1
|
Torres-Román JS, Ybaseta-Medina J, Loli-Guevara S, Bazalar-Palacios J, Valcarcel B, Arce-Huamani MA, Alvarez CS, Hurtado-Roca Y. Disparities in breast cancer mortality among Latin American women: trends and predictions for 2030. BMC Public Health 2023; 23:1449. [PMID: 37507674 PMCID: PMC10386226 DOI: 10.1186/s12889-023-16328-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Breast cancer is among the leading cause of cancer-related mortality among Latin American and Caribbean (LAC) women, but a comprehensive and updated analysis of mortality trends is lacking. The objective of this study was to determine the breast cancer mortality rates between 1997 and 2017 for LAC countries and predict mortality until 2030. METHODS We retrieved breast cancer deaths across 17 LAC countries from the World Health Organization mortality database. Age-standardized mortality rates per 100,000 women-years were estimated. Mortality trends were evaluated with Joinpoint regression analyses by country and age group (all ages, < 50 years, and ≥ 50 years). By 2030, we predict number of deaths, mortality rates, changes in population structure and size, and the risk of death from breast cancer. RESULTS Argentina, Uruguay, and Venezuela reported the highest mortality rates throughout the study period. Guatemala, El Salvador, and Nicaragua reported the largest increases (from 2.4 to 2.8% annually), whereas Argentina, Chile, and Uruguay reported downward trends (from - 1.0 to - 1.6% annually). In women < 50y, six countries presented downward trends and five countries showed increasing trends. In women ≥ 50y, three countries had decreased trends and ten showed increased trends. In 2030, increases in mortality are expected in the LAC region, mainly in Guatemala (+ 63.0%), Nicaragua (+ 47.3), El Salvador (+ 46.2%), Ecuador (+ 38.5%) and Venezuela (+ 29.9%). CONCLUSION Our findings suggest considerable differences in breast cancer mortality across LAC countries by age group. To achieve the 2030 sustainable developmental goals, LAC countries should implement public health strategies to reduce mortality by breast cancer.
Collapse
Affiliation(s)
| | - Jorge Ybaseta-Medina
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
- Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Silvana Loli-Guevara
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Bryan Valcarcel
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | - Miguel A Arce-Huamani
- Cancer Research Networking, Universidad Científica del Sur, Lima, Peru
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | | | | |
Collapse
|
2
|
Armenta-Guirado BI, González-Rocha A, Mérida-Ortega Á, López-Carrillo L, Denova-Gutiérrez E. Lifestyle Quality Indices and Female Breast Cancer Risk: A Systematic Review and Meta-Analysis. Adv Nutr 2023; 14:685-709. [PMID: 37085092 PMCID: PMC10334144 DOI: 10.1016/j.advnut.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/14/2023] [Accepted: 04/18/2023] [Indexed: 04/23/2023] Open
Abstract
Breast cancer (BC) poses an important burden of disease, which probably could be reduced by adopting healthy lifestyles like healthy body weight, healthy diet, and physical activity, among others. Many studies have reported that adherence to healthy lifestyles may decrease BC risk. The main objective of this study was to estimate a summary association of studies evaluating a healthy lifestyle index and BC risk. A systematic review and meta-analysis following the Cochrane methodology were carried out. Observational studies, including healthy lifestyle indices and their association with BC, were searched from 4 databases. For the meta-analysis, random-effects model was used to evaluate overall BC risk, BC by molecular subtype and menopausal status. Thirty-one studies were included in the systematic review, and 29 studies in the meta-analysis. When the highest vs. the lowest category to a healthy lifestyle index were compared, the study identified a 20% risk reduction for BC in prospective studies (hazard ratio [HR] 0.80 95% CI: 0.78, 0.83) and an odds ratio (OR) of 0.74 (95% CI: 0.63, 0.86) for retrospective studies. The inverse association remained statistically significant when stratified by menopausal status, except for premenopausal BC in prospective studies. Furthermore, an inverse association was found for molecular subtypes estrogen receptor (ER+)/progesterone receptor (PR+): HR = 0.68 (95%CI: 0.63, 0.73), ER+/PR-: HR = 0.78 (95% CI: 0.67, 0.90) and ER-/PR-: HR = 0.77 (95% CI: 0.64, 0.92). Most studies scored at a low risk of bias and a moderate score for the certainty of the evidence. Adherence to a healthy lifestyle reduces the risk of BC, regardless of its molecular subtypes, which should be considered a priority to generate recommendations for BC prevention at a population level. International prospective register of systematic reviews (PROSPERO) ID: CRD42021267759.
Collapse
Affiliation(s)
- Brianda I Armenta-Guirado
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico; Department of Health Sciences, University of Sonora, México
| | - Alejandra González-Rocha
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Ángel Mérida-Ortega
- Center of Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Lizbeth López-Carrillo
- Center of Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Edgar Denova-Gutiérrez
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico.
| |
Collapse
|
3
|
El Sharif N, Khatib I. Healthy Lifestyle and Breast Cancer Risk in Palestinian Women: A Case-Control Study. Nutr Cancer 2023; 75:901-911. [PMID: 36655429 DOI: 10.1080/01635581.2023.2168022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The aim of this study was to investigate the association between a combined healthy lifestyle score and the risk of breast cancer (BC) in Palestinian women. A hospital-based case-control study compared 237 BC cases with confirmed diagnoses to 237 healthy controls. Women's lifestyle components were assessed using a validated questionnaire. A healthy lifestyle index (HLI) has been developed. We used logistic regression models to investigate the relationship between combined lifestyle scores and BC odds. The results revealed that HLI was significantly higher in the control group than in the study group. A higher HLI score was associated with a lower risk of BC in the multivariate analysis. The adjusted odds ratios (AOR) were 0.19 for all women, 0.15 for postmenopausal women, and 0.23 for premenopausal women when the HLI highest and lowest tertiles were compared. HLI score increases of one point resulted in a 41% reduction in the risk of BC for all women, a 42% reduction for postmenopausal and premenopausal women, and a 39% reduction for postmenopausal women. Women who live a healthy lifestyle, according to our findings, have a lower risk of breast cancer. BC prevention programs must promote long-term healthy food and lifestyle choices.
Collapse
Affiliation(s)
- Nuha El Sharif
- School of Public Health, Al-Quds University, Jerusalem, Palestine
| | - Imtithal Khatib
- School of Public Health, Al-Quds University, Jerusalem, Palestine
| |
Collapse
|
4
|
Llaneza DH, Kim H, Correa-Fernández V. A Health Inequity: Associations Between Cigarette Smoking Status and Mammogram Screening Among Women of Color. Nicotine Tob Res 2022; 25:66-72. [PMID: 35869504 PMCID: PMC9717359 DOI: 10.1093/ntr/ntac175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION We evaluated differences in yearly mammogram screening by smoking status in a sample of US women. We also examined differences in mammogram screening by race/ethnicity, age, and health care coverage. METHODS Data were from 1884 women participants in the 2018 Health of Houston Survey study. Binary logistic regression was used to assess the association between smoking status (current/former/non-smokers) and mammograms within 12 months. Moderators included race/ethnicity (Hispanic, Black, Asian, Other, White), age, and health care coverage. RESULTS In comparison to women who were non-smokers, current and former smokers showed lower odds to get a yearly mammogram (OR = 0.720; 95% CI = 0.709, .730 and OR = 0.702; 95% CI = 0.693, 0.710, respectively). Current smokers who identified as Hispanic or Black women and former smokers who identified as Hispanic, Asian, and other women showed lower odds of getting a mammogram (OR = 0.635, 95% CI = 0.611, 0.659; OR = 0.951, 95% CI = 0.919, 0.985) and (OR = 0.663, 95% CI = 0.642, 0.684; OR = 0.282, 95% CI = 0.263, 0.302; OR = 0.548, 95% CI = 0.496, 0.606) compared to White women. There were significant interactions by age and health care coverage. CONCLUSIONS Women of color who are current and former smokers showed lower odds to engage in mammogram screening, thus increasing their risk of undiagnosed breast cancer when compared to non-smokers. Ethnically diverse women already experience increased health disparities and smoking puts them at exacerbated risk of health complications and death. IMPLICATIONS Our findings suggest that smoking status is a modifiable behavioral risk factor that requires further attention in the prevention of breast cancer in ethnic minority women. Health care institutions and policymakers need to increase their awareness of and outreach efforts to women of color who smoke. These outreach efforts should focus on increasing access to smoking interventions and cancer screenings.
