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1.
JAMA Netw Open ; 7(7): e2422493, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39012631

RESUMO

Importance: Hormone-modulating therapy (HMT) is a widely accepted treatment for hormone receptor-positive breast cancer, although its cognitive effects, including a potential link to Alzheimer disease and related dementias (ADRD), remain understudied. Objective: To investigate the association between HMT for breast cancer treatment and risk of developing ADRD in women aged 65 years or older. Design, Setting, and Participants: This cohort study used a comprehensive dataset from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to identify patients who did and did not receive HMT treatment within 3 years after the initial diagnosis of breast cancer and assessed their risk of developing ADRD in later life. Individuals with a preexisting diagnosis of ADRD or receiving HMT before the diagnosis of breast cancer were excluded. This study was performed from June 2022 through January 2024. Exposure: Receipt of HMT. Main Outcomes and Measures: Risk of ADRD associated with HMT; associations of risk with age, self-identified race, and HMT type. Risk was measured using hazard ratios (HRs) with 95% CIs and adjusted for potential confounders such as demographic, sociocultural, and clinical variables. Results: Among 18 808 women aged 65 years and older diagnosed with breast cancer between 2007 and 2009 (1266 Black [6.7%], 16 526 White [87.9%], 1016 other [5.4%]), 12 356 (65.7%) received HMT within 3 years after diagnosis, while 6452 (34.3%) did not. The most common age group in both samples was the 75 to 79 years age group (HMT, 2721 women [22.0%]; no HMT, 1469 women [22.8%]), and the majority of women in both groups self-identified as White (HMT, 10 904 women [88.3%]; no HMT, 5622 women [87.1%]). During an average of 12 years of follow-up, 2926 (23.7%) of HMT users and 1802 (27.9%) of non-HMT users developed ADRD. HMT was associated with a 7% lower relative risk of ADRD overall (HR, 0.93; 95% CI, 0.88-0.98; P = .005). The association decreased with age and varied by race. The reduction in ADRD risk associated with HMT was greatest for women aged 65 to 74 years who self-identified as Black (HR, 0.76; 95% CI, 0.62-0.92). This association decreased among women aged 75 years or older (HR, 0.81; 95% CI, 0.67-0.98). Women aged 65 to 74 years who self-identified as White had an 11% relative risk reduction (HR, 0.89; 95% CI, 0.81-0.97), but the association disappeared for women aged 75 years or older (HR, 0.96; 95% CI, 0.90-1.02). Other races showed no significant association between HMT and ADRD. Age- and race-based associations also varied by HMT type. Conclusions and Relevance: In this retrospective cohort study, hormone therapy was associated with protection against ADRD in women aged 65 years or older with newly diagnosed breast cancer; the decrease in risk was relatively greater for Black women and women under age 75 years, while the protective effect of HMT diminished with age and varied by race in women. When deciding to use HMT for breast cancer in women aged 65 years or more, clinicians should consider age, self-identified race, and HMT type in treatment decisions.


Assuntos
Doença de Alzheimer , Neoplasias da Mama , Demência , Programa de SEER , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/tratamento farmacológico , Idoso , Doença de Alzheimer/epidemiologia , Idoso de 80 Anos ou mais , Estados Unidos/epidemiologia , Demência/epidemiologia , Estudos de Coortes , Fatores de Risco
2.
Int J Epidemiol ; 53(4)2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-39018665

RESUMO

BACKGROUND: The carcinogenicity of air pollution and its impact on the risk of lung cancer is well known; however, there are still knowledge gaps and mixed results for other sites of cancer. METHODS: The current study aimed to evaluate the associations between ambient air pollution [fine particulate matter (PM2.5) and nitrogen oxides (NOx)] and cancer incidence. Exposure assessment was based on historical addresses of >900 000 participants. Cancer incidence included primary cancer cases diagnosed from 2007 to 2015 (n = 30 979). Cox regression was used to evaluate the associations between ambient air pollution and cancer incidence [hazard ratio (HR), 95% CI]. RESULTS: In the single-pollutant models, an increase of one interquartile range (IQR) (2.11 µg/m3) of PM2.5 was associated with an increased risk of all cancer sites (HR = 1.51, 95% CI: 1.47-1.54), lung cancer (HR = 1.73, 95% CI: 1.60-1.87), bladder cancer (HR = 1.50, 95% CI: 1.37-1.65), breast cancer (HR = 1.50, 95% CI: 1.42-1.58) and prostate cancer (HR = 1.41, 95% CI: 1.31-1.52). In the single-pollutant and the co-pollutant models, the estimates for PM2.5 were stronger compared with NOx for all the investigated cancer sites. CONCLUSIONS: Our findings confirm the carcinogenicity of ambient air pollution on lung cancer and provide additional evidence for bladder, breast and prostate cancers. Further studies are needed to confirm our observation regarding prostate cancer. However, the need for more research should not be a barrier to implementing policies to limit the population's exposure to air pollution.


