Purpose: Modifiable risk factors, including nutrition, are of particular interest in cancer research. There are limited studies establishing associations between dietary patterns and breast cancer risk. The purpose of this qualitative study is to explore the nutritional practices and perceptions of nutrition and cancer among breast cancer patients in northern Tanzania. Methods: Participants with confirmed diagnosis of breast cancer were identified in an outpatient setting and included in a larger qualitative study regarding patient breast cancer experiences and reasons for advanced stage at time of diagnosis. Semi-structured interviews were conducted by trained interviewers and transcribed verbatim, then translated from Swahili to English. Thematic coding using a grounded theory approach was done by two independent researchers. Results: Twenty patients (10 rural and 10 urban) participated in the interviews. The average age was 56; 11 (55%) completed primary education, 10 (50%) were unemployed, and 5 (25%) were married. Fourteen (70%) of the patients had stage 4 breast cancer, 3 (15%) had stage 3, and 3 (15%) had stage 2. Food access varied with 6 (30%) patients identifying as farmers or growing up on coffee plantations. Within this group, two-thirds mentioned pesticide use. Cancer causes perceived by patients included animal products (n = 5, 25%), cooking oil and fried food (n = 5, 25%), toxins or chemicals in food (n = 6, 30%), alcohol use (n = 5, 25%), smoking (n = 2, 10%), and being overweight/obese (n = 1, 5%). After receiving the cancer diagnosis, 55% (n = 11) modified their diet: decreased or ceased alcohol intake (n = 4, 20%), stopped consuming soda (n = 2, 10%), prepared food by boiling instead of frying (n = 2, 10%), and increased vegetable intake (n = 3, 15%). Conclusions: Many participants perceived cancer to be caused by dietary factors with some correctly identifying risk factors including smoking, alcohol use, and being overweight/obese. These beliefs were impactful enough to lead many to change their dietary habits after cancer diagnosis. Further research is needed to elucidate the impact of dietary habits on cancer outcomes in Sub-Saharan Africa and provide educational interventions to promote healthier lifestyles in patients. Citation Format: Garrett Barnes, Sindhu Dwarampudi, Elizabeth Msoka-Bright, Lily Gutnik. The Perceived Relationship Between Nutrition and Cancer Among Breast Cancer Patients in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 83.
This paper presents a mixed methods approach to understanding wellbeing in the Kilimanjaro region of northern Tanzania—a country consistently ranked by the World Happiness Report as one of the least happy in the world. A primary objective is to demonstrate how qualitative data offering bottom-up perspectives on wellbeing offer a necessary complement to quantitative self-report measures, allowing for more nuanced cultural understandings of lived experience and wellbeing that recognize diversity both globally and locally. The research contextualized responses to standardized life evaluations (including the Cantril ladder question used by the World Happiness Report) through observations and interviews along with culturally sensitive measures of emotional experience. Findings show Kilimanjaro to have more positive life evaluations than Tanzania as a whole, and significant within-region demographic variation driven particularly by lower levels of wellbeing for nonprofessional women compared with nonprofessional men and professionals. In part because such demographic groups were often unfamiliar with standardized self-report measures, it was only through interviews, case studies, and culturally sensitive reports of emotional experience that we were able to recognize the diverse and nuanced life circumstances which individuals and groups were navigating and how those circumstances interacted with wellbeing. Drawing on the example of nonprofessional women for illustration, we describe how key sociocultural factors – particularly, family stability, parenting circumstances, social relationships, and meeting life course expectations -- intersect with economic realities to create varied experiences of wellbeing. The complex picture of locally understood wellbeing that emerged from this research presents an alternative picture to global perspectives reliant on survey self-reports. It serves as a reminder of the importance of methodological choices in global wellbeing research and urges the addition of local perspectives and paradigms to inform policy and practice.
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