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Garduño-Alanis A, Morales-González L, Ángeles-Llerenas A, Delgado-Ramírez JZ, Ortega-Olvera C, Torres-Mejía G. The effect of the number of biopsies on the delay in the time from the delivery of mammography results to breast cancer histopathological diagnosis. Cancer Causes Control 2022; 33:1355-1361. [PMID: 36029415 DOI: 10.1007/s10552-022-01622-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The delay in the time (in calendar days) from the delivery of mammography results to histopathological breast cancer (BC) diagnosis could be associated with more advanced clinical stages, a worse prognosis and higher mortality. Therefore, we assessed the association between the number of biopsies and the delay in the time (in calendar days) from the delivery of mammography results to histopathological BC. METHODS A survey was performed on 563 women aged between 35 and 69 years with histopathologically confirmed BC who attended 11 Mexican hospitals. RESULTS After adjusting for potential confounders, the odds of having a delay in the time (in calendar days) from the delivery of mammography results to histopathological BC diagnosis (≥ 60 days) among women with ≥ 3 biopsies were 2.99 times the odds of those who had only one biopsy (95% CI 1.35, 6.63). CONCLUSION The number of biopsies should be considered as a predictor of the time delay between the delivery of the mammography result and the diagnostic result.
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Affiliation(s)
- Adriana Garduño-Alanis
- School of Nursing and Obstetrics, Autonomous University of the State of Mexico, Paseo Tollocan s/n, Esquina Jesús Carranza, Col. Moderna de la Cruz, C.P. 50180, Toluca, MEX., Mexico
| | - Lizbeth Morales-González
- Research Department, Universidad de la Salud del Estado de México, Vialidad Toluca Atlacomulco 1946, Col. La Aviación, C.P. 50295, Toluca, MEX., Mexico
| | - Angélica Ángeles-Llerenas
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - José Zaim Delgado-Ramírez
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Carolina Ortega-Olvera
- School of Nursing and Nutrition, Autonomous University of San Luis Potosi, Av. Niño Artillero #130, Zona Universitaria, C.P. 78240, San Luis Potosí, Mexico
| | - Gabriela Torres-Mejía
- Center for Population Health Research, Instituto Nacional de Salud Pública, Mexico City, Mexico.
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Huerta-Gutierrez R, Murillo-Zamora E, Ángeles-Llerenas A, Ortega-Olvera C, Torres-Mejía G. Patient and treatment delays among Mexican women with breast cancer before and after the Seguro Popular. Salud Publica Mex 2021; 64:87-95. [DOI: 10.21149/12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/21/2021] [Indexed: 11/06/2022] Open
Abstract
Objective. To assess whether the Catastrophic Health Expenditures Fund (FPGC, Spanish acronym) was associated with delays in seeking medical care and in starting treatment. Materials and methods. We conducted a before and after cross-sectional study. We included 266 women with breast cancer (BC) diagnosis treated during the last three years before the hospitals received the FPGC and 309 women treated in the following three years after the fund was received by the accredited hospitals. Results. After adjusting for potential confounders, we found no association between the FPGC and delay in seeking medical care or between the FPGC and the treatment delay. Conclusions. The FPGC initiative reduced neither the delay in seeking breast cancer medical care for breast cancer nor the treatment delay.
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Vázquez-Salas A, Hubert C, Villalobos A, Sánchez-Ferrer J, Ortega-Olvera C, Romero M, Barrientos-Gutiérrez T. [Factors associated with early childhooddevelopment in mexican children]. Salud Publica Mex 2021; 62:714-724. [PMID: 33620968 DOI: 10.21149/11869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/25/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To estimate levels of early childhood develop-ment (ECD) and associated factors in Mexican population aged 19-59 months. MATERIALS AND METHODS The Ensanut 2018-19 evaluated ECD using the Early Childhood Development Index (ECDI) and level of language develop-ment. We used multivariate models, with logistic or linear regression, depending on the outcome variable. RESULTS Children of wealthier households and with children's books at home are more likely of having an adequate ECDI; in contrast, children who experienced violent discipline methods are less likely. Children living in rural areas, with more highly educated mothers, who were not undernourished, and with support for learning have higher language scores. CONCLUSIONS Public policies aimed to enhance early childhood development should take into account the associated modifiable factors.