Assuntos
Poluição do Ar , Neoplasias da Mama , Exposição Ambiental , Neoplasias Pulmonares , Material Particulado , Neoplasias da Próstata , Neoplasias da Bexiga Urinária , Humanos , Masculino , Incidência , Feminino , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/induzido quimicamente , Neoplasias da Bexiga Urinária/etiologia , Poluição do Ar/efeitos adversos , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/etiologia , Neoplasias da Próstata/induzido quimicamente , Material Particulado/efeitos adversos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/etiologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/etiologia , Pessoa de Meia-Idade , Idoso , Exposição Ambiental/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Adulto , Óxidos de Nitrogênio/efeitos adversos , Poluentes Atmosféricos/efeitos adversos , Modelos de Riscos Proporcionais , Fatores de Risco
3.
J Cancer Res Ther ; 20(3): 822-826, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-39023589

RESUMO

BACKGROUND: This study aims to report the increasing incidence of second primary malignancies to better understand the association of multiple primary cancers and the duration of their occurrence. Keeping in view the current trends in dual malignancies and to further emphasize the importance of screening and follow-up diagnosis, we reviewed the records of patients who were diagnosed with dual malignancies. MATERIAL AND METHODS: This is a retrospective observational study. We collected data from the hospital database, of patients presenting with either histologically proven synchronous or metachronous double primaries between January 1, 2017, and December 31, 2021. The time interval to differentiate between synchronous and metachronous has been taken as 6 months. RESULTS: During the period of five years, twenty-three patients presented with dual malignancy. Out of 23 cases, seven were synchronous (30.43%), and 16 were metachronous (69.56%). In the synchronous malignancy group, the most common site of first and second primary malignancy was breast [5 cases (71.4%) and 3 cases (42.8%), respectively]. In the metachronous malignancy group, the most common site of the first primary was breast (7 cases; 43.75%), followed by the head and neck (4 cases; 25%), and the most common site of the second primary was also the breast (6 cases; 37.5%), followed by the lung (5 cases; 31.25%). CONCLUSION: Second primary malignancies are not rare and can occur at any age. Regular follow-up and screening procedures by the treating oncologist can play a major role in early detection followed by appropriate treatment of second primary tumors.


Assuntos
Neoplasias Primárias Múltiplas , Segunda Neoplasia Primária , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/diagnóstico , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/epidemiologia , Neoplasias Primárias Múltiplas/diagnóstico , Idoso , Adulto , Incidência , Neoplasias da Mama/patologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/diagnóstico , Seguimentos , Idoso de 80 Anos ou mais
4.
J Cancer Res Ther ; 20(3): 999-1005, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-39023609

RESUMO

AIMS: This study aims to investigate the incidence rate of pulmonary fibrosis as a late radiotherapy complication and identify the associated dosimetric and demographic factors using radiological findings between Iranian patients with breast cancer. METHODS AND MATERIAL: Breast cancer patients treated at the education hospital of Shohada-e Tajrish Hospital, Tehran, Iran, from 2017 to 2021 were considered. Patients have included for whom a secondary chest CT scan was available at least six months after radiotherapy. Dose-volume histogram (DVH) parameters of three-dimensional conformal radiotherapy (3D-CRT) treatment plans were exported. Demographic features and data on underlying lung diseases, diabetes, and smoking history were extracted. RESULTS: A total of 250 patients were included in the study with a mean age of 46.1 ± 7.5 yrs and a mean body mass index (BMI) of 24.5 ± 4.2 kg/m2. Pulmonary fibrosis was detected for sixty-two cases. A significant relationship was obtained between the ipsilateral lung DVH parameters of patients with pulmonary fibrosis (P value < 0.05). The V5Gy, V10Gy, V13Gy, V20Gy, V30Gy, MLD, and DMax for individuals with pulmonary fibrosis were significantly higher than those without this injury. CONCLUSIONS: Pulmonary fibrosis was distinguished for 25% of the breast cancer cases at least six months after adjuvant radiotherapy. A significant relationship between the DVH parameters, underlying lung disease, diabetes, radiotherapy fields (i.e., Breast + LN + SC or Breast/Chest-wall only), age, and BMI with the frequency of the ipsilateral pulmonary fibrosis was obtained. V13Gy and V30Gy of the ipsilateral lung may be the most predictor of pulmonary fibrosis incidence.


