Extrinsic Risk Factors for Women Breast Cancer in Gaza Strip, Palestine: Associations and Interactions in a Case-Control Study

Abstract

Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women's ability to function normally in everyday life. Methods: The present hospital-based case-control study was carried out between January and August 2018 using a structured questionnaire on 105 breast cancer women and 210 controls who are clinically free from breast cancer. Data about the study cases were collected in the oncology day-care clinics of the two main hospitals in Gaza strip "Al-Shifa and European Gaza hospitals". Univariate logistic regression and multivariate logistic regression analyses were employed to identify the significant factors associated with BC. Results: Multivariate logistic regression analyses with adjustment for all confounders revealed that woman with BMI more than or equal 30 kg/m 2 are under risk of getting BC 2.9 times greater than those having BMI less than 29 kg/m 2 (AOR = 2.895; 95% CI: 1.305-6.423). Analysis of risk according to reaching menopause showed that the estimated AOR was greater among those reached menopause (3.137, 95% CI 1.824-5.395) than among those that did not reach menopause. The risk of developing BC in the case of a history of incidence of BC in the family was more than two times higher (AOR = 2.632, 95% CI 1.528-4.535) than in case of the history of a free family of BC. Conclusion: In this context, the above-mentioned risk factors must be taken into consideration in BC management processes in the Gaza strip.

Association of Hypertension and Organ-Specific Cancer: A Meta-Analysis

“…The studies in [ 5 ] included 148 studies up until 2017 and looked at both studies that had no association and studies that had a positive association. The impact of hypertension on breast, colorectal, and endometrial cancers has also been reported in other studies [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], but the most confirmed association has been made for renal cell carcinoma (RCC) [ 5 , 25 , 26 ]. One study observed the odds ratio (OR) with a 95% confidence ratio in individuals with self-reported hypertension in both men and women and found that hypertension was independently associated with a 40% increased risk of RCC compared to the refenced nonhypertensive patients (OR: 1.4; CI: 1.1–1.9 and OR: 1.0; CI: reference, respectfully) [ 26 ], and this increase was also observed in younger (20–39 years of age) hypertensive patients, where they saw a smaller but significant 16% increase in risk [ 27 ].…”

“…Moreover, we found that even when adjusting for menopausal status, the association increased for postmenopausal women [ 44 ]. Through our further analysis [ 9 , 11 , 12 , 13 , 14 , 15 , 20 , 21 , 23 ], we saw a significant increase in risk for postmenopausal women, possibly because the present study mostly observed postmenopausal women and only included one study that observed a significant association found between hypertension and breast cancer over the entire sample regardless of menopausal status [ 12 ]. To understand the mechanisms underlying hypertension-caused organ-specific cancer, we here discuss the most vital mechanisms.…”

“…After conducting a hand search specifically for studies from 2017 to 2021, 22 studies were identified. In total 47 studies were identified without the use of machine learning [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ]. Of these 47 studies, 22 were published after 2017, as one of our focuses was to obtain more recent publications as new data have been introduced over the past 5 years since the previous meta-analysis was conducted [ 5 ].…”

“…Breast cancer also showed a positive association between hypertension and cancer risk ( Figure 2 ; n = 9; RR: 1.65; CI: 1.30–3.55; I 2 : 69.1%) [ 9 , 11 , 12 , 13 , 14 , 15 , 20 , 21 , 23 ]. This organ-specific site contained the most outcome estimates, and the between-study heterogeneity was higher ( I 2 : 69.1%).…”