Collapse
Affiliation(s)
- Danielle H Llaneza
- Corresponding Author: Danielle H Llaneza, MA, Department of Psychological, Health and Learning Sciences, UH College of Education, University of Houston, Stephen Power Farish Hall 3657 Cullen Blvd., Room 491, Houston, TX 77204-5023, USA. Telephone: 713-743-7676; E-mail:
| | - Hanjoe Kim
- Department of Psychological, Health and Learning Sciences, University of Houston, TX, USA
| | | |
Collapse
|
5
|
The associations of healthy lifestyle index with breast cancer incidence and mortality in a population-based study. Breast Cancer 2022; 29:957-966. [DOI: 10.1007/s12282-022-01374-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/16/2022] [Indexed: 12/29/2022]
|
6
|
Romieu I, Khandpur N, Katsikari A, Biessy C, Torres-Mejía G, Ángeles-Llerenas A, Alvarado-Cabrero I, Sánchez GI, Maldonado ME, Porras C, Rodriguez AC, Garmendia ML, Chajés V, Aglago EK, Porter PL, Lin M, His M, Gunter MJ, Huybrechts I, Rinaldi S. Consumption of industrial processed foods and risk of premenopausal breast cancer among Latin American women: the PRECAMA study. BMJ Nutr Prev Health 2022; 5:1-9. [PMID: 35814719 PMCID: PMC9237890 DOI: 10.1136/bmjnph-2021-000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022] Open
Abstract
Ultra-processed food intake has been linked to an increased risk of breast cancer in Western populations. No data are available in the Latin American population although the consumption of ultra-processed foods is increasing rapidly in this region. We evaluated the association of ultra-processed food intake to breast cancer risk in a case-control study including 525 cases (women aged 20-45 years) and 525 matched population-based controls from Chile, Colombia, Costa Rica and Mexico. The degree of processing of foods was classified according to the NOVA classification. Overall, the major contributors to ultra-processed food intake were ready-to-eat/heat foods (18.2%), cakes and desserts (16.7%), carbonated and industrial fruit juice beverages (16.7%), breakfast cereals (12.9%), sausages and reconstituted meat products (12.1%), industrial bread (6.1%), dairy products and derivatives (7.6%) and package savoury snacks (6.1%). Ultra-processed food intake was positively associated with the risk of breast cancer in adjusted models (OR T3-T1=1.93; 95% CI=1.11 to 3.35). Specifically, a higher risk was observed with oestrogen receptor positive breast cancer (ORT3-T1=2.44, (95% CI=1.01 to 5.90, P-trend=0.049), while no significant association was observed with oestrogen receptor negative breast cancer (ORT3-T1=1.87, 95% CI=0.43 to 8.13, P-trend=0.36). Our findings suggest that the consumption of ultra-processed foods might increase the risk of breast cancer in young women in Latin America. Further studies should confirm these findings and disentangle specific mechanisms relating ultra-processed food intake and carcinogenic processes in the breast.
Collapse
Affiliation(s)
- Isabelle Romieu
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA
| | - Neha Khandpur
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Aikaterini Katsikari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Gabriela Torres-Mejía
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Angélica Ángeles-Llerenas
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Isabel Alvarado-Cabrero
- Servicio de Patología del Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Gloria Inés Sánchez
- Group Infection and Cancer, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Maria Elena Maldonado
- Grupo Impacto de los Componentes Alimentarios en la Salud, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA, San Jose, Costa Rica
| | - Ana Cecilia Rodriguez
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA, San Jose, Costa Rica
| | - Maria Luisa Garmendia
- Instituto de Nutrición y de Tecnología de los Alimentos, Universidad de Chile, Santiago de Chile, Chile
| | - Vèronique Chajés
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Elom K Aglago
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Peggy L Porter
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - MingGang Lin
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Mathilde His
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | |
Collapse
|
7
|
Chen SH, Liu JE, Guo DM, Su YL, Liu YF. PEACE-S risk coping: A qualitative study exploring protective behavioral strategies of first-degree relatives of breast cancer survivors. Eur J Oncol Nurs 2022; 56:102095. [DOI: 10.1016/j.ejon.2022.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/12/2021] [Accepted: 01/09/2022] [Indexed: 11/30/2022]
|
8
|
Peila R, Arthur RS, Dannenberg AJ, Rohan TE. Association of a healthy lifestyle index with risk of breast cancer among women with normal body mass index in the UK Biobank. Cancer Epidemiol Biomarkers Prev 2021; 31:554-560. [PMID: 34933955 DOI: 10.1158/1055-9965.epi-21-0765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/01/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A high healthy lifestyle index (HLI), a composite score based on good diet quality, low alcohol consumption, no smoking, moderate to high physical activity, and waist circumference <80cm, has been consistently associated with a reduced risk of breast cancer (BC). Recently, high levels of body fat were found to be associated with an elevated risk of BC in postmenopausal women with a normal body mass index (BMI) (18.5-<25 kg/m2). Whether the HLI is associated with BC risk in women with normal BMI is unknown. METHODS We studied 102,572 women aged 40-69 years with a normal BMI at enrollment into the UK Biobank cohort study. The HLI was created by assigning to each component higher scores for healthier behaviors and then summing the scores. The HLI was categorized by tertiles and age- and multivariable-adjusted hazard ratios (HRs) for the association of the HLI with BC risk by menopausal status were estimated using Cox proportional hazards models. RESULTS In postmenopausal women, compared to a low HLI, higher scores were associated with a reduced risk of BC (HRHLI-3rd tertile 0.76; 95% CI, 0.64-0.91). Findings were similar for premenopausal women, although they did not reach statistical significance, except when smoking status was excluded from the HLI score (HLIwithout smoking: HR3rd tertile, 0.71; 95% CI, 0.56-0.90). CONCLUSIONS In normal BMI postmenopausal women, a high HLI score was associated with a reduced risk of BC. IMPACT Following a healthy lifestyle may reduce the risk of BC among normal weight postmenopausal women.
Collapse
Affiliation(s)
- Rita Peila
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| | - Rhonda S Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| | - Andrew J Dannenberg
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| |
Collapse
|
9
|
Chen SLF, Braaten T, Borch KB, Ferrari P, Sandanger TM, Nøst TH. Combined Lifestyle Behaviors and the Incidence of Common Cancer Types in the Norwegian Women and Cancer Study (NOWAC). Clin Epidemiol 2021; 13:721-734. [PMID: 34429658 PMCID: PMC8378914 DOI: 10.2147/clep.s312864] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Only a small number of studies have examined the impact of combined lifestyle behaviors on cancer incidence, and never in a Norwegian population. PURPOSE To examine linear and nonlinear associations of combined lifestyle factors, assessed through a healthy lifestyle index (HLI), with the incidence of postmenopausal breast, colorectal, lung, postmenopausal endometrial, postmenopausal ovarian, pancreatic, and kidney cancer among women in Norway. METHODS This prospective study included 96,869 women enrolled in the Norwegian Women and Cancer (NOWAC) cohort. Baseline information on lifestyle factors was collected between 1996 and 2004. The HLI was constructed from five lifestyle factors: physical activity level, body mass index, smoking, alcohol consumption, and diet. Each factor contributed 0 to 4 points to the HLI score, which ranged from 0 to 20, with higher scores representing a healthier lifestyle. Multiple imputation was used to handle missing data. Cox proportional hazard regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Restricted cubic splines were used to examine nonlinearity in the associations. RESULTS The HRs for a one-point increment on the HLI score were 0.97 (95% CI: 0.96-0.98) for postmenopausal breast cancer, 0.98 (0.96-1.00) for colorectal cancer, 0.86 (0.84-0.87) for lung cancer, 0.93 (0.91-0.95) for postmenopausal endometrial cancer, 0.99 (0.96-1.02) for postmenopausal ovarian cancer, 0.92 (0.89-0.95) for pancreatic cancer, and 0.94 (0.91-0.97) for kidney cancer. Nonlinearity was observed for the inverse associations between HLI score and the incidence of lung cancer and postmenopausal breast cancer. CONCLUSION Based on our results, healthier lifestyle, as assessed by the HLI score, was associated with lower incidence of postmenopausal breast, colorectal, lung, postmenopausal endometrial, pancreatic, and kidney cancer among women, although the magnitude and linearity varied. Adoption of healthier lifestyle behaviors should be a public health priority to reduce the cancer burden among Norwegian women.
Collapse
Affiliation(s)
- Sairah L F Chen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tonje Braaten
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristin B Borch
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Torkjel M Sandanger
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Therese H Nøst
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
10
|
Vegunta S, Lester SP, Pruthi S, Mussallem DM. Effects of major lifestyle factors on breast cancer risk: impact of weight, nutrition, physical activity, alcohol and tobacco. BREAST CANCER MANAGEMENT 2020. [DOI: 10.2217/bmt-2020-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Breast cancer (BC) is the most commonly diagnosed cancer and second most common cause of cancer death in US women. Family history and genetics are well-known BC risk factors, but they only account for 15–20% of BC cases. Therefore, in addition to family history, healthcare providers must consider a woman’s modifiable and nonmodifiable personal risk factors that are associated with an increase in BC risk. The World Cancer Research Fund/American Institute for Cancer Research estimate that 30% of BC cases in the US are preventable. Lifestyle education is imperative given the magnitude of BC occurrence. Evidence supports prevention as an effective, long-term strategy for reducing risk. Healthcare providers are key stakeholders in empowering patients to adopt a healthy lifestyle for primary BC prevention. In this paper, we review the available evidence on modifiable BC risk including weight management, nutrition, physical activity, alcohol and tobacco use and provide strategies to counsel patients on lifestyle modifications.
Collapse
Affiliation(s)
- Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Sara P Lester
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sandhya Pruthi
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Dawn M Mussallem
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
11
|
Arthur RS, Wang T, Xue X, Kamensky V, Rohan TE. Genetic Factors, Adherence to Healthy Lifestyle Behavior, and Risk of Invasive Breast Cancer Among Women in the UK Biobank. J Natl Cancer Inst 2020; 112:893-901. [PMID: 31899501 PMCID: PMC7492765 DOI: 10.1093/jnci/djz241] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/01/2019] [Accepted: 11/25/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Breast cancer is considered to result from a combination of genetic and lifestyle-related factors, but the degree to which an overall healthy lifestyle may attenuate the impact of multiple genetic variants on invasive breast cancer risk remains equivocal. METHODS Using Cox proportional hazards regression models, we examined the association of a modified healthy lifestyle index (HLI) with risk of invasive breast cancer by genetic risk group among 146 326 women from the UK Biobank. We generated an HLI score based on a combination of diet, physical activity, smoking, alcohol consumption and anthropometry, and a polygenic risk score (PRS) using 304 breast cancer-associated genetic loci. RESULTS Among premenopausal and postmenopausal women, a favorable lifestyle (highest tertile) was associated with 22% and 31% reductions in invasive breast cancer risk, respectively (hazard ratio [HR]high vs low = 0.78, 95% confidence interval [CI] = 0.64 to 0.94; HRhigh vs low = 0.69, 95% CI = 0.63 to 0.77, respectively), whereas a high PRS (highest tertile) was associated with more than a doubling in the risk in both groups. For premenopausal women, the greatest risk reduction in association with the HLI was seen among those with a high PRS (HRhigh vs low = 0.73, 95% CI = 0.75 to 0.95). In postmenopausal women, those with a favorable lifestyle had 30%, 29%, and 32% reductions in risk of invasive breast cancer in the low, intermediate, and high PRS groups, respectively (HRhigh vs low = 0.70, 95% CI = 0.56 to 0.88; HRhigh vs low = 0.71, 95% CI = 0.59 to 0.84; and HRhigh vs low = 0.68, 95% CI = 0.59 to 0.78, respectively). There was an additive but not multiplicative interaction between the HLI score and PRS for postmenopausal and, to a lesser extent, premenopausal women. CONCLUSION Our findings support the view that an overall healthy lifestyle may attenuate the impact of genetic factors on invasive breast cancer risk among women of European ancestry.
