Breast cancer in Iraq is associated with a unimodally distributed predominance of luminal type B over luminal type A surrogates from young to old age

Abstract

BackgroundBreast cancer has recently increased in post-menopausal Iraqi women. In Western countries at high-risk for breast cancer, there is a bimodal increase in estrogen receptor (ER) positive tumors with a peak of low proliferation rate luminal A over higher proliferation rate luminal B tumors after 60 years of age. The aim of this study was to analyze in Iraqi women whether shifts are occurring in immunohistochemical (IHC) surrogates of molecular breast cancer subtypes toward a high-risk profile.MethodsAge specific and age standardized womens breast cancer incidence was estimated for the years 2006 through 2012. IHC results of ER, PR, HER2, and Ki67 testing were analyzed on the breast cancers of 125 Arabic and 725 Kurdish women by frequency of distribution and by age.ResultsBetween 2006 and 2012, age standardized incidence of breast cancer in Iraq increased from 30 to 40/100,000 women with the increase specifically occurring in women ≥ 60 years old (P < 0.001). Breast cancers in Kurdish women ≥ 60 years old may also have increased (P = 0.047) with urban exceeding rural rates by 2:1. For both Kurdish and Arabic women, there was a marked predominance of luminal B tumors at all ages in which luminal B and luminal A tumors were asymmetric skewed toward older age but with no late luminal A age peak.ConclusionsOlder Iraqi women do not show the bimodal shift toward higher rates of luminal A breast cancers seen in the West. The modest increase in age standardized incidence of breast cancer in Iraqi is being seen specifically in older women and may be better attributed to a trend for care in urban cancer centers rather than changing tumor characteristics.

Non-Hodgkin Lymphoma in the Middle East Is Characterized by Low Incidence Rates With Advancing Age

“…The low rates of NHL in the elderly of Middle East may seem peculiar but are also seen with other cancers. 5,6 The similarity of the NHL rates in Iraq, Jordan, and Saudi Arabia indicates a region-wide phenomenon, and it is unlikely that undue numbers of lymphomas are being undiagnosed at any age.…”

“…The Kurdish Province of Sulaimaniyah has a well-defined population, with public cancer services that provide a comprehensive registration of patients and centrally reviewed diagnoses. 5,6 Jordan and Saudi Arabia have population-based cancer registries that meet criteria for submitting data to the International Association for Research on Cancer (IARC). 7 The Cancer Registry of Iraq is not a part of the IARC but collects provincial data and has recently published national statistics that are similar to other large Middle Eastern countries and seem to accurately reflect cancer risk in the country.…”

Effects of Bodybuilding Supplements on the Kidney: A Population-Based Incidence Study of Biopsy Pathology and Clinical Characteristics among Middle Eastern Men

“…The annual ASIR of kidney biopsy diagnoses per 100,000 males among the general Kurdistan population was calculated for the two year period 2012-2013 as previously reported [10]. An estimate of the Kurdistan population at 4,900,000 persons was derived from 2011-2012 United Nations Iraq population data and the 2012 Iraqi Cancer Registry [12]. The estimated number of males between 15 to 39 years of age was 1,100,000.…”

Interrelation of the Circulating and Tissue MicroRNA-21 with Tissue PDCD4 Expression and the Invasiveness of Iraqi Female Breast Tumors

“…One out of eight women is diagnosed with breast cancer during her lifetime, with an estimated 1.57 million new cases in 2012 [1]. The incidence of women breast cancer in Iraq increased from 30/100,000 to 40/100,000 in latest Iraqi cancer registry report and this unimodal increase is distributed homogenously in different geographical regions [2,3]. Al-Janabi et al [4] reported that the incidence of breast cancer in the first half of year 2015 increased to exceed half of that for 2014 in Kerbala city in Southern Iraq.…”