment and Prediction in Hangzhou City, China. Sci Rep 2017; 7:3188. [PMID: 28600508 PMCID: PMC5466684 DOI: 10.1038/s41598-017-03524-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 05/08/2017] [Indexed: 11/21/2022] Open
Abstract
Breast cancer (BC) is the main cause of death of female cancer patients in China. Mainstream mapping techniques, like spatiotemporal ordinary kriging (STOK), generate disease incidence maps that improve our understanding of disease distribution. Yet, the implementation of these techniques experiences substantive and technical complications (due mainly to the different characteristics of space and time). A new spatiotemporal projection (STP) technique that is free of the above complications was implemented to model the space-time distribution of BC incidence in Hangzhou city and to estimate incidence values at locations-times for which no BC data exist. For comparison, both the STP and the STOK techniques were used to generate BC incidence maps in Hangzhou. STP performed considerably better than STOK in terms of generating more accurate incidence maps showing a closer similarity to the observed incidence distribution, and providing an improved assessment of the space-time BC correlation structure. In sum, the inter-connections between space, time, BC incidence and spread velocity established by STP allow a more realistic representation of the actual incidence distribution, and generate incidence maps that are more accurate and more informative, at a lower computational cost and involving fewer approximations than the incidence maps produced by mainstream space-time techniques.
Collapse
Affiliation(s)
- Zhaohan Lou
- Institute of Islands and Coastal Ecosystems, Zhejiang University, Zhoushan, China
| | - Xufeng Fei
- College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, China
| | - George Christakos
- Institute of Islands and Coastal Ecosystems, Zhejiang University, Zhoushan, China. .,Department of Geography, San Diego State University, San Diego, CA, USA.
| | - Jianbo Yan
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Jiaping Wu
- Institute of Islands and Coastal Ecosystems, Zhejiang University, Zhoushan, China.
| |
Collapse
|
17
|
Balekouzou A, Yin P, Pamatika CM, Bekolo CE, Nambei SW, Djeintote M, Kota K, Mossoro-Kpinde CD, Shu C, Yin M, Fu Z, Qing T, Yan M, Zhang J, Chen S, Li H, Xu Z, Koffi B. Reproductive risk factors associated with breast cancer in women in Bangui: a case-control study. BMC WOMENS HEALTH 2017; 17:14. [PMID: 28264686 PMCID: PMC5340027 DOI: 10.1186/s12905-017-0368-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 02/04/2017] [Indexed: 12/26/2022]
Abstract
Background Breast cancer (breast Ca) is recognised as a major public health problem in the world. Data on reproductive factors associated with breast Ca in the Central African Republic (CAR) is very limited. This study aimed to identify reproductive variables as risk factors for breast Ca in CAR women. Methods A case–control study was conducted among 174 cases of breast Ca confirmed at the Pathology Unit of the National Laboratory in Bangui between 2003 and 2015 and 348 age-matched controls. Data collection tools included a questionnaire, interviews and a review of medical records of patients. Data were analysed using SPSS software version 20. Odd ratios and 95% confidence intervals (CI) for the likelihood of developing breast Ca were obtained using unconditional logistic regression. Results In total, 522 women with a mean age of 45.8 (SD = 13.4) years were enrolled. Women with breast Ca were more likely to have attained little or no education (AOR = 11.23, CI: 4.65–27.14 and AOR = 2.40, CI: 1.15–4.99), to be married (AOR = 2.09, CI: 1.18–3.71), to have had an abortion (AOR = 5.41, CI: 3.47–8.44), and to be nulliparous (AOR = 1.98, CI: 1.12–3.49). Decreased odds of breast Ca were associated with being employed (AOR = 0.32, CI: 0.19–0.56), living in urban areas (AOR = 0.16, CI: 0.07–0.37), late menarche (AOR = 0.18, CI: 0.07–0.44), regular menstrual cycles (AOR = 0.44, CI: 0.23–0.81), term pregnancy (AOR = 0.26, CI: 0.13–0.50) and hormonal contraceptive use (AOR = 0.62, CI: 0.41–0.93). Conclusion Breast Ca risk factors in CAR did not appear to be significantly different from that observed in other populations. This study highlighted the risk factors of breast Ca in women living in Bangui to inform appropriate control measures.