Collapse
Affiliation(s)
| | - Tao Wang
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | |
Collapse
|
12
|
Abstract
Breast cancer (BC) is the most frequently diagnosed type of cancer and the leading cause
of cancer deaths in women worldwide. A number of established risk factors for BC have been identified
in many previous studies which included age, reproductive history, lactation, hormone levels or
use, genetic factors, breast density and various diet and lifestyle factors. Several previous studies
highlighted the independent effect of dietary patterns, lifestyle factors, macro- and micronutrients intake,
physical activity, tobacco smoking, and weight gain on the risk BC. Although a number of risk
factors have been identified for BC, however, some are difficult to modify such as genetic factors,
while dietary pattern, physical activity, nutrient intake and smoking are modifiable risk factors which
could be targeted to reduce the risk of this devastating disease. Even though there is a quick advancement
in BC cancer therapy, but still, the survival rate is not increasing. Therefore, preventing
cancer development is more important than treating or inhibiting its progression and such prevention
can reduce the suffering and pain of patients and their families.
Collapse
Affiliation(s)
- Reema I. Mahmoud
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan
| | - Reema F. Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan
| |
Collapse
|
13
|
Ghosn B, Benisi-Kohansal S, Ebrahimpour-Koujan S, Azadbakht L, Esmaillzadeh A. Association between healthy lifestyle score and breast cancer. Nutr J 2020; 19:4. [PMID: 31937325 PMCID: PMC6961278 DOI: 10.1186/s12937-020-0520-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Majority of earlier studies have assessed the association between individual lifestyle factors and the risk of breast cancer (BC); however, limited information is available linking the whole lifestyle factors to BC. We aimed to examine the association between combined lifestyle score (diet, physical activity (PA) and smoking) and risk of BC in Iranian population. METHODS This population-based case-control study included 350 newly diagnosed cases of BC and 700 healthy controls randomly selected from adult women. Dietary intakes, PA and smoking status of study participants were examined using validated questionnaires. The lifestyle risk factors examined in this study included cigarette smoking, physical inactivity, and Healthy Eating Index-2010 (HEI-2010). The lifestyle score ranged from zero (non-healthy) to 3 (most healthy) points. Logistic regression models were fitted to investigate the association between combined lifestyle scores and odds of BC. RESULTS Mean age and body mass index (BMI) of study participants were 62.4 years and 24.3 kg/m2, respectively. In the whole study population, individuals with the highest healthy lifestyle score (HLS) were 0.38 times less likely to have BC than those with the lowest score (OR: 0.62; 95% CI: 0.40, 0.93, Ptrend = 0.01). The analysis by menopausal status showed that postmenopausal women with the highest HLS had 44% lower odds of BC compared with those with the lowest score (OR: 0.56; 95% CI: 0.36, 0.88, P trend = 0.004). Such association was not seen in premenopausal women. After analyzing each component of HLS, we found that individuals with the highest HEI score were 46% less likely to have BC than those with the lowest score (OR: 0.54; 95% CI: 0.35, 0.82, Ptrend < 0.001). No other significant associations were found between PA and smoking and risk of BC. CONCLUSIONS Significant inverse associations were found between HLS and HEI with BC especially among postmenopausal women. Prospective studies are required to confirm these findings.
Collapse
Affiliation(s)
- Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Sanaz Benisi-Kohansal
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Soraiya Ebrahimpour-Koujan
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. .,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
14
|
Sánchez-Zamorano LM, Angeles-Llerenas A, Salinas-Rodríguez A, Lazcano-Ponce EC, Romieu I, Pérez-Rodríguez E, Flores-Luna L, Torres-Mejía G. Synergistic action of folate intake and testosterone associated with breast cancer risk. Nutr Res 2019; 71:100-110. [PMID: 31757629 DOI: 10.1016/j.nutres.2019.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/09/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
The amount of irreparable DNA damage is a function of the rate of cell division, and the association between sex hormones and the risk of breast cancer has been explained by an increase in cell division. Folate intake insufficiency leads to disturbances in DNA replication and DNA repair. We hypothesized that folate intake insufficiency and high serum concentrations of sex hormones act synergistically on the risk of breast cancer. The aim of this study was to investigate the interaction between sex hormones (exposure of interest A) and dietary folate intake (exposure of interest B) on the risk of breast cancer. We included 342 breast cancer primary postmenopausal cases and 294 controls obtained from a large population-based case-control study. Multiple conditional logistic regression models were used for the analysis and interactions were tested. The joint effect of the lowest dietary folate intake (T1 < 259.40 mg/d) and the highest serum concentration of testosterone (T3 ≥ 0.410 on the risk of breast cancer was odds ratio = 9.18 (95% confidence interval 2.56-32.88) when compared to the lowest-risk category, namely, the group of women with the highest dietary folate intake (T3 > 381.29 mg/d) and the lowest serum concentration of testosterone (T1 ≤ 0.25 pg/mL). There were some indications that the estimated join effect was greater than the product of the estimated effects alone (P = .001). These findings have important public health implications with respect to reducing the risk of the most frequent cancer in women worldwide.
Collapse
Affiliation(s)
- Luisa María Sánchez-Zamorano
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
| | - Angélica Angeles-Llerenas
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
| | - Aaron Salinas-Rodríguez
- Evaluation and Surveys Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
| | - Eduardo C Lazcano-Ponce
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
| | - Isabelle Romieu
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico; Hubert Department of Global Health, Emory University, 1518 Clifton Rd. NE Atlanta, GA 30329, USA.
| | - Edelmiro Pérez-Rodríguez
- Hospital Universitario, Dr. José Eleuterio González, Gonzalitos 235, Mitras Centro, 64460, Monterrey, N.L., Mexico.
| | - Lourdes Flores-Luna
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
| | - Gabriela Torres-Mejía
- Population Health Research Center, National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
| |
Collapse
|
15
|
Heberg J, Simonsen MK, Danielsen AK, Klausen TW, Zoffmann V, Thomsen T. Joint tobacco smoking and alcohol intake exacerbates cancer risk in women- the Danish nurse cohort. Eur J Oncol Nurs 2019; 43:101675. [PMID: 31644965 DOI: 10.1016/j.ejon.2019.101675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/04/2019] [Accepted: 10/08/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore separate and combined tobacco and alcohol use and risk of overall, smoking-related, alcohol-related, breast and gynecological cancers in women. METHOD Questionnaires from 19,898 women in The Danish Nurse Cohort in 1993 were linked to registries on hospitalizations, death causes and migration until Dec 2016. Cancer risk by tobacco and alcohol was estimated using Cox proportional hazards models. RESULTS 16,106 nurses, aged >44 years (mean = 56), were eligible for analysis. Throughout 23 years (mean follow-up = 18.8 years) overall cancers counted 4,968. Of these, 1,897, 2,231, 1,407 and 579 events were smoking-related, alcohol-related, breast cancers and gynecological cancers. Increased risks of overall, smoking-related, and breast cancer were observed for current smoking and excess alcohol intake (>14 units/week), separately, compared to never smoking and light drinking (1-7 units/week) respectively. Moderate drinking (8-14 units/week) increased the risk of alcohol-related and breast cancer. Additional risk increases were observed among smokers drinking alcohol above light levels for overall, smoking-related, alcohol-related and breast cancer (HR = 1.40, 95% CI:1.30-1.51, HR = 1.72, 95% CI:1.52-1.94, HR = 1.33, 95% CI:1.26-1.40, HR = 1.32, 95% CI:1.15-1.53, respectively), compared to non-smokers drinking lightly. These risks increased further for smokers drinking above moderate levels (HR = 1.49, 95% CI:1.36-1.63, HR = 1.97, 95% CI:171.-2.26, HR = 1.40, 95% CI:1.22-1.60, HR = 1.33, 95% CI:1.12-1.57, respectively). No significant associations were found for gynecological cancer. CONCLUSIONS Smoking and alcohol, both separately and combined, increased risks of overall, smoking-related, alcohol-related and breast cancer; combined use resulted in incremental risk increases. Co-use of smoking and alcohol represent an extensive threat to public health; thus, prevention could benefit from combined targeting.
