A hospital based case control study of female breast cancer risk factors in a Sub-Saharan African country

Abstract

INTRODUCTIONBreast cancer is the most common cancer diagnosed in women worldwide with over 1.3 million new cases per year. There is a wide variation in the geographical burden of the disease with the highest incidences seen in the developed regions of the world and the lowest incidences observed in the least developed regions. ABSTRACTBackground: Breast cancer is the most common cancer diagnosed in women worldwide with over 1.3 million new cases per year. There is a wide variation in the geographical burden of the disease with the highest incidences seen in the developed regions of the world and the lowest incidences observed in the least developed regions. The objective of this study was to understand further the risks for breast cancer in Senegalese population which can then inform public health strategies to try and reduce the burden of breast cancer.Methods: This matched case control study was conducted in 2015 in Aristide Le Dantec Teaching Hospital in Dakar. All women with pathologically confirmed primary breast cancer were considered as cases. For each case, 2 agematched women were recruited. We collected and compared demographic factors, family history of breast cancer, socioeconomic variables, reproductive variables (age at menarche, age at first pregnancy and first live birth, parity, menopausal status, duration of breastfeeding), and exogenous hormone use up to 6 months. Odds ratios from univariate logistic regression were used to estimate the relative risk of breast cancer associated with the various factors, and their predictive effects. Results: In all, 212 women with breast cancer who were diagnosed as having breast cancer and 424 control women were involved in the study. The mean±SD age of cases and controls was 43.37±11.94 years (range 18-83 years) and 42.04±11.08 years (range 18-84 years), respectively. There were no significant differences between cases and controls with regards to marital status, parity, age at menarche, past oral contraceptive use, age at first last full-term pregnancy and history of breastfeeding. Breast cancer risk was significantly greater in women with a family history of the disease (OR 2.12, 95% confidence interval [CI] 1.35-3.31). A significant increase in breast cancer was observed among illiterate women compared to educated women (OR 1.27, CI 1.02-1.58), in premenopausal women and those without occupation. Conclusions: In this study, reproductive factors as early menarche or menopausal status were not associative to the risk of breast cancer and the early age at diagnosis and the positive history of breast cancer suggest a genetic pattern of this disease in Senegalese woman. But this fact is difficult to confirm for financial reasons.

Risk Factors Associated with Breast Cancer among Women in Addis Ababa, Ethiopia: Unmatched Case–Control Study

“…Family history is an important risk factor for breast cancer and is significantly greater in women with a family history of the disease. 24,28,54 Similarly, in this study, family history has significantly associated with the risk of breast cancer. However, this finding is in contrast with the results of a previous similar study conducted in Vietnam, which indicated that there was no significant association between family history and breast cancer.…”

“…The sample size was calculated using Epi-Info version 7.2 based on the following assumptions: 95% confidence interval, 80% power, and 1:2 ratio of cases to controls, 24.3% proportion of family history of breast cancer in Senegal Dakar with an odds ratio of 2.12 28 and a 10% non-response rate. This yields a maximum sample size of 116 cases and 232 controls.…”

Breast cancer in sub-Saharan Africa: The current state and uncertain future

“…50 Reproductive factors including early menarche and menopausal status have been acclaimed breast cancer risk factors; however, no association was found between these risk factors and breast cancer in Senegalese women. 51 Some breast cancers have been attributed to postmenopausal body mass index (Figure 5) globally. Possibly, many more risk factors are unexplored; hence there is an urgent need to exhaustively investigate breast cancer-associated risk factors in SSA.…”

“…52 Early age at diagnosis and a positive breast cancer history may be suggestive of familial predispositions, which have not been thoroughly investigated in the SSA population. 51 Women with a familial breast cancer history with one or two first-degree premenopausal breast cancer relatives are at a 3.3-fold and 3.6fold greater risk of developing breast cancer, respectively, compared to women without a family history. 53 Approximately 13-19% of diagnosed breast cancer patients had an affected first-degree relative.…”

Identifying Risk Factors of Breast Cancer Among Women Attending Selected Hospitals of Addis Ababa City: Hospital-Based Unmatched Case-Control Study

“…5 Among the identified risk determinants of breast cancer include age, family history, medical history, weight, physical activity, alcohol consumption, cigarette smoking, breastfeeding, parity, menopausal status, stress, vegetable intake, fruit intake, and oral contraceptive use. [6][7][8][9][10][11][12] No studies have been performed to analyze the risk factors for breast cancer in Ethiopia. The present study may add information on evidence of risk factors for breast cancer in Ethiopia and supporting evidence to reduce the burden of the disease.…”