Collapse
Affiliation(s)
- Augustin Balekouzou
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China.,National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China.
| | | | - Cavin Epie Bekolo
- Ministry of Public Health, Centre Medical d'Arrondissement de Bare, Nkongsamba, Cameroon
| | - Sylvain Wilfrid Nambei
- Faculty of Health Sciences, University of Bangui, Avenue of the Martyrs, Bangui, Central African Republic
| | - Marceline Djeintote
- National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic
| | - Komlan Kota
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | | | - Chang Shu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Minghui Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Zhen Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Tingting Qing
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Mingming Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Jianyuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Shaojun Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Hongyu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Zhongyu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Hangkong Road 13, Wuhan City, Hubei Province, China
| | - Boniface Koffi
- National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic
| |
Collapse
|
18
|
Balekouzou A, Yin P, Afewerky HK, Bekolo C, Pamatika CM, Nambei SW, Djeintote M, Doui Doumgba A, Mossoro-Kpinde CD, Shu C, Yin M, Fu Z, Qing T, Yan M, Zhang J, Chen S, Li H, Xu Z, Koffi B. Behavioral risk factors of breast cancer in Bangui of Central African Republic: A retrospective case-control study. PLoS One 2017; 12:e0171154. [PMID: 28178283 PMCID: PMC5298279 DOI: 10.1371/journal.pone.0171154] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/16/2017] [Indexed: 11/18/2022] Open
Abstract
Breast cancer is recognized as a major public health problem in developing countries; however, there is very little evidence of behavioral factors associated with breast cancer risk. This study was conducted to identify lifestyles as risk factors for breast cancer among Central African women. A case-control study was conducted with 174 cases confirmed histologically by the pathology unit of the National Laboratory and 348 age-matched controls. Data collection tools included a questionnaire with interviews and medical records of patients. Data were analyzed using SPSS software version 20. Odd ratio (OR) and 95% confidence intervals (95% CI) were obtained by unconditional logistic regression. In total, 522 women were studied with a mean age of 45.8 (SD = 13.4) years. By unconditional logistic regression model, women with breast cancer were more likely to have attained illiterate and elementary education level [11.23 (95% CI, 4.65-27.14) and 2.40 (95% CI, 1.15-4.99)], married [2.09 (95% CI, 1.18-3.71)], positive family history [2.31 (95% CI, 1.36-3.91)], radiation exposure [8.21 (95% CI, 5.04-13.38)], consumption charcuterie [10.82 (95% CI, 2.39-48.90)], fresh fish consumption [4.26 (95% CI, 1.56-11.65)], groundnut consumption [6.46 (95% CI, 2.57-16.27)], soybean consumption [16.74 (95% CI, 8.03-39.84)], alcohol [2.53 (95% CI, 1.39-4.60)], habit of keeping money in bras[3.57 (95% CI, 2.24-5.69)], overweight [5.36 (95% CI, 4.46-24.57)] and obesity [3.11(95% CI, 2.39-20.42)]. However, decreased risk of breast cancer was associated with being employed [0.32 (95% CI, 0.19-0.56)], urban residence [0.16 (95% CI, 0.07-0.37)], groundnut oil consumption [0.05 (95% CI, 0.02-0.14)], wine consumption [0.16 (95% CI, 0.09-0.26)], non habit of keeping cell phone in bras [0.56 (95% CI, 0.35-0.89)] and physical activity [0.71(95% CI, 0.14-0.84)]. The study showed that little or no education, marriage, positive family history of cancer, radiation exposure, charcuterie, fresh fish, groundnut, soybean, alcohol, habit of keeping money in bras, overweight and obesity were associated with breast cancer risk among Central African women living in Bangui. Women living in Bangui should be more cautious on the behavioral risk associated with breast cancer.
Collapse
Affiliation(s)
- Augustin Balekouzou
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Henok Kessete Afewerky
- Department of Pathology and Pathophysiology, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Cavin Bekolo
- Ministry of Public Health, Centre Medical d’Arrondissement de Bare, Nkongsamba, Yaoundé, Cameroon
| | | | | | - Marceline Djeintote
- National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic
| | - Antoine Doui Doumgba
- Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic
| | | | - Chang Shu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Minghui Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Zhen Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Tingting Qing
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Mingming Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Jianyuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Shaojun Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Hongyu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Zhongyu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Sciences and Technology, Wuhan, China
| | - Boniface Koffi
- National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic
| |
Collapse
|
19
|
Exercise and Sports Medicine Issues in Underserved Populations. Prim Care 2017; 44:141-154. [PMID: 28164813 DOI: 10.1016/j.pop.2016.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary care providers can make a strong argument for exercise promotion in underserved communities. The benefits are vitally important in adolescent physical, cognitive, and psychological development as well as in adult disease prevention and treatment. In counseling such patients, we should take into account a patient's readiness for change and the barriers to exercise.