Collapse
Affiliation(s)
- Jette Heberg
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Mette Kildevæld Simonsen
- The Parker Institute and Diakonissestiftelsen, Bispebjerg and Frederiksberg Hospital, Region H, Denmark
| | - Anne Kjaergaard Danielsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Tobias Wirenfeldt Klausen
- Department of Hematology, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, University of Copenhagen, Denmark
| | - Vibeke Zoffmann
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; University of Copenhagen, IFSV, Section of Health Services Research, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark; University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| |
Collapse
|
16
|
Sahrai MS, Huybrechts I, Biessy C, Gunter MJ, Romieu I, Torres-Mejía G, Dossus L. Association of a Priori-Defined Dietary Patterns with Anthropometric Measurements: A Cross-Sectional Study in Mexican Women. Nutrients 2019; 11:E603. [PMID: 30871053 PMCID: PMC6471597 DOI: 10.3390/nu11030603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional study aimed to evaluate associations between a priori defined dietary patterns and anthropometric measures in Mexican women. A total of 1062 women aged 35 to 69 years old from the control participants of the CAMA (Cancer de Mama) study, a multi-center population-based case-control study on breast cancer conducted in Mexico, were interviewed and dietary intakes were assessed using questionnaires. The following indices were derived from these data: Dietary Approaches to Stop Hypertension (DASH) score, the Healthy Eating Index (HEI), the Mediterranean Diet Score (aMED), the Diet Quality Index (DQI), glycemic index (GI) and glycemic load (GL). Adjusting for age, center, educational level, physical activity and energy intake, a high GI was positively associated with a higher body mass index (BMI) and waist circumference (WC). Higher adherence to aMED was associated with lower WC and waist-to-hip ratio (WHR) but no significant association was observed with other a priori dietary patterns. In this population of Mexican women, higher adherence to Mediterranean diet was associated with lower WC but other a priori dietary scores appeared to be of limited value in exploring the association between diet and anthropometric measures.
Collapse
Affiliation(s)
- Mohammad Sediq Sahrai
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
| | - Marc James Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
| | - Isabelle Romieu
- National Institute of Public Health, Centre for Population Health Research, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P., Cuernavaca 62100, Morelos, México.
| | - Gabriela Torres-Mejía
- National Institute of Public Health, Centre for Population Health Research, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P., Cuernavaca 62100, Morelos, México.
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, 69372 Lyon CEDEX 08, France.
| |
Collapse
|
17
|
Khalis M, Chajès V, Moskal A, Biessy C, Huybrechts I, Rinaldi S, Dossus L, Charaka H, Mellas N, Nejjari C, Dorn J, Soliman AS, Romieu I, El Rhazi K, Charbotel B. Healthy lifestyle and breast cancer risk: A case-control study in Morocco. Cancer Epidemiol 2019; 58:160-166. [PMID: 30597481 DOI: 10.1016/j.canep.2018.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/29/2018] [Accepted: 12/21/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Some modifiable risk factors have been independently associated with breast cancer (BC) risk in Moroccan women, but no studies have investigated their joint association. This study aimed to investigate the association between a Healthy Lifestyle Index (HLI) score and BC risk among Moroccan women. METHODS In this case-control study, 300 incident BC cases and 300 controls, matched by age and area of residence were recruited. Cases were women newly-diagnosed with histopathologically-confirmed BC at the University Hospital in Fez, Morocco. Controls were randomly selected healthy women recruited from 6 primary health centers in Fez. HLI scores developed within this study were assigned to participants based on 11 factors (red and processed meat, white meat, cream, cheese, fish, fruit and vegetables, physical activity, BMI, smoking, alcohol consumption, and breastfeeding), where 0 was given to unhealthy and 0.5 or 1 to healthy levels of each factor. Conditional and unconditional logistic regression models were used to assess the association between HLI scores and BC risk. RESULTS Mean of HLI scores were 8.1 (±1.1) and 9.0 (±0.9) in cases and controls, respectively, p < 0.01. After adjusting for potential confounders, one-point increment in the HLI score was associated with 56% (95% CI, CI: 39-68%), 49% (95% CI: 30-63%), and 59% (95% CI: 40-72%) lower risks of BC in all, premenopausal, and postmenopausal women, respectively. CONCLUSION High HLI scores were associated with decreased risk of BC in Moroccan women. These findings suggest that BC prevention policies should include strategies for engaging Moroccan women in healthy lifestyles.
Collapse
Affiliation(s)
- Mohamed Khalis
- Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco; University of Lyon, UCBL, Ifsttar, UMRESTTE, Lyon, France; Department of Community Health and Social Medicine, City University of New York, School of Medicine, NY, USA.
| | - Véronique Chajès
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Aurelie Moskal
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Hafida Charaka
- Department of Research and Development, Hassan II University Hospital of Fez, Morocco
| | - Nawfel Mellas
- Department of Oncology, Hassan II University Hospital of Fez, Morocco
| | - Chakib Nejjari
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Joan Dorn
- Department of Community Health and Social Medicine, City University of New York, School of Medicine, NY, USA
| | - Amr S Soliman
- Department of Community Health and Social Medicine, City University of New York, School of Medicine, NY, USA
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Karima El Rhazi
- Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco
| | | |
Collapse
|
18
|
Xiao Y, Xia J, Li L, Ke Y, Cheng J, Xie Y, Chu W, Cheung P, Kim JH, Colditz GA, Tamimi RM, Su X. Associations between dietary patterns and the risk of breast cancer: a systematic review and meta-analysis of observational studies. Breast Cancer Res 2019; 21:16. [PMID: 30696460 PMCID: PMC6352362 DOI: 10.1186/s13058-019-1096-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 01/04/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Epidemiologic evidence suggests that certain dietary patterns were associated with breast cancer risk, but the results have been inconclusive. We assessed the associations between different dietary patterns and the risk of breast cancer by conducting a meta-analysis of observational studies. METHODS Relevant articles were searched in PubMed, Embase, and Cochrane library databases through September 2017. Multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) comparing the highest and lowest categories of Western and prudent dietary patterns were combined by using the random-effects meta-analyses. RESULTS We identified 32 eligible articles including 14 cohort and 18 case-control studies (34 Western and 35 prudent studies). The pooled analyses found that a Western dietary pattern was associated with a 14% increased risk (RR 1.14, 95% CI 1.02, 1.28), whereas a prudent dietary pattern was associated with an 18% reduced risk of breast cancer (RR 0.82, 95% CI 0.75, 0.89). In addition, sub-group analyses showed that the positive association between a Western dietary pattern and breast cancer risk was significant among postmenopausal (RR 1.20, 95% CI 1.06, 1.35), but not premenopausal women (RR 1.18, 95% CI 0.99, 1.40), and significant for hormone receptor-positive tumors (RR 1.18, 95% CI 1.04, 1.33), but not receptor-negative tumors (RR 0.97, 95% CI 0.83, 1.12). In contrast, the inverse association between a prudent dietary pattern and breast cancer was significant in premenopausal (RR 0.77, 95% CI 0.61, 0.98), but not postmenopausal women (RR 0.88, 95% CI 0.74, 1.03), and significant for both hormone receptor-positive and receptor-negative tumors. CONCLUSIONS The results of the current meta-analysis suggest a possible increased risk of breast cancer associated with a Western dietary pattern and a reduced risk with a prudent dietary pattern. Large-scale cohort studies with a high quality need to be conducted to further confirm the findings of the current meta-analysis. As dietary patterns are modifiable, these findings may provide viable strategies for breast cancer prevention through changes in dietary intake.
Collapse
Affiliation(s)
- Yunjun Xiao
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Junjie Xia
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Liping Li
- MPH Education Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yuebin Ke
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Jinquan Cheng
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Yaojie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Winnie Chu
- Department of Imaging & Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Polly Cheung
- Hong Kong Breast Cancer Foundation, Hong Kong, China
| | - Jean Hee Kim
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Xuefen Su
- MPH Education Center, Shantou University Medical College, Shantou, Guangdong, China.
| |
Collapse
|
19
|
Hardefeldt PJ, Penninkilampi R, Edirimanne S, Eslick GD. Physical Activity and Weight Loss Reduce the Risk of Breast Cancer: A Meta-analysis of 139 Prospective and Retrospective Studies. Clin Breast Cancer 2018; 18:e601-e612. [DOI: 10.1016/j.clbc.2017.10.010] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/21/2017] [Accepted: 10/11/2017] [Indexed: 12/17/2022]
|
20
|
Ellingjord-Dale M, Vos L, Vik Hjerkind K, Hjartåker A, Russnes HG, Tretli S, Hofvind S, Dos-Santos-Silva I, Ursin G. Number of Risky Lifestyle Behaviors and Breast Cancer Risk. JNCI Cancer Spectr 2018; 2:pky030. [PMID: 31360858 PMCID: PMC6649737 DOI: 10.1093/jncics/pky030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/03/2018] [Accepted: 06/05/2018] [Indexed: 11/13/2022] Open
Abstract
Background Lifestyle factors are associated with overall breast cancer risk, but less is known about their associations, alone or jointly, with risk of specific breast cancer subtypes. Methods We conducted a case-control subjects study nested within a cohort of women who participated in the Norwegian Breast Cancer Screening Program during 2006-2014 to examine associations between risky lifestyle factors and breast cancer risk. In all, 4402 breast cancer cases subjects with information on risk factors and hormone receptor status were identified. Conditional logistic regression was used to estimate odds ratios (ORs), with 95% confidence intervals (CIs), in relation to five risky lifestyle factors: body mass index (BMI) of 25 kg/m² or greater, three or more glasses of alcoholic beverages per week, ever smoking, fewer than four hours of physical activity per week, and ever use of menopausal hormone therapy. Analyses were adjusted for education, age at menarche, number of pregnancies, and menopausal status. All statistical tests were two-sided. Results Compared with women with no risky lifestyle behaviors, those with five had 85% (OR = 1.85, 95% CI = 1.42 to 2.42, P trend < .0001) increased risk of breast cancer overall. This association was limited to luminal A-like (OR = 2.20, 95% CI = 1.55 to 3.12, P trend < .0001) and luminal B-like human epidermal growth factor receptor 2 (HER2)-positive (OR = 1.66, 95% CI = 0.61 to 4.54, P trend < .004) subtypes. Number of risky lifestyle factors was not associated with increased risk of luminal B-like HER2-negative, HER2-positive, or triple-negative subtypes (P trend > .18 for all). Conclusions Number of risky lifestyle factors was positively associated with increased risk for luminal A-like and luminal B-like HER2-positive breast cancer.
