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Sighoko D, Hou N, Ogundiran T, Adebamowo C, Ademola A, Ojengbede O, Anetor I, Akinleye S, Ndom P, Gakwaya A, Huo D, Olopade OI. Abstract P3-06-13: Transient increase in breast cancer risk after a full term pregnancy among African women. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-06-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
African women affected by breast cancer (BC) have high parity with five children or more, are relatively young at first full term pregnancy (FFTP), are diagnosed at a young age and are often premenopausal at diagnosis. While several studies have assessed the role of reproductive factors for BC risk among African women, none of them have assessed whether there is dual effect of age at full term pregnancy (FTP). In this communications, using a large dataset from an on-going hospital-based case-control study, we examine the role of age at full term pregnancy on breast cancer risk among African women.
Methods
The study includes sites in Nigeria (University College Hospital, Ibadan), Cameroon (Yaoundé General Hospital) and Uganda (Breast Clinic of Mulago Hospital of Kampala). It was initiated in 1998 in Nigeria and extended to Cameroon and Uganda in 2011. Cases were consecutive females diagnosed with invasive BC. Controls were recruited from the community or within the hospital and have never being diagnosed with any cancer. Cases and controls were aged 18 years or more and gave informed consent. Full term pregnancy was defined as a pregnancy that lasted at least 7 months and included both live birth and stillbirth. Logistic regression models were used to assess the effects of age at first and second FTP, and their interaction with current age on BC risk. Age at menarche, parity, body mass index and hormone contraception use were included in the models.
Results
The study includes 1668 cases and 2399 controls recruited between 1998 and May 2013. Mean duration of live birth was 9 months (SD±0.52) and 8.8 months (SD±0.66) for a stillbirth. Overall, the mean age at FFTP was 23 years (SD±4.91) for both cases and controls. Compared to nulliparous women, parous women who had FFTP at 20 years have increased risk (OR = 1.59, CI 95%, 1.16-2.21) to develop BC in the year following the pregnancy. Up to 5 years following the FFTP, this OR is 1.38 (CI 95%, 1.06-1.80) while it is 0.77 (CI 95%, 0.62-0.95) 25 years later. This observation was also true for parous women who have had their FFTP at 25, 30, or 35 years. Moreover, a similar pattern was observed when comparing uniparous women to women with 2 or more children.
Conclusion
Our results show a transient increase in risk of BC after a full term pregnancy which declined and became protective over time. This observation is consistent with the effect of pregnancy on BC that has been described in other populations and may partially explain the current profile of breast cancer among African women.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-06-13.
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Affiliation(s)
- D Sighoko
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - N Hou
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - T Ogundiran
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - C Adebamowo
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - A Ademola
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - O Ojengbede
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - I Anetor
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - S Akinleye
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - P Ndom
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - A Gakwaya
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - D Huo
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
| | - OI Olopade
- The University of Chicago, Chicago, IL; The University of Ibadan, Ibadan, Nigeria; University of Maryland, Baltimore, MD; Institute of Human Virology, Abuja, Nigeria; Healthy Life for All Foundation, Ibadan, Nigeria; Yaoundé General Hospital, Yaounde, Cameroon; Mulago Hospital, Kampala, Uganda
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von Karsa L, Patnick J, Segnan N, Atkin W, Halloran S, Lansdorp-Vogelaar I, Malila N, Minozzi S, Moss S, Quirke P, Steele RJ, Vieth M, Aabakken L, Altenhofen L, Ancelle-Park R, Antoljak N, Anttila A, Armaroli P, Arrossi S, Austoker J, Banzi R, Bellisario C, Blom J, Brenner H, Bretthauer M, Camargo Cancela M, Costamagna G, Cuzick J, Dai M, Daniel J, Dekker E, Delicata N, Ducarroz S, Erfkamp H, Espinàs JA, Faivre J, Faulds Wood L, Flugelman A, Frkovic-Grazio S, Geller B, Giordano L, Grazzini G, Green J, Hamashima C, Herrmann C, Hewitson P, Hoff G, Holten I, Jover R, Kaminski MF, Kuipers EJ, Kurtinaitis J, Lambert R, Launoy G, Lee W, Leicester R, Leja M, Lieberman D, Lignini T, Lucas E, Lynge E, Mádai S, Marinho J, Maučec Zakotnik J, Minoli G, Monk C, Morais A, Muwonge R, Nadel M, Neamtiu L, Peris Tuser M, Pignone M, Pox C, Primic-Zakelj M, Psaila J, Rabeneck L, Ransohoff D, Rasmussen M, Regula J, Ren J, Rennert G, Rey J, Riddell RH, Risio M, Rodrigues V, Saito H, Sauvaget C, Scharpantgen A, Schmiegel W, Senore C, Siddiqi M, Sighoko D, Smith R, Smith S, Suchanek S, Suonio E, Tong W, Törnberg S, Van Cutsem E, Vignatelli L, Villain P, Voti L, Watanabe H, Watson J, Winawer S, Young G, Zaksas V, Zappa M, Valori R. European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy 2013; 45:51-9. [PMID: 23212726 PMCID: PMC4482205 DOI: 10.1055/s-0032-1325997] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010. They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines.