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Affiliation(s)
- Argelia Vázquez-Salas
- Conacyt, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Celia Hubert
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Ciudad de México, México
| | - Aremis Villalobos
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Ciudad de México, México
| | - José Sánchez-Ferrer
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Ciudad de México, México
| | - Carolina Ortega-Olvera
- Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí. San Luis Potosí, México
| | - Martín Romero
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Ciudad de México, México
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Ortega-Olvera C, Ulloa-Aguirre A, Ángeles-Llerenas A, Mainero-Ratchelous FE, González-Acevedo CE, Hernández-Blanco MDL, Ziv E, Avilés-Santa L, Pérez-Rodríguez E, Torres-Mejía G. Thyroid hormones and breast cancer association according to menopausal status and body mass index. Breast Cancer Res 2018; 20:94. [PMID: 30092822 PMCID: PMC6085630 DOI: 10.1186/s13058-018-1017-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/10/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Thyroxine (T4) has been positively associated with tumor cell proliferation, while the effect of triiodothyronine (T3) on cell proliferation has not been well-established because it differs according to the type of cell line used. In Mexico, it has been reported that 14.5% of adult women have some type of thyroid dysfunction and abnormalities in thyroid function tests have been observed in a variety of non-thyroidal illnesses, including breast cancer (BC). These abnormalities might change with body mass index (BMI) because thyroid hormones are involved in the regulation of various metabolic pathways and probably by menopausal status because obesity has been negatively associated with BC in premenopausal women and has been positively associated with BC in postmenopausal women. METHODS To assess the association between serum thyroid hormone concentration (T4 and T3) and BC and the influence of obesity as an effect modifier of this relationship in premenopausal and postmenopausal women, we measured serum thyroid hormone and thyroid antibody levels in 682 patients with incident breast cancer (cases) and 731 controls, who participated in a population-based case-control study performed from 2004 to 2007 in three states of Mexico. We tested the association of total T4 (TT4) and total T3 (TT3) stratifying by menopausal status and body mass index (BMI), and adjusted for other health and demographic risk factors using logistic regressions models. RESULTS Higher serum total T4 (TT4) concentrations were associated with BC in both premenopausal (odds ratio (OR) per standard deviation = 5.98, 95% CI 3.01-11.90) and postmenopausal women (OR per standard deviation = 2.81, 95% CI 2.17-3.65). In premenopausal women, the effect of TT4 decreased as BMI increased while the opposite was observed in postmenopausal women. The significance of the effect modification was marginal (p = 0.059) in postmenopausal women and was not significant in premenopausal women (p = 0.22). Lower TT3 concentrations were associated with BC in both premenopausal and postmenopausal women and no effect modification was observed. CONCLUSIONS There is a strong association between BC and serum concentrations of TT3 and TT4; this needs to be further investigated to understand why it happens and how important it is to consider these alterations in treatment.
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Affiliation(s)
- Carolina Ortega-Olvera
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición, Niño Artillero #130, Zona Universitaria, C.P. 78240 San Luis Potosí, S.L.P. México
| | - Alfredo Ulloa-Aguirre
- Red de Apoyo a la Investigación, Universidad Nacional Autónoma de México-Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, calle Vasco de Quiroga No. 15, Col. Belisario Domínguez Sección XVI, Del. Tlalpan, C.P. 14080 Ciudad de México, México
| | - Angélica Ángeles-Llerenas
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655, Col. Santa María Ahuacatitlán, Cuernavaca, C.P. 62100 Morelos México
| | - Fernando Enrique Mainero-Ratchelous
- Hospital de Ginecología y Obstetricia No. 4 Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Avenida Río Magdalena No. 289, Col. Tizapán, San Angel, Ciudad de México, C.P. 01090 México
| | - Claudia Elena González-Acevedo
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición, Niño Artillero #130, Zona Universitaria, C.P. 78240 San Luis Potosí, S.L.P. México
| | - Ma. de Lourdes Hernández-Blanco
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición, Niño Artillero #130, Zona Universitaria, C.P. 78240 San Luis Potosí, S.L.P. México
| | - Elad Ziv
- Department of Medicine, Division of General Internal Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1450 3rd St, San Francisco, CA 94143 USA
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1450 3rd St, San Francisco, CA 94143 USA
| | - Larissa Avilés-Santa
- National Heart, Lung, and Blood Institute at the National Institutes of Health, 6701 Rockledge, Room 10188, Bethesda, MD 20892 USA
| | - Edelmiro Pérez-Rodríguez
- Hospital Universitario “Dr José Eleuterio González”. Madero y Dr. Aguirre Pequeño, Col. Mitras, C.P. 64460 Monterrey, N.L. México
| | - Gabriela Torres-Mejía
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655, Col. Santa María Ahuacatitlán, Cuernavaca, C.P. 62100 Morelos México
