Nutrition in the Prevention of Breast Cancer: A Middle Eastern Perspective

Abstract

This paper reviews the escalating burden of breast cancer (BC) in the Middle East (ME) and the prevalence of modifiable risk factors and underscores opportunities to promote the prevention of the disease. Similar to more developed countries, BC is the most frequent cancer among women in countries of the ME, accounting for one-third of total cancer cases and 24% of total cancer deaths. Average age at BC diagnosis appears to be a decade earlier in Middle Eastern countries compared to the Western countries, and its incidence is predicted to further increase. Although incidence rates of BC are still lower in Middle Eastern countries than Western ones, mortality rates are similar and at times even higher. It is estimated that 30% of BC cases are due to environmental and lifestyle factors, such as obesity and diet and hence can be preventable. The ME suffers from surging rates of obesity, with eight of its countries ranking among the highest worldwide in obesity prevalence among adults aged 18 and above. ME countries with the highest prevalence of obesity that are among the top 20 worldwide include United Arab Emirates (UAE), Lebanon, Egypt, Libya, Qatar, Saudi Arabia, Jordan, and Kuwait with rates ranging from 30% in UAE to 37% in Kuwait. In parallel, studies in the ME have consistently showed a shift in dietary intake whereby traditional diets, rich in fruits and vegetables, are progressively eroding and being replaced by westernized diets high in energy and fat. Accumulating evidence is reporting convincing association between consumption of such westernized diets and higher BC risk. Addressing these risk factors and studying their association with BC in terms of their nature and magnitude in Middle Eastern countries could provide the basis for intervention strategies to lower the risk and alleviate the burden of BC in these countries.

Genomic Assays in Node Positive Breast Cancer Patients: A Review

“…It also quantifies the rale of proliferation, luminal gene expression, ESR1, PGR, and ERBB2 expression ( 90 , 91 ). It is incorporated in the ESMO, St Gallen’s, NCCN, ASCO, and AGO guidelines and has an evidence level of IIA ( 4 , 15 ). PAM50 results are used to generate the RoR score.…”

“…While the IR is 0.025% in Central Africa and East Asia and 0.092% in Western Europe, the age-standardized IR of BCA is 45.3 per 100,000 females in the region and is considerably rising, with estimates to touch Western numbers ( 2 , 3 ). Incident cases are projected to rise globally by at least 46.5% in the next 20 years ( 4 ). With the progresses in BCA screening techniques, cancer detection rate has improved.…”

Evaluating the Knowledge and Attitude of Menopaused Women for Breast Cancer Screening: A Cross Sectional Study in Iran

“…BC is on the rise in the Middle East and is rapidly approaching the level of the disease in Western countries (4). The rate of BC is expected to double in 2030 compared to 2012 in the Middle East, which is the highest relative increase compared to other parts of the world (5). The mortality rate from BC in the Eastern Mediterranean countries is 70%, which is higher than the mortality rate in developed countries (6).…”

Cancer Awareness Among Lebanese Adults, A Cross Sectional Study 

“…[2] However, this trend can be slowed down: it has been estimated that around 33% of all cancers in adults in the Eastern Mediterranean Region region are attributable to eight avoidable lifestyle factors such as tobacco, alcohol, low physical activity, and high Body Mass Index (BMI). [3][4][5] Strategies to change existing behaviour are therefore essential to lower cancer burden.…”

“…Unfortunately, the prevalence of these lifestyle risk factors is increasing rather than decreasing. [2,4,6] To obtain a change in existing behaviour, increasing knowledge of risk factors and symptoms (summarized as "Cancer awareness") is necessary [7]. In Lebanon, data on cancer awareness is scarce but points towards a lack of awareness.…”