Assuntos
Neoplasias da Mama , Fibrose Pulmonar , Humanos , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Pessoa de Meia-Idade , Irã (Geográfico)/epidemiologia , Estudos Transversais , Fibrose Pulmonar/etiologia , Fibrose Pulmonar/epidemiologia , Radioterapia Adjuvante/efeitos adversos , Prevalência , Adulto , Radioterapia Conformacional/efeitos adversos , Lesões por Radiação/epidemiologia , Lesões por Radiação/etiologia , Lesões por Radiação/diagnóstico , Dosagem Radioterapêutica , Incidência
5.
Breast Cancer Res ; 26(1): 116, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39010116

RESUMO

BACKGROUND: Higher mammographic density (MD), a radiological measure of the proportion of fibroglandular tissue in the breast, and lower terminal duct lobular unit (TDLU) involution, a histological measure of the amount of epithelial tissue in the breast, are independent breast cancer risk factors. Previous studies among predominantly white women have associated reduced TDLU involution with higher MD. METHODS: In this cohort of 611 invasive breast cancer patients (ages 23-91 years [58.4% ≥ 50 years]) from China, where breast cancer incidence rates are lower and the prevalence of dense breasts is higher compared with Western countries, we examined the associations between TDLU involution assessed in tumor-adjacent normal breast tissue and quantitative MD assessed in the contralateral breast obtained from the VolparaDensity software. Associations were estimated using generalized linear models with MD measures as the outcome variables (log-transformed), TDLU measures as explanatory variables (categorized into quartiles or tertiles), and adjusted for age, body mass index, parity, age at menarche and breast cancer subtype. RESULTS: We found that, among all women, percent dense volume (PDV) was positively associated with TDLU count (highest tertile vs. zero: Expbeta = 1.28, 95% confidence interval [CI] 1.08-1.51, ptrend = < .0001), TDLU span (highest vs. lowest tertile: Expbeta = 1.23, 95% CI 1.11-1.37, ptrend = < .0001) and acini count/TDLU (highest vs. lowest tertile: Expbeta = 1.22, 95% CI 1.09-1.37, ptrend = 0.0005), while non-dense volume (NDV) was inversely associated with these measures. Similar trend was observed for absolute dense volume (ADV) after the adjustment of total breast volume, although the associations for ADV were in general weaker than those for PDV. The MD-TDLU associations were generally more pronounced among breast cancer patients ≥ 50 years and those with luminal A tumors compared with patients < 50 years and with luminal B tumors. CONCLUSIONS: Our findings based on quantitative MD and TDLU involution measures among Chinese breast cancer patients are largely consistent with those reported in Western populations and may provide additional insights into the complexity of the relationship, which varies by age, and possibly breast cancer subtype.


Assuntos
Densidade da Mama , Neoplasias da Mama , Mamografia , Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Adulto , Idoso , China/epidemiologia , Mamografia/métodos , Idoso de 80 Anos ou mais , Adulto Jovem , Fatores de Risco , Mama/diagnóstico por imagem , Mama/patologia , Glândulas Mamárias Humanas/diagnóstico por imagem , Glândulas Mamárias Humanas/patologia , Glândulas Mamárias Humanas/anormalidades , População do Leste Asiático
6.
PLoS One ; 19(7): e0306612, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39012888