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Avenida Universidad 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos México
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Cruz-Jiménez L, Torres-Mejía G, Mohar-Betancourt A, Campero L, Ángeles-Llerenas A, Ortega-Olvera C, Martínez-Matsushita L, Reynoso-Noverón N, Duggan C, Anderson BO. Factors associated with ever use of mammography in a limited resource setting. A mixed methods study. Int J Qual Health Care 2018; 30:520-529. [PMID: 29648641 DOI: 10.1093/intqhc/mzy053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 03/01/2018] [Indexed: 12/31/2022] Open
Abstract
Objective To evaluate facilitators and barriers influencing mammography screening participation among women. Design Mixed methods study. Setting Three hospital catchment areas in Hidalgo, Mexico. Participants Four hundred and fifty-five women aged 40-69 years. Intervention Three hundred and eighty women completed a survey about knowledge, beliefs and perceptions about breast cancer screening, and 75 women participated in semi-structured, in-person interviews. Survey data were analyzed using logistic regression; semi-structured interviews were transcribed and analyzed using elements of the grounded theory method. Main Outcome Measure Women were categorized as never having had mammography or having had at least one mammogram in the past. Results From survey data, having had a Pap in the past year was associated with ever having had breast screening (odds ratio = 2.15; 95% confidence interval 1.30-3.54). Compared with never-screened women, ever-screened women had better knowledge of Mexican recommendations for the frequency of mammography screening (49.5% vs 31.7% P < 0.001). A higher percentage of never-screened women perceived that a mammography was a painful procedure (44.5% vs 33.8%; P < 0.001) and feared receiving bad news (38.4% vs 22.2%; P < 0.001) compared with ever-screened women. Women who participated in semi-structured, in-person interviews expressed a lack of knowledge about Mexican standard mammographic screening recommendations for age for starting mammography and its recommended frequency. Women insured under the 'Opportunities' health insurance program said that they are referred to receive Pap tests and mammography. Conclusions Local strategies to reduce mammogram-related pain and fear of bad news should work in tandem with national programs to increase access to screening.
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Affiliation(s)
- L Cruz-Jiménez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - G Torres-Mejía
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - A Mohar-Betancourt
- Unidad de Epidemiología, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - L Campero
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - A Ángeles-Llerenas
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - C Ortega-Olvera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - L Martínez-Matsushita
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - N Reynoso-Noverón
- Unidad de Epidemiología, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - C Duggan
- The Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Public Health Sciences, Fred Hutchinson Cancer Research Center, WA, USA
| | - B O Anderson
- The Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Public Health Sciences, Fred Hutchinson Cancer Research Center, WA, USA
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Sánchez-Zamorano LM, Flores-Luna L, Angeles-Llerenas A, Ortega-Olvera C, Lazcano-Ponce E, Romieu I, Mainero-Ratchelous F, Torres-Mejía G. The Western dietary pattern is associated with increased serum concentrations of free estradiol in postmenopausal women: implications for breast cancer prevention. Nutr Res 2016; 36:845-54. [PMID: 27440539 DOI: 10.1016/j.nutres.2016.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 11/25/2022]
Abstract
Little is known about the possible influence of food consumption on the serum concentrations of endogenous sex hormones in postmenopausal women. We evaluated the relationships of the Western dietary pattern with serum concentrations of free estradiol and testosterone of postmenopausal women to test the hypothesis that a highly Western dietary pattern is associated with high serum concentrations of these hormones. We used data from a representative subsample of 305 women from the control group of a population-based case-control study conducted in Mexico from 2004 to 2007. A Western dietary pattern index value was compared with log natural serum concentrations of testosterone and estradiol using multiple linear regression models. The median values of serum concentrations of free estradiol and testosterone were 0.26 pg/mL (interquartile range, 0.14-0.43) and 0.40 pg/mL (interquartile range, 0.30-0.70), respectively. A multiple linear regression model showed that for each unit increase in the Western dietary pattern index, there was a 16.2% increase in the serum concentrations of free estradiol (β=0.15; 95% confidence interval [CI], 0.01-0.29); for each additional serving per week of chicken eggs, the increase was 31.0% (β=0.27; 95% CI, 0.106-0.441); for each additional serving per week of red meat, the increase was 64.9% (β=0.50; 95% CI, 0.01-1.01). There was no relationship found between dietary patterns and serum concentrations of free testosterone. The present findings suggest that intake of a Western diet, particularly of chicken eggs and meat, increases serum concentrations of free estradiol; these results have implications for breast cancer prevention.
