Association of risk factors and breast cancer among women treated at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a case-control study

Dietary factors associated with breast cancer among women in Ethiopia: a systematic review and meta-analysis of case-control studies

Background

Diet is the primary and largely modifiable factor associated with breast cancer risk. However, inconsistent findings were evidenced in many epidemiological studies and resulted in a lack of conclusiveness. Therefore, this systematic review and meta-analysis aimed to explore dietary risk factors that may predict breast cancer among Ethiopian women.

Design data source and eligibility criteria

A systematic review and meta-analysis was carried out. The articles were retrieved through electronic databases searching, including PubMed/Medline, Web of Science, Science Direct, EMBASE and Google Scholar. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was applied for the critical appraisal. All case-control studies conducted in Ethiopia and reporting dietary factors of breast cancer in women were included in the final analysis.

Data extraction

Two independent reviewers extracted the data using a standardized data extraction format in Excel software. Stata version 17 software was used for the data analysis. Cochran's Q statistic with inverse variance (I2) was used to assess the presence of heterogeneity. A random effect model was used to estimate the odds ratio with a 95% confidence interval.

Results

Overall, eight eligible articles with 2,774 women were included to explore the dietary predictors of breast cancer in Ethiopia. As a result, alcohol consumption (OR: 1.26, 95% CI: 1.01, 1.57), packed food intake (OR: 6.83; 95% CI: 4.56, 10.24), saturated fat/oil intake (OR: 1.51; 95% CI: 1.13, 2.02), meat consumption (OR: 6.08, 95% CI: 3.62, 10.22), and vegetable consumption (OR: 0.75, 95% CI: 0.49, 0.89) were identified as significant predictors of breast cancer among women in Ethiopia.

Conclusion

The current study revealed a significant relationship between dietary factors and breast cancer. Avoiding the consumption of alcohol, saturated fats/oils, packed foods, and meat, coupled with promotion of vegetable consumption, could substantially contribute to reduce the burden of breast cancer among women in Ethiopia. Therefore, policymakers and other concerned bodies should provide routine community-based nutrition education to raise public awareness about the contribution of women's dietary practices on their breast cancer risk.

Breast cancer and its determinants in Ethiopia: a systematic review and meta-analysis

OBJECTIVES

Breast cancer is the leading cause of cancer morbidity and mortality among women. Still, there is a paucity of studies to know the magnitude of the problem in Ethiopia. Hence, this review was intended to pool the prevalence and identify the determinants of breast cancer in Ethiopia.

DESIGN

A systematic review and meta-analysis was conducted.

DATA SOURCES

Databases like PubMed/MEDLINE, HINARI, Science Direct, and Google Scholar, as well as websites of organisationsI organizations,rewere searched between 25 February and 6 March 2023.

ELIGIBILITY CRITERIA

All observational studies in Ethiopia that reported either the magnitude and/or determinants of breast cancer regardless of publication status were included.

DATA EXTRACTION AND SYNTHESIS

Two authors independently assessed and extracted the data. The Joanna Briggs Institute meta-analysis of statistics assessment and review instrument quality appraisal tool was used to assess the quality of the articles. Effect estimates were done by using the random-effects model. The meta-analysis results were displayed by using forest plots.

RESULTS

Seventeen articles were reviewed with 24 435 total participants. The pooled proportion of breast cancer morbidity among patients with cancer was 20. 58% (95% CI 17.25%, 23.90%) in Ethiopia. Consuming packed foods (POR=2.12, 95% CI 1.41, 3.17), presence of high cholesterol (POR=4.08; 95% CI 2.75, 6.07), physical inactivity (POR=3.27; 95% CI 1.80, 5.94), high body mass index (BMI) (POR=2.27; 95% CI 0.85, 6.03), postmenopause (POR=2.25; 95% CI 1.63, 3.10), family history of cancer (POR=3.65; 95% CI 0.85, 15.71) and lack of breastfeeding (POR=2.76; 95% CI 0.90, 7.92) were the determinants of breast cancer.

CONCLUSIONS

One of five patients with cancer is diagnosed with breast cancer in Ethiopia. Furthermore, more than a quarter of women with cancer suffer from breast cancer. Processed food consumption, high cholesterol in the body, lack of physical activity, high BMI, postmenopause, family history of cancer and lack of breastfeeding were the risk factors for breast cancer. The use of healthy food sources such as fruits and vegetables, and homegrown varieties of crops rather than seeking processed foods would help.

PROSPERO REGISTRATION NUMBER

CRD42023417733.

Physical activities and breast cancer: a Mendelian randomization study

Introduction

Previous research suggests a potential association between physical activity (PA) and breast cancer (BC), but the causal relationship remains uncertain. The aim of this study was to explore the causal relationship between PA and BC through Mendelian randomization (MR) analysis.

