Understanding rural–urban differences in risk factors for breast cancer in an Indian population

Nagrani, Rajini; Mhatre, Sharayu; Boffetta, Paolo; Rajaraman, Preetha; Badwe, Rajendra; Gupta, Sudeep; Romieu, Isabelle; Parmar, Vani; Dikshit, Rajesh

doi:10.1007/s10552-015-0697-y

Cited by 18 publications

(15 citation statements)

References 36 publications

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“…In India, BC incidence is rising more in urban women compared to rural women. A study done on women residing in urban areas in Mumbai, India reported that the waist to hip ratio and late age of first child delivery in urban women compared to rural women were key factors responsible for BC to occur more in urban women [12]. Gupta A. et al showed in their study that there is very poor awareness among Indian women irrespective of their socioeconomic status with regard to BC symptoms and early detection [13].…”

Section: Discussionmentioning

confidence: 99%

A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study

Ramakant

Singh

Jaiswal³

et al. 2017

Indian J Surg Oncol

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Breast cancer (BC) has become the most common cancer in urban women. Unfortunately, most women are not aware of BC symptoms/signs, prevention, and management. In resource-limited countries like India where we do not have structured screening/awareness programs, a majority of women present with locally advanced BC. The aim of our study is to identify the present status of awareness about BC prevention, early detection, symptoms, and management in urban and rural Indian women (medical, paramedical, and nonmedical) and to assess whether education and socioeconomic strata have any role in better awareness about BC or not. We did a prospective cross-sectional observation study among the medical, paramedical, and nonmedical women in the northern part of India. We designed a questionnaire keeping in mind the three domains about BC-knowledge (questions 1-25 include risk factors, genetics, lifestyle changes, hormones, associated cancers, and modes of presentation like lump, nipple/skin changes), breast self

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Section: Discussionmentioning

confidence: 99%

A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study

Ramakant

Singh

Jaiswal³

et al. 2017

Indian J Surg Oncol

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“…Living in rural areas decreases the risk for breast carcinoma as compared to urban counterparts mainly due their adherence to rural lifestyle . Waist‐to‐hip ratio of ≥0.95 compared to ratio ≤0.84 was found strongly associated with risk of BC in both rural and urban populations (OR urban = 4.10, 95% CI, 3.03–5.56; OR rural = 3.01, 95% CI, 1.85‐4.90) . Though increased anthropometric measures like larger body size and obesity determines breast cancer risk in India however it does not contribute appreciably to the urban–rural breast cancer differences .…”

Section: Methodsmentioning

confidence: 96%

Epidemiology of breast cancer in Indian women

Malvia

Bagadi

Dubey

et al. 2017

Asia-Pac J Clin Oncol

574

376

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Breast cancer has ranked number one cancer among Indian females with age adjusted rate as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women. Data reports from various latest national cancer registries were compared for incidence, mortality rates. The age adjusted incidence rate of carcinoma of the breast was found as high as 41 per 100,000 women for Delhi, followed by Chennai (37.9), Bangalore (34.4) and Thiruvananthapuram District (33.7). A statistically significant increase in age adjusted rate over time in all the PBCRs namely Bangalore (annual percentage change: 2.84%), Barshi (1.87%), Bhopal (2.00%), Chennai (2.44%), Delhi (1.44%) and Mumbai (1.42%) was observed. Mortality-to-incidence ratio was found to be as high as 66 in rural registries whereas as low as 8 in urban registries. Besides this young age has been found as a major risk factor for breast cancer in Indian women. Breast cancer projection for India during time periods 2020 suggests the number to go as high as 1797900. Better health awareness and availability of breast cancer screening programmes and treatment facilities would cause a favorable and positive clinical picture in the country.

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“…The details of anthropometric measurements have been explained earlier [7] . WHR was calculated as waist circumference (WC) (in cm) divided by hip circumference (HC) (in cm) and grouped into three categories.…”

Section: Methodsmentioning

confidence: 99%

Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity

Nagrani

Mhatre

Rajaraman

et al. 2016

European Journal of Cancer

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BackgroundCurrent evidence suggests that the relationship between obesity and breast cancer (BC) risk may vary between ethnic groups.MethodsA total of 1633 BC cases and 1504 controls were enrolled in hospital-based case–control study in Mumbai, India, from 2009 to 2013. Along with detailed questionnaire, we collected anthropometric measurements on all participants. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence interval (CI) for BC risk associated with anthropometry measurements, stratified on tumour subtype and menopausal status.ResultsWaist-to-hip ratio (WHR) of ≥0.95 was strongly associated with risk of BC compared to WHR ≤0.84 in both premenopausal (OR = 4.3; 95% CI: 2.9–6.3) and postmenopausal women (OR = 3.4; 95% CI: 2.4–4.8) after adjustment for body mass index (BMI). Premenopausal women with a BMI ≥30 were at lower risk compared to women with normal BMI (OR = 0.5; 95% CI: 0.4–0.8). A similar protective effect was observed in women who were postmenopausal for <10 years (OR = 0.6; 95% CI: 0.4–0.9) but not in women who were postmenopausal for ≥10 years (OR = 1.8; 95% CI: 1.1–3.3). Overweight and obese women (BMI: 25–29.9 and ≥ 30 kg/m2, respectively) were at increased BC risk irrespective of menopausal status if their WHR ≥0.95. Central obesity (measured in terms of WC and WHR) increased the risk of both premenopausal and postmenopausal BCs irrespective of hormone receptor (HR) status.ConclusionsCentral obesity appears to be a key risk factor for BC irrespective of menopausal or HR status in Indian women with no history of hormone replacement therapy.

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Understanding rural–urban differences in risk factors for breast cancer in an Indian population

Abstract: Differences in the prevalence of central adiposity and age at first full-term pregnancy between rural and urban women from India may explain some differences in breast cancer rates between these two populations.

Cited by 18 publications

References 36 publications

A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study

A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study

Epidemiology of breast cancer in Indian women

Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity

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