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Affiliation(s)
- Luisa María Sánchez-Zamorano
- Population Health Research Center, National Institute of Public Health, Cuernavaca, Mor, Mexico, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán CP 62100
| | - Lourdes Flores-Luna
- Population Health Research Center, National Institute of Public Health, Cuernavaca, Mor, Mexico, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán CP 62100
| | - Angélica Angeles-Llerenas
- Population Health Research Center, National Institute of Public Health, Cuernavaca, Mor, Mexico, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán CP 62100
| | - Carolina Ortega-Olvera
- Population Health Research Center, National Institute of Public Health, Cuernavaca, Mor, Mexico, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán CP 62100
| | - Eduardo Lazcano-Ponce
- Population Health Research Center, National Institute of Public Health, Cuernavaca, Mor, Mexico, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán CP 62100
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas 69372, Lyon, Cedex, 08, France
| | - Fernando Mainero-Ratchelous
- Mexican Institute of Social Security, Dr. Luis Castelazo Ayala Hospital for Gynecology and Obstetrics # 4, Mexico City, Mexico
| | - Gabriela Torres-Mejía
- Population Health Research Center, National Institute of Public Health, Cuernavaca, Mor, Mexico, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán CP 62100.
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Torres-Mejía G, Smith RA, Carranza-Flores MDLL, Bogart A, Martínez-Matsushita L, Miglioretti DL, Kerlikowske K, Ortega-Olvera C, Montemayor-Varela E, Angeles-Llerenas A, Bautista-Arredondo S, Sánchez-González G, Martínez-Montañez OG, Uscanga-Sánchez SR, Lazcano-Ponce E, Hernández-Ávila M. Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists. BMC Cancer 2015; 15:410. [PMID: 25975383 PMCID: PMC4436872 DOI: 10.1186/s12885-015-1399-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries. METHODS We evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed. RESULTS Radiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms. CONCLUSIONS Given the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography.
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Affiliation(s)
- Gabriela Torres-Mejía
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
| | - Robert A Smith
- American Cancer Society, 250 Williams St., Atlanta, GA, 30303, USA.
| | - María de la Luz Carranza-Flores
- Centro de Diagnóstico Digital México-España, Secretaria de Salud Pública del Distrito Federal, Mariano Escobedo No. 148 col. Anáhuac, Ciudad de México D. F., 11320, Mexico.
| | - Andy Bogart
- Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave #1600, Seattle, WA, 98101, USA.
| | - Louis Martínez-Matsushita
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
| | - Diana L Miglioretti
- Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave #1600, Seattle, WA, 98101, USA.
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, 1 Shields Ave, Davis, CA, 95616, USA.
| | - Karla Kerlikowske
- Department of Epidemiology and Biostatistics and the General Internal Medicine Section, University of California, 4150 Clement St, San Francisco, CA, 94121, USA.
- Department of Veterans Affairs, University of California, 4150 Clement St, San Francisco, CA, 94121, USA.
| | - Carolina Ortega-Olvera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
| | - Ernesto Montemayor-Varela
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
| | - Angélica Angeles-Llerenas
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
| | - Sergio Bautista-Arredondo
- Dirección de Economía de la Salud, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, CP. 62100, Cuernavaca, Morelos, Mexico.
| | - Gilberto Sánchez-González
- Dirección de Economía de la Salud, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, CP. 62100, Cuernavaca, Morelos, Mexico.
| | - Olga G Martínez-Montañez
- Hospital de Oncología, Centro Médico Siglo XXI, Instituto Mexicano del Seguro Social, Av. Cuauhtémoc 330, Cuauhtemoc Doctores, Ciudad de México, D.F. 06720, Mexico.
| | - Santos R Uscanga-Sánchez
- Federación Mexicana de Colegios de Ginecología y Obstetricia, Nueva York 38, Col. Nápoles, Benito Juárez, Ciudad de México, D.F. 03810, Mexico.