Collapse
Affiliation(s)
| | - Linda Vos
- Department of research, Cancer Registry of Norway, Oslo, Norway
| | | | - Anette Hjartåker
- Department of nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Hege G Russnes
- Department of Pathology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Steinar Tretli
- Department of research, Cancer Registry of Norway, Oslo, Norway
| | - Solveig Hofvind
- Department of research, Cancer Registry of Norway, Oslo, Norway.,Department of radiography and dental technology, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Giske Ursin
- Department of research, Cancer Registry of Norway, Oslo, Norway.,Division of epidemiology, University of Southern California, Los Angeles, CA
| |
Collapse
|
21
|
Arthur R, Kirsh VA, Kreiger N, Rohan T. A healthy lifestyle index and its association with risk of breast, endometrial, and ovarian cancer among Canadian women. Cancer Causes Control 2018; 29:485-493. [PMID: 29667103 DOI: 10.1007/s10552-018-1032-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 04/11/2018] [Indexed: 02/03/2023]
Abstract
PURPOSE Several modifiable risk factors have been associated with risk of female cancers, but there is limited data regarding their combined effect on risk among Canadian women. Therefore, we assessed the joint association of modifiable risk factors, using a healthy lifestyle index (HLI) score, with risk of specific reproductive cancers. METHOD This study included a subcohort of 3,185 of the 39,618 women, who participated in the Canadian Study of Diet, Lifestyle, and Health, and in whom 410, 177, and 100 postmenopausal breast, endometrial, and ovarian cancers, respectively, were ascertained. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards regression models modified for the case-cohort design. RESULTS Each unit increase in the HLI score was associated with 3% and 5% reductions in risk of postmenopausal breast cancer and endometrial cancer, respectively (HR 0.97; 95% CI 0.94-0.99 and HR 0.95; 95% CI 0.90-0.99, respectively). Compared to those with HLI score in the lowest category, those in the highest category had 30% and 46% reductions in risk of these cancers, respectively. The HLI score was not associated with altered risk of ovarian cancer. CONCLUSION Our findings suggest that promoting a healthy lifestyle may aid in the primary prevention of postmenopausal breast and endometrial cancers.
Collapse
Affiliation(s)
- Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA.
| | - Victoria A Kirsh
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Nancy Kreiger
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
| |
Collapse
|
22
|
Guinter MA, McLain AC, Merchant AT, Sandler DP, Steck SE. An estrogen-related lifestyle score is associated with risk of postmenopausal breast cancer in the PLCO cohort. Breast Cancer Res Treat 2018; 170:613-622. [PMID: 29651647 DOI: 10.1007/s10549-018-4784-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/07/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE Healthy or unhealthy lifestyle behaviors are often adopted together. We aimed to investigate the combined effect of estrogen-related lifestyle factors on postmenopausal breast cancer risk. METHODS Data from 27,153 women enrolled in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial were used. We created an estrogen-related lifestyle score (ERLS) by incorporating a previously developed measure of estrogenic diet, alcohol intake, body mass index (BMI), and physical activity. The scores ranged from 0 to 6 with alcohol and BMI accounting for higher weights than the other factors. To evaluate the preventive possibilities of a low estrogen-related lifestyle and to be consistent with other published lifestyle scores, higher scores were set to correspond with potentially lower estrogenic lifestyle. The association between the ERLS and incident breast cancer was examined using Cox proportional hazards models. RESULTS Participants with an ERLS of 4 or ≥ 5 had a 23% (HR 0.77; 95% CI 0.67-0.89) and 34% (HR 0.66; 95% CI 0.56-0.78) lower risk of breast cancer, respectively, compared to those with an ERLS ≤ 2 after multivariable adjustment. Estimates were similar when restricting to invasive cases or estrogen receptor-positive subtypes. No single lifestyle component appeared to drive the association. CONCLUSIONS Our findings suggest that the combined effect of a lifestyle characterized by a low estrogenic diet, low alcohol consumption, low body weight, and high levels of physical activity are associated with a reduction in postmenopausal breast cancer risk, possibly through an influence on estrogen metabolism.
Collapse
Affiliation(s)
- Mark A Guinter
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. .,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.
| |
Collapse
|
23
|
Arthur R, Wassertheil-Smoller S, Manson JE, Luo J, Snetselaar L, Hastert T, Caan B, Qi L, Rohan T. The Combined Association of Modifiable Risk Factors with Breast Cancer Risk in the Women's Health Initiative. Cancer Prev Res (Phila) 2018; 11:317-326. [PMID: 29483073 DOI: 10.1158/1940-6207.capr-17-0347] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/09/2018] [Accepted: 02/15/2018] [Indexed: 12/19/2022]
Abstract
Although several modifiable risk factors have been independently associated with risk of breast cancer, few studies have investigated their joint association with breast cancer risk. Using a healthy lifestyle index (HLI) score, we assessed the association of a combination of selected modifiable risk factors (diet, alcohol, physical activity, BMI, and smoking) with risk of invasive breast cancer in the Women's Health Initiative (WHI). This study comprised 131,833 postmenopausal women, of whom 8,168 had breast cancer, who were enrolled in the WHI Observational Study or the WHI clinical trials. Cox proportional hazards regression was used to estimate the HRs and 95% confidence intervals (CI) for the association of the score with the risk of developing breast cancer overall and according to specific breast cancer clinicopathologic characteristics. There was a 4% reduction in the risk of breast cancer per unit increase in the HLI score. Compared with those with an HLI score in the lowest quintile level, those in the highest quintile level had 30%, 37%, and 30% lower risk for overall, ER+/PR+, and HER2+ breast cancer, respectively (HR = 0.70; 95% CI, 0.64-0.76; 0.63, 0.57-0.69; and 0.70; 0.55-0.90, respectively). We also observed inverse associations between the score and risk of breast cancer irrespective of nodal status, tumor grade, and stage of the disease. Most individual lifestyle factors were independently associated with the risk of breast cancer. Our findings support the view that promoting healthy lifestyle practices may be beneficial with respect to lowering risk of breast cancer among postmenopausal women. Cancer Prev Res; 11(6); 317-26. ©2018 AACRSee related editorial by Friedenreich and McTiernan, p. 313.
Collapse
Affiliation(s)
- Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
| | | | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana
| | - Linda Snetselaar
- Department of Epidemiology, School of Public Health, University of Iowa, Iowa City, Iowa
| | - Theresa Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, California
| | - Lihong Qi
- Department of Public Health Science, School of Medicine, UC Davis, Davis, California
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
24
|
Sánchez-Zamorano LM, Burguete-García AI, Flores-Sánchez G, Salmerón-Castro J, Lazcano-Ponce EC, Diaz-Benitez CE. [Unhealthy behavior associated with the development of high blood pressure in adolescents]. CAD SAUDE PUBLICA 2017; 33:e00017616. [PMID: 28380137 DOI: 10.1590/0102-311x00017616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/02/2016] [Indexed: 11/21/2022] Open
Abstract
This article aims to evaluate the association between unhealthy behavior pattern and prevalence and incidence of high blood pressure in adolescents. Based on data from a cohort study with a baseline population of 2,813 adolescents enrolled in a public school system, the study measured the baseline prevalence and incidence of high blood pressure as a function of smoking, alcohol and illegal drug use, and physical activity. These variables were used to build a model called "unhealthy behavior pattern", and its relationship was evaluated in relation to high blood pressure in adolescents, using multiple logistic regression models. Prevalence of high blood pressure was 8.67%. Accumulated incidence of high blood pressure was 7.58%. In the multivariate analysis of high blood pressure adjusted by degree of adiposity, there was an association with the unhealthy behavior pattern in males (OR = 3.13; 95%CI: 1.67-5.84). The association between incidence of high blood pressure and unhealthy behavior pattern was observed in females (OR = 2.34; 95%CI: 1.11-4.95). In conclusion, high blood pressure is present in the adolescent population, associated with unhealthy behaviors like smoking, alcohol and illegal drug use, and physical inactivity, independently of the degree of adiposity.
Collapse
|
25
|
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
|
26
|
Di Sibio A, Abriata G, Forman D, Sierra MS. Female breast cancer in Central and South America. Cancer Epidemiol 2016; 44 Suppl 1:S110-S120. [PMID: 27678313 DOI: 10.1016/j.canep.2016.08.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/31/2016] [Accepted: 08/05/2016] [Indexed: 12/21/2022]
Abstract
RATIONALE AND OBJECTIVE The burden of breast cancer has increased worldwide. Breast cancer mortality has been increasing in Central and South America (CSA) in the last few decades. We describe the current burden of breast cancer in CSA and review the current status of disease control. METHODS We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence and mortality rates per 100,000 person-years for 2003-2007 and the estimated annual percentage change to describe time trends. RESULTS In the most recent 5-year period, Argentina, Brazil, and Uruguay had the highest incidence rates (67.7-71.9) and Bolivia and El Salvador had the lowest (7.9-12.7). For most countries, mortality rates were ≤12.3, except in Uruguay, Argentina and Cuba (14.9-20.5). Age-specific rates increased after the age of 40-50 years and reached a maximum after age 65 years (mean age at diagnosis 56-62 years). Most countries have developed national screening guidelines; however, there is limited capacity for screening. CONCLUSION The geographic variation of breast cancer rates may be explained by differences in the prevalence of reproductive patterns, lifestyle factors, early detection, and healthcare access. Extending early-detection programs is challenging because of inequalities in healthcare access and coverage, limited funding, and inadequate infrastructure, and thus it may not be feasible. Given the current status of breast cancer in CSA, data generated by population-based cancer registries is urgently needed for effective planning for cancer control.