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Affiliation(s)
| | - L. von Karsa
- International Agency for Research on Cancer, Lyon, France
| | - J. Patnick
- NHS Cancer Screening Programmes Sheffield, United Kingdom,Oxford University Cancer Screening Research Unit, Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - N. Segnan
- International Agency for Research on Cancer, Lyon, France,CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - W. Atkin
- Imperial College London, London, United Kingdom
| | - S. Halloran
- Bowel Cancer Screening Southern Programme Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom,University of Surrey, Guildford, United Kingdom
| | | | - N. Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - S. Minozzi
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - S. Moss
- The Institute of Cancer Research, Royal Cancer Hospital, Sutton, United Kingdom
| | - P. Quirke
- Leeds Institute of Molecular Medicine, St James’ University Hospital, Leeds, United Kingdom
| | - R. J. Steele
- Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - M. Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
| | - L. Aabakken
- Department of Medical Gastroenterology, Stavanger University Hospital, Stavanger, Norway
| | - L. Altenhofen
- Central Research Institute of Ambulatory Health Care, Berlin, Germany
| | | | - N. Antoljak
- Croatian National Institute of Public Health, Zagreb, Croatia,University of Zagreb School of Medicine, Zagreb, Croatia
| | - A. Anttila
- Finnish Cancer Registry, Helsinki, Finland
| | - P. Armaroli
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | | | - J. Austoker
- University of Oxford, Oxford, United Kingdom
| | - R. Banzi
- Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - C. Bellisario
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - J. Blom
- Karolinska Institutet, Stockholm, Sweden
| | - H. Brenner
- German Cancer Research Center, Heidelberg, Germany
| | - M. Bretthauer
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - M. Camargo Cancela
- National Cancer Registry, Cork, Ireland,Formerly International Agency for Research on Cancer, Lyon, France
| | | | - J. Cuzick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom
| | - M. Dai
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - J. Daniel
- Formerly International Agency for Research on Cancer, Lyon, France,American Cancer Society, Atlanta, Georgia, United States of America
| | - E. Dekker
- Academic Medical Centre, Amsterdam, the Netherlands
| | - N. Delicata
- National Health Screening Services, Ministry of Health, Elderly & Community Care, Valletta, Malta
| | - S. Ducarroz
- International Agency for Research on Cancer, Lyon, France
| | - H. Erfkamp
- University of Applied Sciences FH Joanneum, Graz, Austria
| | - J. A. Espinàs
- Catalan Cancer Strategy, L’Hospitalet de Llobregat, Spain
| | - J. Faivre
- Digestive Cancer Registry of Burgundy, INSERM U866, University and CHU, Dijon, France
| | - L. Faulds Wood
- Lynn’s Bowel Cancer Campaign, Twickenham, United Kingdom
| | - A. Flugelman
- National Israeli Breast and Colorectal Cancer Detection, Haifa, Israel
| | - S. Frkovic-Grazio
- Department of Gynecological Pathology and Cytology, University Medical Center Ljubljana, Slovenia
| | - B. Geller
- University of Vermont, Burlington, Vermont, United States of America
| | - L. Giordano
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - G. Grazzini
- Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - J. Green
- University of Oxford, Oxford, United Kingdom
| | | | - C. Herrmann
- Formerly International Agency for Research on Cancer, Lyon, France,Cancer League of Eastern Switzerland, St. Gallen, Switzerland
| | - P. Hewitson
- University of Oxford, Oxford, United Kingdom
| | - G. Hoff
- Cancer Registry of Norway, Oslo, Norway,Telemark Hospital, Skien, Norway
| | - I. Holten
- Danish Cancer Society, Copenhagen, Denmark
| | - R. Jover
- Hospital General Universitario de Alicante, Alicante, Spain
| | - M. F. Kaminski
- Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