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
| | - Mauricio Hernández-Ávila
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, 62100, , Morelos, Mexico.
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8
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Torres-Mejía G, Royer R, Llacuachaqui M, Akbari MR, Giuliano AR, Martínez-Matsushita L, Angeles-Llerenas A, Ortega-Olvera C, Ziv E, Lazcano-Ponce E, Phelan CM, Narod SA. Recurrent BRCA1 and BRCA2 mutations in Mexican women with breast cancer. Cancer Epidemiol Biomarkers Prev 2015; 24:498-505. [PMID: 25371446 PMCID: PMC4495576 DOI: 10.1158/1055-9965.epi-13-0980] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Germline mutations in the BRCA1 and BRCA2 genes confer an estimated 58% to 80% lifetime risk of breast cancer. In general, screening is done for cancer patients if a relative has been diagnosed with breast or ovarian cancer. There are few data on the prevalence of mutations in these genes in Mexican women with breast cancer and this hampers efforts to develop screening policies in Mexico. METHODS We screened 810 unselected women with breast cancer from three cities in Mexico (Mexico City, Veracruz, and Monterrey) for mutations in BRCA1 and BRCA2, including a panel of 26 previously reported mutations. RESULTS Thirty-five mutations were identified in 34 women (4.3% of total) including 20 BRCA1 mutations and 15 BRCA2 mutations. Twenty-two of the 35 mutations were recurrent mutations (62.8%). Only five of the 34 mutation carriers had a first-degree relative with breast cancer (three with BRCA1 and two with BRCA2 mutations). CONCLUSION These results support the rationale for a strategy of screening for recurrent mutations in all women with breast cancer in Mexico, as opposed to restricting screening to those with a sister or mother with breast or ovarian cancer. IMPACT These results will impact cancer genetic testing in Mexico and the identification of at-risk individuals who will benefit from increased surveillance. Cancer Epidemiol Biomarkers Prev; 24(3); 498-505. ©2014 AACR.
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Affiliation(s)
- Gabriela Torres-Mejía
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, México
| | - Robert Royer
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Marcia Llacuachaqui
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mohammad R Akbari
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida. Department of Cancer Epidemiology, Population Sciences Division, Moffitt Cancer Center, Tampa, Florida
| | - Louis Martínez-Matsushita
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, México
| | - Angélica Angeles-Llerenas
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, México
| | - Carolina Ortega-Olvera
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, México
| | - Elad Ziv
- Division of General Internal Medicine, Department of Medicine, Institute for Human Genetics; Helen Diller Family Comprehensive Cancer Center; Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Eduardo Lazcano-Ponce
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, México
| | - Catherine M Phelan
- Department of Cancer Epidemiology, Population Sciences Division, Moffitt Cancer Center, Tampa, Florida.