Collapse
Affiliation(s)
| | | | - David Forman
- The International Agency for Research on Cancer, Section of Cancer Surveillance, France
| | - Mónica S Sierra
- The International Agency for Research on Cancer, Section of Cancer Surveillance, France.
| |
Collapse
|
27
|
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] [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.
Collapse
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.
| |
Collapse
|
28
|
Orenstein L, Chetrit A, Dankner R. Healthy Lifestyle Pattern is Protective Against 30-Yr Cancer Incidence in Men and Women: A Cohort Study. Nutr Cancer 2016; 68:410-9. [PMID: 27007270 DOI: 10.1080/01635581.2016.1153673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Investigate associations of healthier behaviors with 30-yr cancer incidence. SUBJECTS/METHODS In 1982, 632 healthy men and women (ages 40-70) were interviewed for nutritional habits using a Food Frequency Questionnaire and a 24-h physical activity questionnaire. Blood pressure, weight, and height were measured, and blood was drawn for biochemical profiles. Thirteen and four subjects were excluded due to cancer diagnosis ≤1 yr from recruitment and extreme values of reported total daily calorie intake, respectively. RESULTS During a mean follow-up of 24.2 yr, 146 cancer incident patients (23.7%) were documented. Total cancer risk was 38% lower in the medium vegetable intake tertile [adjusted hazards ratio (HR) = 0.62, 95%confidence interval (CI): 0.40-0.95], and 66% higher in the medium fruit intake tertile (adjusted HR = 1.66, 95%CI: 1.08-2.55) compared to the lowest tertile. The risk of gastrointestinal cancers was 3 times greater for the highest, compared to the lowest, dairy consumption tertile (HR = 3.06, 95%CI: 1.01-9.23). "Healthy lifestyle" (normal BMI, never smoked, consuming high levels of dietary fiber and vegetables, and more physically active) reduced overall cancer risk (adjusted HR = 0.63, 95%CI: 0.44-0.91) as compared to the rest of the cohort. CONCLUSIONS Our findings reinforce the importance of lifestyle-related factors, which are relatively low-cost and may contribute to reduction in the burden of malignant diseases.
Collapse
Affiliation(s)
- Liat Orenstein
- a Sackler Faculty of Medicine, School of Public Health , Department of Epidemiology and Preventive Medicine , Tel Aviv University , Ramat Aviv , Tel Aviv , Israel
| | - Angela Chetrit
- b The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center , Israel
| | - Rachel Dankner
- a Sackler Faculty of Medicine, School of Public Health , Department of Epidemiology and Preventive Medicine , Tel Aviv University , Ramat Aviv , Tel Aviv , Israel.,b The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center , Israel
| |
Collapse
|
29
|
Connor AE, Baumgartner KB, Baumgartner RN, Pinkston CM, Boone SD, John EM, Torres-Mejía G, Hines LM, Giuliano AR, Wolff RK, Slattery ML. Cigarette Smoking and Breast Cancer Risk in Hispanic and Non-Hispanic White Women: The Breast Cancer Health Disparities Study. J Womens Health (Larchmt) 2015; 25:299-310. [PMID: 26682495 DOI: 10.1089/jwh.2015.5502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Few epidemiological studies have included Hispanics with the evaluation of the effects of cigarette smoking and breast cancer. We examined the relationship between cigarette smoking, ethnicity, and breast cancer risk using data from the Breast Cancer Health Disparities Study (BCHDS). MATERIALS AND METHODS The BCHDS is a consortium of three population-based case-control studies, including U.S. non-Hispanic whites (NHWs) (1,525 cases; 1,593 controls), U.S. Hispanics/Native Americans (1,265 cases; 1,495 controls), and Mexican women (990 cases; 1,049 controls). Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Breast cancer risk was elevated among Mexican former smokers (OR 1.43, 95% CI 1.04-1.96) and among those who smoked ≥ 31 years (OR 1.95, 95% CI 1.13-3.35), compared to never smokers. In addition, Mexican former smokers with a history of alcohol consumption had increased breast cancer risk (OR 2.30, 95% CI 1.01-5.21). Among NHW premenopausal women, breast cancer risk was increased for smoking ≥ 20 cigarettes per day (OR 1.61, 95% CI 1.07-2.41). CONCLUSION Our findings suggest the possibility of ethnic differences with the associations between cigarette smoking and breast cancer risk.
Collapse
Affiliation(s)
- Avonne E Connor
- 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.,2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Kathy B Baumgartner
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Richard N Baumgartner
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Christina M Pinkston
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Stephanie D Boone
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Esther M John
- 3 Cancer Prevention Institute of California , Fremont, California.,4 Division of Epidemiology, Department of Health Research and Policy, Stanford Cancer Institute, Stanford University School of Medicine , Stanford, California
| | - Gabriela Torres-Mejía
- 5 Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional , Cuernavaca, Morelos, México
| | - Lisa M Hines
- 6 Department of Biology, University of Colorado at Colorado Springs , Colorado Springs, Colorado
| | - Anna R Giuliano
- 7 H. Lee Moffit Cancer Center & Research Institute , Tampa, Florida
| | - Roger K Wolff
- 8 Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Martha L Slattery
- 8 Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| |
Collapse
|
30
|
Fanidi A, Ferrari P, Biessy C, Ortega C, Angeles-Llerenas A, Torres-Mejia G, Romieu I. Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and breast cancer risk in the Cancer de Màma (CAMA) study. Public Health Nutr 2015; 18:3337-48. [PMID: 25805146 PMCID: PMC10271688 DOI: 10.1017/s1368980015000634] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 10/08/2014] [Accepted: 01/23/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We investigated the association between adherence to the recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and breast cancer (BC) risk in the Cancer de Màma (CAMA) study in a Mexican population. DESIGN Population-based case-control study. SUBJECTS Incident BC cases (n 1000) and controls (n 1074) matched on age, region and health-care system were recruited. SETTING In-person interviews were conducted to assess BC risk factors and habitual diet was assessed with an FFQ. Conformity to the WCRF/AICR recommendations was evaluated through a score incorporating seven WCRF/AICR components (body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks and breast-feeding), with high scores indicating adherence to the WCRF/AICR recommendations. RESULTS No statistically significant associations between WCRF/AICR score and risk of BC were observed. After excluding BMI from the WCRF/AICR score, the top quartile was associated with a decreased BC risk overall, with ORQ4-Q1=0.68 (95% CI 0.49, 0.92, P trend=0.03), and among postmenopausal women, with ORQ4-Q1=0.60 (95% CI 0.39, 0.94, P trend=0.03). Inverse associations were observed between BMI and risk of BC overall and among premenopausal women, with OR=0.57 (95% CI 0.42, 0.76, P trend <0.01) and 0.48 (95% CI 0.31, 0.73, P trend<0.01), respectively. Physical activity level was inversely associated with BC risk. CONCLUSIONS The WCRF/AICR index was not related with BC risk in the CAMA study. A combination of six components excluding BMI showed strong protective associations, particularly in postmenopausal women. Further prospective studies are required to clarify the role of adherence to WCRF/AICR recommendations, particularly with respect to BMI, in the Mexican population.
Collapse
Affiliation(s)
- Anouar Fanidi
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| | - Pietro Ferrari
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| | | | | | | | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France
| |
Collapse
|
31
|
Khalili R, Bagheri-Nesami M, Janbabai G, Nikkhah A. Lifestyle in Iranian Patients with Breast Cancer. J Clin Diagn Res 2015; 9:XC06-XC09. [PMID: 26393190 DOI: 10.7860/jcdr/2015/13954.6233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/03/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND One of the most commonly diagnosed cancers is breast cancer that leads to mortality and morbidity among Iranian women. Behavioural risk factors, such as common lifestyle patterns are often associated with risk of breast cancer incidence. AIM This study aimed to investigate lifestyle of breast cancer patients admitted to Cancer Research Center of Mazandaran University of Medical Sciences. MATERIALS AND METHODS This descriptive cross-sectional study was conducted using convenient sampling method. Sample size consisted of 150 cancer patients, and data collection tool included a researcher-made questionnaire on dimensions of lifestyle containing four dimensions of self-care, exercise and physical activity, diet and coping with stress. Maximum score in different dimensions, based on 100% of marks earned, was evaluated in three categories of undesirable, relatively desirable and desirable. Data were analysed with SPSS-19 software using descriptive statistics (relative and absolute frequencies, mean and standard deviation). RESULTS In total of 150 women, the mean age of patients was 51.9 ± 1.04 (27-78). The majority of participants were married, housewives, with high school education. Among the four parts of healthy lifestyle, desirable level of physical activity and exercise had the least participants, and in the dimensions of physical activity and exercise, the lowest level related to walking, followed by daily exercise. Most of the participants had undesirable level of self-care and lowest frequency related to mammography after 40-year-old, followed by annual check-up and Pap-smear. With regard to nutrition, most of them were at desirable level. CONCLUSION The results indicated undesirable levels in two lifestyle dimensions (self-care and physical activity and exercise) in the majority of participants for a year before contracting breast cancer. Primary prevention programs should be implemented with a comprehensive approach, thus, effective strategies are required to modify lifestyle.