RESUMO

PURPOSE: We present a methodically devised protocol for conducting a systematic review and meta-analysis aimed at ascertaining the prevalence of BReast CAncer gene (BRCA) mutations in breast and ovarian cancer (BOC) among women in India. The review will include cross-sectional, cohort, case-series, and registry-based studies focusing on females clinically diagnosed with any stage of BOC, tested for BRCA germline mutation and undergone any form of treatment. METHODS: A Cochrane literature search will be carried out to identify all the published and unpublished articles available in English from 2010 till date across various electronic databases including PubMed, Psych Info, SCI, Cochrane Central, Embase, Scopus, IND Med and Google Scholar. A step-by-step process will be followed to select all the relevant studies for final inclusion using Rayyan software. The selection process of the review will be reported based on Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) checklist. The protocol has been registered in PROSPERO (ID: CRD42023463452). Joanna Briggs Institute Critical Appraisal Checklist will be used to evaluate the methodological quality of the included studies. The outcome measure will be the prevalence of BRCA1/2 gene mutation in this population. Meta-analysis will be performed to report the pooled prevalence along with 95% confidence interval. DISCUSSION: The results of this review study will provide valuable insights for clinicians, and policy makers, enabling them to formulate guidelines that underscore the importance of screening for BRCA mutations in cases of BOC.


Assuntos
Neoplasias da Mama , Neoplasias Ovarianas , Revisões Sistemáticas como Assunto , Feminino , Humanos , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Neoplasias da Mama/epidemiologia , Mutação em Linhagem Germinativa , Índia/epidemiologia , Metanálise como Assunto , Mutação , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/epidemiologia , Prevalência
7.
BMC Cancer ; 24(1): 843, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39009977

RESUMO

BACKGROUND: Cancer is one of the leading causes of morbidity and mortality worldwide. Among all cancer types, breast cancer stands out as the most common and is characterized by distinct molecular characteristics. This disease poses a growing public health concern, particularly in low and middle-income countries where it is associated with high mortality rates. Despite these challenges, there is a paucity of data on breast cancer preventive practices and associated factors among reproductive-age women in Wollo, Ethiopia. Hence, this study aimed to evaluate the level of breast cancer awareness, preventive practices, and associated factors among women of reproductive age residing in Wadila district, Wollo, Ethiopia in the year 2022. METHOD: A cross-sectional community-based study involving 352 women of reproductive age in Wadila district was carried out between May and June 2022. Participants were selected using a systematic random sampling technique, and data analysis was conducted using Statistical Package for Social Science (SPSS) version 23 software. Logistic regression analysis was utilized to determine the odds ratio for variable associations, with statistical significance set at p < 0.05. RESULT: The prevalence of breast-examination among women of reproductive age was determined to be 40.1% (95% Interval [CI]: 34.94-45.18). Factors such as educational status (Adjusted Odds Ratio [AOR]: 0.28, 95% CI: 0.13-0.6), income (AOR: 0.19, 95% CI: 0.11-0.33), and family history of breast conditions in reproductive-age women (AOR: 1.90, 95% CI: 1.08-3.34) were significantly linked to the practice of breast self-examination in this population. CONCLUSION: The study highlighted a decline in regular breast self-examination among women of reproductive age. It revealed that the reduced frequency of regular breast self-examination was a prevalent concern among women in this age group and the broader community. Educational level, monthly income, and family history of cancer among women of reproductive age were identified as significant factors linked to the practice of regular breast examination.


Assuntos
Neoplasias da Mama , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Feminino , Etiópia/epidemiologia , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/epidemiologia , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Autoexame de Mama/estatística & dados numéricos , Adolescente , Detecção Precoce de Câncer
8.
Sci Rep ; 14(1): 15805, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38982173

RESUMO

Coronary artery disease (CAD) such as acute myocardial infarction (MI) share several common risk factors with cancers, and each disease may influence the prognosis of the other. Recently, acute MI was demonstrated to accelerate the outgrowth of preexisting breast cancer cells but the risk of breast cancer after MI remains unclear. This study aimed to investigate the association between acute MI and a subsequent diagnosis of breast cancer. Female patients with and without a history of acute MI were identified from nationwide databases in Taiwan. Patients with a diagnosis of cancer, MI or CAD prior to the study period were excluded. After reducing confounding through inverse probability of treatment weighting, we compared the incidence of newly diagnosed breast cancer between patients with a history of acute MI and those without. As a result, a total of 66,445 female patients were obtained, including 15,263 patients with a history of acute MI and 51,182 patients without. The incidences of breast cancer during follow-up were 1.93 (95% confidence interval [CI] 1.78-2.09) and 1.80 (95% CI 1.67-1.93) per 1,000 person-years for patients with and without a history of acute MI, respectively. The hazard ratio (HR) was 1.05 (95% CI 0.78-1.41, P = 0.756). In subgroup analysis, breast cancer risk was significantly associated with acute MI in patients using antidiabetic drugs (HR 1.27; 95% CI 1.02-1.58) and in low to moderate urbanization levels (HR 1.28; 95% CI 1.06-1.53). In conclusion, the risk of newly diagnosed breast cancer was not increased in patients with acute MI when compared to general population without MI or CAD.