| | - Steven A Narod
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
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Torres-Mejía G, Ortega-Olvera C, Martínez-Matsushita L, Lazcano-Ponce E, Ziv E, Angeles-Llerenas A. Response to comment on: Torres-Mejia et al. Moderate-intensity physical activity ameliorates the breast cancer risk in diabetic women. Diabetes Care 2012;35:2500-2502. Diabetes Care 2013; 36:e210. [PMID: 24265379 PMCID: PMC3836118 DOI: 10.2337/dc13-1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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10
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Amadou A, Fabre A, Torres-Mejía G, Ortega-Olvera C, Angeles-Llerenas A, McKenzie F, Biessy C, Hainaut P, Romieu I. Hormonal therapy and risk of breast cancer in mexican women. PLoS One 2013; 8:e79695. [PMID: 24260282 PMCID: PMC3829873 DOI: 10.1371/journal.pone.0079695] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/04/2013] [Indexed: 11/19/2022] Open
Abstract
The use of hormonal therapies, including hormonal contraceptives (HC) and postmenopausal hormone replacement therapy (HRT) have been shown to influence breast cancer (BC) risk. However, the variations of these effects among populations and ethnic groups are not completely documented, especially among Hispanic women. We evaluated the association between HC and premenopausal BC risk, and between HRT and postmenopausal BC risk in Mexican women. Data from a Mexican multi-center population-based case–control study ofwomen aged 35 to 69 years were analysed. A total of 1000 cases and 1074 matched controls were recruited between 2004 and 2007. Information on hormonal therapy was collected through a structured questionnaire. Results were analysed using conditional logistic regression models. Overall, HC were used by 422/891 (47.3%) premenopausal women and HRT was used by 220/1117 (19.7%) postmenopausal women. For HC, odds ratios (ORs) for BC were 1.11 (95% confidence interval (CI): 0.82, 1.49) for current users and 1.68 (95% CI: 0.67, 4.21) for ever-users. No clear effect of duration of use was observed. For HRT, the OR for BC was significantly increased in ever users (OR: 1.45; 95% CI: 1.01, 2.08). A non-significant increased risk was observed for combined estrogen/progestin, (OR = 1.85; 95% CI: 0.84, 4.07) whereas no effect was observed for the use of estrogen alone (OR = 1.14; 95% CI: 0.68, 1.91). Our results indicate that, HC had a non-significant effect on the risk of pre-menopausal BC, but suggested that injected contraceptives may slightly increase the risk, whereas HRT had a significant effect on post-menopausal BC in this population. This study provides new information about the effects of HC and HRT on BC risk in a Mexican population, which may be of relevance for the population of Latin America as a whole.
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Affiliation(s)
- Amina Amadou
- Nutrition and Metabolism Section/Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Alban Fabre
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Nutrition, Hormones and Women’s Health Institute Gustave Roussy, INSERM U1018, Paris, France
| | | | | | | | - Fiona McKenzie
- Nutrition and Metabolism Section/Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Section/Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Pierre Hainaut
- International Prevention Research Institute, Lyon, France
| | - Isabelle Romieu
- Nutrition and Metabolism Section/Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- * E-mail:
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11
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Torres-Mejía G, Ortega-Olvera C, Ángeles-Llerenas A. Patrones de utilización de programas de prevención y diagnóstico temprano de cáncer en la mujer. ACTA ACUST UNITED AC 2013. [DOI: 10.21149/spm.v55s2.5121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objetivo. Estimar los patrones de utilización de los programas preventivos de cáncer en la mujer durante el periodo 2000-2012 en mujeres mexicanas que participaron en tres encuestas nacionales. Material y métodos. Se analizó información de la ENSA 2000 y de las ENSANUT 2006 y 2012 que son representativas de la población del país. Se obtuvieron prevalencias y se aplicaron pruebas de tendencia y regresión de Poisson para determinar las posibilidades de tener una mayor cobertura. Resultados. La cobertura de uso de Papanicolaou en los últimos 12 meses en 2012 fue de 45.5%, de prueba de VPH en los últimos cuatro años fue de 11.9% y de mastografía en los últimos dos años fue de 29.4 y de 17.2% en mujeres de 50 a 69 años y de 40 a 49 años, respectivamente. Conclusiones. Aunque se observa un incremento en la cobertura de los programas de detección se debe impulsar la calidad de los servicios y la cobertura universal.
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Torres-Mejía G, Ortega-Olvera C, Ángeles-Llerenas A, Villalobos-Hernández AL, Salmerón-Castro J, Lazcano-Ponce E, Hernández-Ávila M. [Utilization patterns of prevention and early diagnosis for cancer in women]. Salud Publica Mex 2013; 55 Suppl 2:S241-S248. [PMID: 24626701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 02/08/2013] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To estimate the utilization patterns of cancer prevention programs in women during the period 2000-2012 in Mexican women who participated in three national surveys. MATERIALS AND METHODS We analyzed data from the ENSA 2000, ENSANUT 2006 and ENSANUT 2012 that are representative of the Mexican population. Prevalences were obtained, trend tests and Poisson regression were used to determine the possibility of having more coverage. RESULTS The coverage of Papanicolaou use in the last 12 months in 2012 was 45.5%, HPV testing in the last four years was 11.9% and mammography use in the past two years was 29.4% and 17.2% in women aged 50-69 years and 40-49 years, respectively. CONCLUSIONS Although there was an increase in the coverage of screening programs, there should be a boost in the service quality and universal coverage.