Collapse
Affiliation(s)
- Robabeh Khalili
- PhD Candidate of Nursing Education, School of Nursing, Baqiyatallah University of Medical Sciences , Tehran, Iran
| | - Masoumeh Bagheri-Nesami
- Medical-Surgical Nursing Department, Molecular and Cell Biology Research Center (MCBRC), Mazandaran University of Medical Sciences , Sari, Iran
| | - Ghasem Janbabai
- Department of Oncology, Cellular and Molecular Research Center, Mazandaran University of Medical Sciences , Sari, Iran
| | - Attieh Nikkhah
- Medical-Surgical Nursing Department, Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences , Sari, Iran
| |
Collapse
|
32
|
McKenzie F, Ferrari P, Freisling H, Chajès V, Rinaldi S, de Batlle J, Dahm CC, Overvad K, Baglietto L, Dartois L, Dossus L, Lagiou P, Trichopoulos D, Trichopoulou A, Krogh V, Panico S, Tumino R, Rosso S, Bueno-de-Mesquita HBA, May A, Peeters PH, Weiderpass E, Buckland G, Sanchez MJ, Navarro C, Ardanaz E, Andersson A, Sund M, Ericson U, Wirfält E, Key TJ, Travis RC, Gunter M, Riboli E, Vergnaud AC, Romieu I. Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study. Int J Cancer 2015; 136:2640-8. [PMID: 25379993 DOI: 10.1002/ijc.29315] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 09/19/2014] [Indexed: 01/15/2023]
Abstract
Breast cancer is the most common cancer among women and prevention strategies are needed to reduce incidence worldwide. A healthy lifestyle index score (HLIS) was generated to investigate the joint effect of modifiable lifestyle factors on postmenopausal breast cancer risk. The study included 242,918 postmenopausal women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, with detailed information on diet and lifestyle assessed at baseline. The HLIS was constructed from five factors (diet, physical activity, smoking, alcohol consumption and anthropometry) by assigning scores of 0-4 to categories of each component, for which higher values indicate healthier behaviours. Hazard ratios (HR) were estimated by Cox proportional regression models. During 10.9 years of median follow-up, 7,756 incident breast cancer cases were identified. There was a 3% lower risk of breast cancer per point increase of the HLIS. Breast cancer risk was inversely associated with a high HLIS when fourth versus second (reference) categories were compared [adjusted HR = 0.74; 95% confidence interval (CI): 0.66-0.83]. The fourth versus the second category of the HLIS was associated with a lower risk for hormone receptor double positive (adjusted HR = 0.81, 95% CI: 0.67-0.98) and hormone receptor double negative breast cancer (adjusted HR = 0.60, 95% CI: 0.40-0.90). Findings suggest having a high score on an index of combined healthy behaviours reduces the risk of developing breast cancer among postmenopausal women. Programmes which engage women in long term health behaviours should be supported.
Collapse
Affiliation(s)
- Fiona McKenzie
- International Agency for Research on Cancer (IARC), Lyon, France; Centre for Public Health Research, Massey University, Wellington, New Zealand
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
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] [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.
Collapse
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
| |
Collapse
|
34
|
|
35
|
Kesse-Guyot E, Andreeva VA, Lassale C, Hercberg S, Galan P. Clustering of midlife lifestyle behaviors and subsequent cognitive function: a longitudinal study. Am J Public Health 2014; 104:e170-7. [PMID: 25211733 DOI: 10.2105/ajph.2014.302121] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We examined the association between individual and clustered lifestyle behaviors in middle age and later in cognitive functioning. METHODS Middle-aged participants (n = 2430) in the Supplémentation en Vitamines et Minéraux Antioxydant study self-reported their low physical activity, sedentary behavior, alcohol use, smoking, low fruit and vegetable consumption, and low fish consumption. We assessed cognition 13 years later via 6 neuropsychological tests. After standardization, we summed the scores for a composite cognitive measure. We estimated executive functioning and verbal memory scores using principal component analysis. We estimated the mean differences (95% confidence intervals [CIs]) in cognitive performance by the number of unhealthy behaviors using analysis of covariance. We identified latent unhealthy behavior factor via structural equation modeling. RESULTS Global cognitive function and verbal memory were linearly, negatively associated with the number of unhealthy behaviors: adjusted mean differences = -0.36 (95% CI = -0.69, -0.03) and -0.46 (95% CI = -0.80, -0.11), respectively, per unit increase in the number of unhealthy behaviors. The latent unhealthy behavior factor with low fruit and vegetable consumption and low physical activity as main contributors was associated with reduced verbal memory (RMSEA = 0.02; CFI = 0.96; P = .004). No association was found with executive functioning. CONCLUSIONS Comprehensive public health strategies promoting healthy lifestyles might help deter cognitive aging.
Collapse
Affiliation(s)
- Emmanuelle Kesse-Guyot
- Emmanuelle Kesse-Guyot, Valentina A. Andreeva, Camille Lassale, Serge Hercberg, and Pilar Galan are with the Université Paris 13, Sorbonne Paris Cité, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques Paris Nord, Inserm (U1153), Inra (U1125), Cnam, Université Paris 5, Université Paris 7, Bobigny, France
| | | | | | | | | |
Collapse
|
36
|
Sheen YY, Kim MJ, Park SA, Park SY, Nam JS. Targeting the Transforming Growth Factor-β Signaling in Cancer Therapy. Biomol Ther (Seoul) 2014; 21:323-31. [PMID: 24244818 PMCID: PMC3825194 DOI: 10.4062/biomolther.2013.072] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 09/24/2013] [Indexed: 12/21/2022] Open
Abstract
TGF-β pathway is being extensively evaluated as a potential therapeutic target. The transforming growth factor-β (TGF-β) signaling pathway has the dual role in both tumor suppression and tumor promotion. To design cancer therapeutics successfully, it is important to understand TGF-β related functional contexts. This review discusses the molecular mechanism of the TGF-β pathway and describes the different ways of tumor suppression and promotion by TGF-β. In the last part of the review, the data on targeting TGF-β pathway for cancer treatment is assessed. The TGF-β inhibitors in pre-clinical studies, and Phase I and II clinical trials are updated.
Collapse
|
37
|
McKenzie F, Ellison-Loschmann L, Jeffreys M, Firestone R, Pearce N, Romieu I. Healthy lifestyle and risk of breast cancer for indigenous and non-indigenous women in New Zealand: a case control study. BMC Cancer 2014; 14:12. [PMID: 24410858 PMCID: PMC3893580 DOI: 10.1186/1471-2407-14-12] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 11/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The reasons for the increasing breast cancer incidence in indigenous Māori compared to non-Māori New Zealand women are unknown. The aim of this study was to assess the association of an index of combined healthy lifestyle behaviours with the risk of breast cancer in Māori and non-Māori women. METHODS A population-based case-control study was conducted, including breast cancer cases registered in New Zealand from 2005-2007. Controls were matched by ethnicity and 5-year age bands. A healthy lifestyle index score (HLIS) was generated for 1093 cases and 2118 controls, based on public health and cancer prevention recommendations. The HLIS was constructed from eleven factors (limiting red meat, cream, and cheese; consuming more white meat, fish, fruit and vegetables; lower alcohol consumption; not smoking; higher exercise levels; lower body mass index; and longer cumulative duration of breastfeeding). Equal weight was given to each factor. Logistic regression was used to estimate the associations between breast cancer and the HLIS for each ethnic group stratified by menopausal status. RESULTS Among Māori, the mean HLIS was 5.00 (range 1-9); among non-Māori the mean was 5.43 (range 1.5-10.5). There was little evidence of an association between the HLIS and breast cancer for non-Māori women. Among postmenopausal Māori, those in the top HLIS tertile had a significantly lower odds of breast cancer (Odds Ratio 0.47, 95% confidence interval 0.23-0.94) compared to those in the bottom tertile. CONCLUSION These findings suggest that healthy lifestyle recommendations could be important for reducing breast cancer risk in postmenopausal Māori women.
Collapse
Affiliation(s)
- Fiona McKenzie
- International Agency for Research on Cancer, Lyon, France
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | | | - Mona Jeffreys
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ridvan Firestone
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Neil Pearce
- Centre for Public Health Research, Massey University, Wellington, New Zealand
- London School of Hygiene and Tropical Medicine, London, UK
| | | |
Collapse
|
38
|
Abstract
Breast cancer is the most common malignancy in Israeli Jewish and Arab women. The main objective of this study was to reexamine the trends in breast cancer incidence, mortality, and survival in Israel in 1996 through 2007, as well as the use of mammography. Data were obtained from the Israel National Cancer Registry, the Central Bureau of Statistics, and National Health Surveys. Incidence and mortality rates per 100 000 are age adjusted to the world standard population. Time trends are presented using the joinpoint regression analysis. The relative survival was calculated for the diagnosis years 1996-2003. Data on mammography performance were obtained from the Knowledge, Attitudes and Practices surveys carried out in 2002-2008. From 1996 through 2007, the incidence of in-situ breast cancer increased in both subpopulations whereas the incidence of invasive breast cancer decreased by 3% for Jewish women and increased by 98% for Arab women (P value for 'between-populations' differences <0.001). Reports on having had a mammogram in the last 2 years increased by 16% in Jewish women and by 17% in Arab women in 2002 through 2008 (P=0.880). Breast cancer mortality rates decreased significantly from 24.7 in 1996 to 19.0 in 2007 in Jewish women, but remained stable in Arab women (P=0.041). The 5-year relative survival increased in both subpopulations (P=0.420). The incidence of breast cancer has been stable in Jewish women, but had been increasing rapidly in Arab women throughout 1996-2007. The differences indicate an epidemiologic transition in the Arab minority in Israel. Efforts should focus not only on secondary but also on primary prevention strategies.