| | | | | | - R. Lambert
- International Agency for Research on Cancer, Lyon, France
| | - G. Launoy
- U1086 INSERM – UCBN, CHU Caen, France
| | - W. Lee
- The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | | | - M. Leja
- University of Latvia, Riga, Latvia
| | - D. Lieberman
- Oregon Health & Science University, Portland, Oregon, United States of America
| | - T. Lignini
- International Agency for Research on Cancer, Lyon, France
| | - E. Lucas
- International Agency for Research on Cancer, Lyon, France
| | - E. Lynge
- University of Copenhagen, Copenhagen, Denmark
| | - S. Mádai
- MaMMa Healthcare Institute, Budapest, Hungary
| | - J. Marinho
- Health Administration Central Region Portugal, Aveiro, Portugal
| | | | - G. Minoli
- Gastroenterology Unit, Valduce Hospital, Como, Italy
| | - C. Monk
- GlaxoSmithKline Pharma Europe, London, United Kingdom
| | - A. Morais
- Regional Health Administration, Coimbra, Portugal
| | - R. Muwonge
- International Agency for Research on Cancer, Lyon, France
| | - M. Nadel
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - L. Neamtiu
- Prof. Dr Ion Chiricuţă, Cluj-Napoca, Romania
| | - M. Peris Tuser
- Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - M. Pignone
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - C. Pox
- Ruhr Universität, Bochum, Germany
| | - M. Primic-Zakelj
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Slovenia
| | - J. Psaila
- National Health Screening Services, Ministry of Health, Elderly & Community Care, Valletta, Malta
| | - L. Rabeneck
- University of Toronto and Cancer Care Ontario, Toronto, Canada
| | - D. Ransohoff
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Rasmussen
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - J. Regula
- Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
| | - J. Ren
- Formerly International Agency for Research on Cancer, Lyon, France
| | - G. Rennert
- National Israeli Breast and Colorectal Cancer Detection, Haifa, Israel
| | - J. Rey
- Institut Arnault Tzanck, St Laurent du Var, France
| | | | - M. Risio
- Institute for Cancer Research and Treatment, Candiolo-Torino, Italy
| | - V. Rodrigues
- Faculdade de Medicina – Universidade de Coimbra, Coimbra, Portugal
| | - H. Saito
- National Cancer Centre, Tokyo, Japan
| | - C. Sauvaget
- International Agency for Research on Cancer, Lyon, France
| | | | | | - C. Senore
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - M. Siddiqi
- Cancer Foundation of India, Kolkata, India
| | - D. Sighoko
- Formerly International Agency for Research on Cancer, Lyon, France,The University of Chicago, Department of Medicine, Hematology–Oncology Section, Center for Clinical Cancer Genetics, Global Health, Chicago, United States of America
| | - R. Smith
- American Cancer Society, Atlanta, Georgia, United States of America
| | - S. Smith
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - S. Suchanek
- Charles University and Military University Hospital, Prague, Czech Republic
| | - E. Suonio
- International Agency for Research on Cancer, Lyon, France
| | - W. Tong
- Chinese Academy of Medical Sciences, Beijing, China
| | - S. Törnberg
- Department of Cancer Screening, Stockholm Gotland Regional Cancer Centre, Stockholm, Sweden
| | | | - L. Vignatelli
- Agenzia Sanitaria e Sociale Regionale–Regione Emilia-Romagna, Bologna, Italy
| | - P. Villain
- University of Oxford, Oxford, United Kingdom
| | - L. Voti
- Formerly International Agency for Research on Cancer, Lyon, France,University of Miami, Miami, Florida, United States of America
| | | | - J. Watson
- University of Oxford, Oxford, United Kingdom
| | - S. Winawer
- Memorial Sloan–Kettering Cancer Center, New York, United States of America
| | - G. Young
- Gastrointestinal Services, Flinders University, Adelaide, Australia
| | - V. Zaksas
- State Patient Fund, Vilnius, Lithuania
| | - M. Zappa
- Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - R. Valori
- NHS Endoscopy, Leicester, United Kingdom
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