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Affiliation(s)
- Gabriela Torres-Mejía
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Carolina Ortega-Olvera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Angélica Ángeles-Llerenas
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | | | | | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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13
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Torres-Mejía G, Angeles-Llerenas A, Ortega-Olvera C, Lazcano-Ponce E, Ziv E, Pulido-Rodríguez J, García-Solis MDJ, Murillo-Zamora E, Vázquez-Lara J, Romieu I. Moderate-intensity physical activity ameliorates the breast cancer risk in diabetic women. Diabetes Care 2012; 35:2500-2. [PMID: 23033240 PMCID: PMC3507612 DOI: 10.2337/dc11-2362] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the association between self-reported diabetes and the risk of breast cancer (BC) and its interaction with moderate-intensity physical activity in pre- and postmenopausal Mexican women. RESEARCH DESIGN AND METHODS A population-based case-control study was conducted using 1,000 incident case subjects and 1,074 control subjects. Blood samples and information on health, diet, physical activity, and anthropometric measurements were obtained. RESULTS The association between diabetes and BC risk decreased with increasing tertiles of moderate-intensity physical activity (odds ratio [OR] = 4.9 [95% CI 2.3-10.8]; 3.0 [1.3-6.9]; and 1.0 [0.1-9.2], respectively, for each tertile) (test for interaction = 0.04). Compared with the women in the lowest tertiles, increased risk was observed in those premenopausal women with the highest serum C-peptide, IGF-1, and IGF-1 binding protein 3 levels. CONCLUSIONS Moderate-intensity physical activity can substantially ameliorate the increased BC risk in diabetic women.
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Affiliation(s)
- Gabriela Torres-Mejía
- Institute of Public Health, Center for Population Health Research, Cuernavaca, Morelos, Mexico
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Chajès V, Torres-Mejía G, Biessy C, Ortega-Olvera C, Angeles-Llerenas A, Ferrari P, Lazcano-Ponce E, Romieu I. ω-3 and ω-6 Polyunsaturated fatty acid intakes and the risk of breast cancer in Mexican women: impact of obesity status. Cancer Epidemiol Biomarkers Prev 2011; 21:319-26. [PMID: 22194528 DOI: 10.1158/1055-9965.epi-11-0896] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND ω-3 polyunsaturated fatty acids (PUFA) could play a protective role on the risk of breast cancer; however, little is known about this relation among Mexican women. We evaluated the association between ω-3 and ω-6 PUFA intake and breast cancer risk by obesity status in Mexican women. METHODS A population-based case-control study was conducted in Mexico, including 1,000 incident breast cancer cases and 1,074 controls matched to cases by age, health care system, and region. Women provided information on health and diet by in-person interview. Body mass index (BMI) measures were used to define overall obesity. Obesity status was categorized as normal weight (18.5 < BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). A conditional logistic regression model was used to assess the association between PUFA and breast cancer risk. RESULTS Overall, there was no significant association between ω-3 PUFA intake and breast cancer risk (P = 0.31). An increased risk of breast cancer was associated with increasing ω-6 PUFA intake in premenopausal women [OR = 1.92, 95% confidence interval (CI) = 1.13-3.26; P = 0.04]. A decreased risk of breast cancer was significantly associated with increasing ω-3 PUFA intake in obese women (OR = 0.58, 95% CI = 0.39-0.87; P = 0.008) but not in normal weight nor in overweight women (P(heterogeneity) = 0.017). CONCLUSIONS Obesity status may affect the association between ω-3 PUFA intake and breast cancer risk. The underlying mechanisms may be related to decreased inflammation and improved adipokin and estrogen levels induced by ω-3 PUFA in adipose tissue in obese women. IMPACT Increased intake of ω-3 PUFA should be recommended among Mexican women in particular in obese women.