Collapse
|
39
|
Rafi I, Chowdhury S, Chan T, Jubber I, Tahir M, de Lusignan S. Improving the management of people with a family history of breast cancer in primary care: before and after study of audit-based education. BMC FAMILY PRACTICE 2013; 14:105. [PMID: 23879178 PMCID: PMC3734209 DOI: 10.1186/1471-2296-14-105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 07/08/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND In England, guidance from National Institute for Clinical Excellence (NICE) states women with a family history of breast cancer presenting to primary care should be reassured or referred.We reviewed the evidence for interventions that might be applied in primary care and conducted an audit of whether low risk women are correctly advised and flagged. METHODS We conducted a literature review to identify modifiable risk factors. We extracted routinely collected data from the computerised medical record systems of 6 general practices (population approximately 30,000); of the variables identified in the guidance. We implemented a quality improvement (QI) intervention called audit-based education (ABE) comparing participant practices with guidelines and each other before and after; we report odds ratios (OR) of any change in data recording. RESULTS The review revealed evidence for advising on: diet, weight control, physical exercise, and alcohol. The proportion of patients with recordings of family history of: disease, neoplasms, and breast cancer were: 39.3%, 5.1% and 1.3% respectively. There was no significant change in the recording of family history of disease or cancer; OR 1.02 (95% CI 0.98-1.06); and 1.08 (95% CI 0.99-1.17) respectively. Recording of alcohol consumption and smoking both increased significantly; OR 1.36 (95% CI 1.30-1.43); and 1.42 (95% CI 1.27-1.60) respectively. Recording lifestyle advice fell; OR 0.84 (95% CI 0.81-0.88). CONCLUSIONS The study informs about current data recording and willingness to engage in ABE. Recording of risk factors improved after the intervention. Further QI is needed to achieve adherence to current guidance.
Collapse
Affiliation(s)
- Imran Rafi
- Division of Population Health Sciences and Education, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK
- Clinical Innovation and Research Centre (CIRC), Royal College of General Practitioners, 30 Euston Square, London NW1 2FB, UK
| | - Susmita Chowdhury
- PHG Foundation, 2 Worts Causeway, Cambridge, Cambridgeshire CB1 8RN, UK
| | - Tom Chan
- Department of Healthcare Management and Policy, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Ibrahim Jubber
- Division of Population Health Sciences and Education, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Mohammad Tahir
- Department of Healthcare Management and Policy, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Simon de Lusignan
- Department of Healthcare Management and Policy, University of Surrey, Guildford, Surrey GU2 7XH, UK
| |
Collapse
|
40
|
Mo N, Li ZQ, Li J, Cao YD. Curcumin inhibits TGF-β1-induced MMP-9 and invasion through ERK and Smad signaling in breast cancer MDA- MB-231 cells. Asian Pac J Cancer Prev 2013; 13:5709-14. [PMID: 23317243 DOI: 10.7314/apjcp.2012.13.11.5709] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate the effects of curcumin on matrixmetalloproteinase-9 (MMP-9) and invasion ability induced by transforming growth factor-β1 (TGF-β1) in MDA-MB-231 cells and potential mechanisms. METHODS Human breast cancer MDA- MB-231 cells were used with the CCK-8 assay to measure the cytotoxicity of curcumin. After treatment with 10 ng/ml TGF-β1, with or without curcumin (≤10 μM), cell invasion was checked by transwell chamber. The effects of curcumin on TGF-β1-stimulated MMP-9 and phosphorylation of Smad2, extracellular-regulated kinase (ERK), and p38 mitogen activated protein kinases (p38MAPK) were examined by Western blotting. Supernatant liquid were collected to analyze the activity of MMP-9 via zymography. Following treatment with PD98059, a specific inhibitor of ERK, and SB203580, a specific inhibitor of p38MAPK, Western blotting and zymography were employed to examine MMP-9 expression and activity, respectively. RESULTS Low dose curcumin (≤10 μM) did not show any obvious toxicity to the cells, while 0~10 μmol/L caused a concentration-dependent reduction in cell invasion provoked by TGF-β1. Curcumin also markedly inhibited TGF-β1-regulated MMP-9 and activation of Smad2, ERK1/2 and p38 in a dose- and time-dependent manner. Additionally, PD98059, but not SB203580, showed a similar pattern of inhibition of MMP-9 expression. CONCLUSION Curcumin inhibited TGF-β1-stimulated MMP-9 and the invasive phenotype in MDA-MB-231 cells, possibly associated with TGF-β/Smad and TGF-β/ERK signaling.
Collapse
Affiliation(s)
- Na Mo
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | | | | | | |
Collapse
|
41
|
Abstract
Epidemiological evidence continues to accumulate on the benefits of physical activity in relation to cancer risk, progression and mortality. Recent studies suggest that sedentary behavior may independently affect cancer risk; they also focus on factors that may explain associations with physical activity, including cancer risk factors and whether associations exist for precancerous lesions. Despite enormous efforts to examine associations between physical activity and cancer, the literature is hindered by inconsistent assessment of physical activity across studies, and incomplete consideration of variation of effects across population subgroups (for example, defined by body size, age or sex) or tumors subgroups (organ location, receptor status, or molecular subtype), and whether other factors explain study results. Clearly, public health recommendations for appropriate changes in activity levels are needed; unfortunately, at this time, we have no exact physical activity prescription to give to the public.
Collapse
|
42
|
Wang L, Liao WC, Tsai CJ, Wang LR, Mao IF, Chen CC, Kao PF, Yao CC. The Effects of Perceived Stress and Life Style Leading to Breast Cancer. Women Health 2013; 53:20-40. [DOI: 10.1080/03630242.2012.732680] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
43
|
Abstract
Breast cancer is a major public health issue in low-income and middle-income countries. In Mexico, incidence and mortality of breast cancer have risen in the past few decades. Changes in health-care policies in Mexico have incorporated programmes for access to early diagnosis and treatment of this disease. This Review outlines the status of breast cancer in Mexico, regarding demographics, access to care, and strategies to improve clinical outcomes. We identify factors that contribute to the existing disease burden, such as low mammography coverage, poor quality control, limited access to diagnosis and treatment, and insufficient physical and human resources for clinical care.
Collapse
|
44
|
Slattery ML, John EM, Torres-Mejia G, Lundgreen A, Herrick JS, Baumgartner KB, Hines LM, Stern MC, Wolff RK. Genetic variation in genes involved in hormones, inflammation and energetic factors and breast cancer risk in an admixed population. Carcinogenesis 2012; 33:1512-21. [PMID: 22562547 DOI: 10.1093/carcin/bgs163] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Breast cancer incidence rates are characterized by unique racial and ethnic differences. Native American ancestry has been associated with reduced breast cancer risk. We explore the biological basis of disparities in breast cancer risk in Hispanic and non-Hispanic white women by evaluating genetic variation in genes involved in inflammation, insulin and energy homeostasis in conjunction with genetic ancestry. Hispanic (2111 cases, 2597 controls) and non-Hispanic white (1481 cases, 1586 controls) women enrolled in the 4-Corner's Breast Cancer Study, the Mexico Breast Cancer Study and the San Francisco Bay Area Breast Cancer Study were included. Genetic admixture was determined from 104 ancestral informative markers that discriminate between European and Native American ancestry. Twenty-one genes in the CHIEF candidate pathway were evaluated. Higher Native American ancestry was associated with reduced risk of breast cancer (odds ratio = 0.79, 95% confidence interval 0.65, 0.95) but was limited to postmenopausal women (odds ratio = 0.66, 95% confidence interval 0.52, 0.85). After adjusting for genetic ancestry and multiple comparisons, four genes were significantly associated with breast cancer risk, NFκB1, NFκB1A, PTEN and STK11. Within admixture strata, breast cancer risk among women with low Native American ancestry was associated with IkBKB, NFκB1, PTEN and RPS6KA2, whereas among women with high Native American ancestry, breast cancer risk was associated with IkBKB, mTOR, PDK2, PRKAA1, RPS6KA2 and TSC1. Higher Native American ancestry was associated with reduced breast cancer risk. Breast cancer risk differed by genetic ancestry along with genetic variation in genes involved in inflammation, insulin, and energy homeostasis.
Collapse
Affiliation(s)
- Martha L Slattery
- University of Utah, Department of Medicine295 Chipeta Way Salt Lake City, Utah 84108, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Drabsch Y, ten Dijke P. TGF-β signaling in breast cancer cell invasion and bone metastasis. J Mammary Gland Biol Neoplasia 2011; 16:97-108. [PMID: 21494783 PMCID: PMC3095797 DOI: 10.1007/s10911-011-9217-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 03/14/2011] [Indexed: 12/16/2022] Open
Abstract
The contribution of transforming growth factor β (TGF-β) signaling to breast cancer has been studied for more than two decades. In an early phase TGF-β may act as a tumour suppressor, while later, when cells have become resistant to its anti-mitogenic effects, the role of TGF-β switches towards malignant conversion and progression. TGF-β stimulates cell invasion and modifies the microenvironment to the advantage of cancer cells. Studies have shown that TGF-β promotes bone and lung metastasis via different mechanisms. The therapeutic strategies to target the TGF-β pathway in breast cancer are becoming increasingly clear. This review will focus on the role TGF-β in breast cancer invasion and metastasis.
Collapse
Affiliation(s)
- Yvette Drabsch
- Department of Molecular Cell Biology and Centre for Biomedical Genetics, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands
| | - Peter ten Dijke
- Department of Molecular Cell Biology and Centre for Biomedical Genetics, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands
- Ludwig Institute for Cancer Research and Uppsala University, Box 595, 75124 Uppsala, Sweden
| |
Collapse
|