Collapse
|
20
|
Keshinro A, Hatzaras I, Rifkind K, Dhage S, Joseph KA. The Impact of Primary Care Providers on Patient Screening Mammography and Initial Presentation in an Underserved Clinical Setting. Ann Surg Oncol 2016; 24:692-697. [PMID: 27766557 DOI: 10.1245/s10434-016-5618-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis. Additional variables included race, age at diagnosis, family history of breast and ovarian cancer, and medical comorbidities. RESULTS Patients with a PCP received more mammograms (SMG) compared with patients without a PCP (61 vs. 37 %; p = 0.003). The majority (73 %) of patients without a PCP presented symptomatically with a palpable mass versus 42 % of patients with a PCP. A significant difference was noted with regard to final pathologic stage of breast cancer between the two groups (p = 0.019), and Caucasian and African American patients were more likely to have locally advanced breast cancer. CONCLUSIONS Underserved patients with a PCP are more likely to present asymptomatically and at an earlier stage of breast cancer compared with patients without a PCP. Community engagement programs that build relationships with patients may help bring vulnerable patients into the healthcare system for routine screening. Moreover, PCP education regarding the subtleties of breast cancer screening guidelines and referral to a breast specialist is also critical in improving outcomes of underserved patients.
Collapse
Affiliation(s)
- Ajaratu Keshinro
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Ioannis Hatzaras
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Kenneth Rifkind
- Department of Surgery, NYU Langone Medical Center, NYU Lutheran Hospital, New York, NY, USA
| | - Shubhada Dhage
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Kathie-Ann Joseph
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA.
| |
Collapse
|
21
|
Stroup AM, Herget KA, Hanson HA, Reed DL, Butler JT, Henry KA, Harrell CJ, Sweeney C, Smith KR. Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood. Cancer Epidemiol Biomarkers Prev 2016; 26:75-84. [PMID: 27655898 DOI: 10.1158/1055-9965.epi-16-0371] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology. METHODS For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression. RESULTS Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HRQ1/Q4 = 0.83; 95% confidence interval (CI), 0.72-0.97; HRQ2/Q4 = 0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HRQ1/Q4 = 0.81; 95% CI, 0.67-0.98) and prostate cancer (HRQ1/Q4 = 0.70; 95% CI, 0.56-0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HRQ1/Q4 = 1.44; 95% CI, 1.12-1.85; HRQ2/Q4 = 1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers. CONCLUSIONS Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites. IMPACT This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk. Cancer Epidemiol Biomarkers Prev; 26(1); 75-84. ©2016 AACR.
Collapse
Affiliation(s)
- Antoinette M Stroup
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah. .,Rutgers School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | - Heidi A Hanson
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Diana Lane Reed
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jared T Butler
- Department of Geography, University of Utah, Salt Lake City, Utah
| | - Kevin A Henry
- Department of Geography, University of Utah, Salt Lake City, Utah.,Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.,Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania
| | - C Janna Harrell
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah
| | - Carol Sweeney
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah.,Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Ken R Smith
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah
| |
Collapse
|
22
|
Cheli S, Caligiani L, Nembrini M, Fioretto L. Cancer care in the length of the European migrant crisis rationale and feasibility of a participatory action research. Psychooncology 2016; 25:1116-8. [DOI: 10.1002/pon.4229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 06/21/2016] [Accepted: 07/18/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Simone Cheli
- Scuola di Scienze della Salute Umana; Universita degli Studi di Firenze; Florence Italy
- SOS Psiconcologia, Dipartimento Oncologico; Azienda Sanitaria di Firenze; Florence Tuscany Italy
| | - Lucia Caligiani
- SOS Psiconcologia, Dipartimento Oncologico; Azienda Sanitaria di Firenze; Florence Tuscany Italy
| | - Marinetta Nembrini
- Servizio di Mediazione Linguistica e Culturale; Azienda Sanitaria di Firenze; Florence Tuscany Italy
| | - Luisa Fioretto
- SOS Psiconcologia, Dipartimento Oncologico; Azienda Sanitaria di Firenze; Florence Tuscany Italy
| |
Collapse
|