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Affiliation(s)
- Véronique Chajès
- Nutrition and Metabolism, International Agency for Research on Cancer, 150, cours Albert Thomas, 69372 Lyon cedex 08, France
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Torres-Mejía G, Ángeles-Llerenas A, Ortega-Olvera C, Lazcano-Ponce E, Romieu I. Abstract P6-09-05: Insulin Resistance, Diabetes Mellitus and Breast Cancer Risk in Pre-and Postmenopausal Women: Modification Effect by Moderate Physical Activity. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p6-09-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
It has been hypothesized that diabetes may influence the risk of breast cancer (BC) by impaired regulation of the insulin and insulin-like growth factors (IGF) pathways. Current evidence supports a reduction in BC risk by doing regular physical activity due, in part, by reducing insulin resistance and improving glucose control. Material and Methods
A population based case control study was conducted to evaluate the association between insulin resistance and diabetes mellitus on the risk of BC in Mexican women. A total of 1000 incident cases and 1074 matched controls to cases by five years of age, site and health institution were analyzed. Women provided information on health, diet and physical activity by means of a face to face interview; information about the family history of diabetes mellitus and whether or not women were diagnosed with this disease. Anthropometric measurements and blood samples were obtained from all women. A conditional logistic regression model was used to assess this association. Results
In postmenopausal women, there was an interaction between physical activity and diabetes mellitus on the risk of BC. The effect of diabetes mellitus type 2 decreased with increasing moderate physical activity (OR = 3.67, 95% CI 1.78 — 7.58; OR = 2.86, 95% CI 1.37 — 5.96; OR = 0.82, 95% CI 0.19 — 3.59, by increasing tertiles of daily hours of moderate physical activity respectively); in premenopausal women, this association was not statistically significant (OR = 1.55, 95% CI 0.86-2.79), however in a subsample of premenopausal women, an increase was observed in the risk of BC per unit change in the increase of C-peptide, an indirect marker of insulin resistance (OR = 1.98, 95% CI 1.41 - 2.76). Discussion
The results of this study are consistent with numerous mechanisms linking physical activity directly to reduce BC risk probably, in part, through reducing insulin resistance and improving glucose control.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-09-05.
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Affiliation(s)
- G Torres-Mejía
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; International Agency for Research on Cancer, Lyon, France
| | - A Ángeles-Llerenas
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; International Agency for Research on Cancer, Lyon, France
| | - C Ortega-Olvera
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; International Agency for Research on Cancer, Lyon, France
| | - E Lazcano-Ponce
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; International Agency for Research on Cancer, Lyon, France
| | - I. Romieu
- Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; International Agency for Research on Cancer, Lyon, France
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Beasley JM, Coronado GD, Livaudais J, Angeles-Llerenas A, Ortega-Olvera C, Romieu I, Lazcano-Ponce E, Torres-Mejía G. Alcohol and risk of breast cancer in Mexican women. Cancer Causes Control 2010; 21:863-70. [PMID: 20155314 DOI: 10.1007/s10552-010-9513-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 01/15/2010] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is known about the relationship between alcohol intake and breast cancer risk among Mexican women. This association may be modified by folate and Vitamin B12. METHODS A population-based case-control study conducted in Mexico recruited 1,000 incident breast cancer cases aged 35-69 and 1,074 controls matched on age, region, and health care system. In-person interviews were conducted to assess breast cancer risk factors and recent diet using a food frequency questionnaire. Conditional logistic regression models estimated adjusted odds ratios and 95% confidence intervals. RESULTS Over one-half (57%) of cases and less than one-half of controls (45%) reported any lifetime alcohol consumption. Compared with never drinkers, women reporting ever drinking (Adjusted OR = 1.25, 95% CI = 0.99-1.58) had a greater odds of breast cancer. There was evidence for interaction in the association between ever consuming any alcohol and breast cancer by folate (p for interaction = 0.04) suggesting women with lower folate intake had a higher odds of breast cancer (Adjusted OR = 1.99, 95% CI = 1.26-3.16) compared to women with higher folate intake (OR = 1.12, 95% CI = 0.69-1.83). CONCLUSIONS Our findings support evidence that any alcohol intake increases risk of breast cancer. Insufficient intake of folate may further elevate risk for developing breast cancer among women who consume alcohol.
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Affiliation(s)
- Jeannette M Beasley
- Group Health Research Institute, 1730 Minor Avenue Suite 1600, Seattle, WA, 98101, USA.
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Ángeles-Llerenas A, Ortega-Olvera C, Pérez-Rodríguez E, Esparza-Cano JP, Lazcano-Ponce E, Romieu I, Torres-Mejía G. Moderate physical activity and breast cancer risk: the effect of menopausal status. Cancer Causes Control 2010; 21:577-86. [DOI: 10.1007/s10552-009-9487-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Accepted: 12/05/2009] [Indexed: 11/28/2022]
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