Material and methods

Genome-wide association studies utilizing data from the UK Biobank baseline were employed to analyze PA phenotypes, encompassing 460,376 participants. Summary data for BC, comprising 122,977 cases and 105,974 controls, were obtained from the BC Association Consortium. The cases were further categorized based on estrogen receptor status into estrogen receptor-positive breast cancer (ER+ BC) and estrogen receptor-negative breast cancer (ER- BC). The inverse variance weighted method was employed as the primary approach for two-sample MR. Additionally, the MR-PRESSO (MR-Pleiotropy RESidual Sum and Outlier) method was utilized to eliminate outliers. Tests for heterogeneity and pleiotropy were conducted to enhance result accuracy. Furthermore, multivariable Mendelian randomization was performed, adjusting for potential confounders to ensure result stability.

Results

MR analysis was employed to assess the causal link between PA and BC. Two-sample MR analysis revealed a genetic prediction indicating that walking for pleasure was associated with decreased risk of ER+ BC (odds ratio (OR) = 0.302, 95% CI = 0.105-0.872, p = 0.027), while other physical activities were not significantly correlated with BC, ER+ BC and ER- BC. These findings remained reliable and consistent in the sensitivity analysis, including Cochran's Q and MR-Egger regression. Furthermore, reverse MR analysis suggested that BC did not exert a notable impact on PA.

Conclusions

Our findings suggest that engaging in leisure walking is associated with a reduced risk of ER+ BC. Nevertheless, additional research is warranted to comprehensively elucidate the underlying mechanisms and strengthen the causal relationship.

Determinants of breast cancer among women attending oncology units in selected health facilities of Hawassa City, Sidama Region, Southern Ethiopia, 2023: case-control study

Background

The incidence of breast cancer (BC) is rampantly increasing in developing countries particularly Ethiopia. Unfortunately, the morbidity and mortality rates are sharply increasing, and because of this, families are suffering from socioeconomic crises. Despite this, there is limited evidence on the determinants of breast cancer in Ethiopia as well as in the study area.

Objective

To identify the determinants of BC among women attending oncology units in selected hospitals in Hawassa City, Ethiopia, in 2023.

Method

A hospital-based, case-control study with 300 patients (75 cases and 225 controls) was carried out in Hawassa from June to July 2023. A simple random sampling technique was used to select cases and controls. Data were collected via pretested and structured digitally installed questionnaires with Kobo collection/smartphones. The data were exported from the server to SPSS version 27 for analysis. Descriptive analysis of univariate, bivariate, and multivariable logistic regression data was conducted to determine the associations between breast cancer incidence and independent factors.

Results

A total of 300 women participated in this study for a response rate of 100%. The mean ( ± SD) ages of the respondents were 37.2 ( ± 14.8) and 36.6 ( ± 15.1) years for the cases and controls, respectively. According to the multivariate logistic regression model, postmenopausal status [AOR: 2.49; 95% CI (1.18, 5.23)], family history of cancer [AOR: 2.33; 95% CI (1.12, 4.82)], oral contraceptives [AOR: 2.74; 95% CI (1.34, 5.99)], overweight and/or obesity [AOR: 2.29; 95% CI: (1.14, 4.59)], and consumption of solid oil [AOR: 2.36; 95% CI (1.20, 4.67)] were independently associated with BC risk.

Conclusion

This study revealed important risk factors for BC. Therefore, women should adopt healthier lifestyles through healthy nutrition and regular exercise to reduce the risk of developing BC. In addition, early detection and regular screening are proactive approaches for detecting BC.

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

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

Determinants of breast cancer in Ethiopia: a systematic review and meta-analysis

Background

Breast cancer (BC) is the first leading cancer sharing about 25% of the cancer burden among women globally. This study aimed to identify the determinants of BC in Ethiopia.

Methods

We comprehensively searched primary studies conducted in Ethiopia on associated factors of BC in PubMed, Cochrane Library, Hinari, Google, and Google Scholar) and available online until 2 June 2023. The necessary data were extracted from relevant studies and exported to STATA version 15 for analysis. The pooled odds ratio with its 95% confidence interval (CI) was estimated using a random effect model. The finding was reported following preferred reporting items for systematic reviews and meta-analyses guidelines.

Results

Five studies with 1,819 participants (792 cases and 1,027 controls) were included. The significant determinants of BC were age at menarche <12 years (adjusted odds ratio (AOR) = 3.36, 95% CI: 1.68-5.04), post-menopause (AOR = 2.37, 95% CI: 1.67-3.06), ever breastfeeding (AOR = 0.28, 95% CI: 0.15-0.42), and family history of cancer (AOR = 2.39, 95% CI: 1.29-3.44).

Conclusion

In Ethiopia, the significant determinants of BC among women were age at menarche <12 years, post-menopause, Ever breastfeeding, and family history of cancer. We recommend that the concerned organizations consider the aforementioned factors in addressing the problem of BC in Ethiopia by increasing community awareness, promoting breast self-examination, and developing programs to reduce the increasing burden of BC in the study setting.