Assuntos
Neoplasias da Mama , Infarto do Miocárdio , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/diagnóstico , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/complicações , Pessoa de Meia-Idade , Taiwan/epidemiologia , Idoso , Incidência , Fatores de Risco , Adulto , Estudos de Coortes , Modelos de Riscos Proporcionais
9.
JCO Glob Oncol ; 10: e2300170, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991184

RESUMO

PURPOSE: To understand how breast cancer is diagnosed in Gaza, and disease stage distribution, treatment, and survival. MATERIALS AND METHODS: A clinical record case series study of women diagnosed in 2017 and 2018 was conducted with follow-up until December 31, 2020. Breast cancer crude incidence rates and age-specific incidence rates were calculated. Clinical characteristics, including investigation, diagnosis, and treatment methods by year of diagnosis, were compared using the chi-square test. The 2-year cumulative risk of death from any cause was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazard regressions estimated hazard ratios and their 95% CIs. RESULTS: Five hundred twenty-four new diagnoses (mean age, 53 years; range, 23-100) were recorded, giving a crude annual incidence rate of 27 per 100,000 population. Six percent (32/524) were diagnosed at stage I, 35% (185/524) at stage II, 33% (171/524) at stage III, and 19% (99/524) at stage IV. More than one half (52%, 271/524) underwent modified radical mastectomy. Seventy-seven percent (405/524) received chemotherapy, 70% (368/524) hormone therapy, and 39% (204/524) radiotherapy. Data on key prognostic factors were mostly available-stage (93%), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2; 82%), tumor grade (77%), and tumor size (70%). The overall survival was 95.4% at 1 year and 86.6% at 2 years. CONCLUSION: Women with breast cancer in Gaza have a high short-term survival after diagnosis. However, one half were diagnosed with advanced disease, and their investigations were incomplete. Better reporting on family history, tumor grade, size, and ER, PR, and HER2 receptor status is needed for future studies.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Pessoa de Meia-Idade , Adulto , Idoso , Idoso de 80 Anos ou mais , Oriente Médio/epidemiologia , Adulto Jovem , Incidência , Estadiamento de Neoplasias
10.
Taiwan J Obstet Gynecol ; 63(4): 527-531, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39004480

RESUMO

OBJECTIVE: Breast cancer is the most frequently diagnosed cancer among women worldwide. Mortality-to-incidence ratio (MIR) is a marker that reflects the efficacy and availability of screening interventions and treatment outcomes. MIR can be used to influence public health strategy. The association between the MIRs for breast cancer among countries with different economic statuses and health expenditure is important yet has been investigated. This study was aimed to elucidate the association between the breast cancer MIRs and the human development and health expenditure among different countries. MATERIALS AND METHODS: Cancer incidence and mortality rates were obtained from the GLOBOCAN database. The MIRs were calculated by dividing the crude rate of mortality to the incidence. Associations among the MIR and variants of human development index (HDI) and current health expenditure (CHE) in 50 countries were estimated via linear regression. RESULTS: Breast cancer had a higher incidence rate, but lower mortality rate, in developed countries (high HDI, CHE per capita, CHE/GDP), as compared with developing countries. Favorable MIRs were associated with a high HDI and high health expenditure countries (presented by high CHE per capita, and CHE/GDP) (both p < 0.001) CONCLUSION: The MIR for breast cancer is reversely correlated with the development and healthcare disparities among different countries. This implies that allocating more resources to healthcare systems for breast cancer screening and treatment can improve disease outcomes. Our report may be helpful for public health policy making.


Assuntos
Neoplasias da Mama , Países Desenvolvidos , Países em Desenvolvimento , Gastos em Saúde , Humanos , Neoplasias da Mama/mortalidade , Neoplasias da Mama/economia , Neoplasias da Mama/epidemiologia , Feminino , Gastos em Saúde/estatística & dados numéricos , Incidência , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Desenvolvimento Humano
11.
Nutrients ; 16(13)2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38999846

RESUMO

Obesity is a risk factor for postmenopausal breast cancer (BC), and evidence suggests a role for adiponectin in the relationship between obesity and BC. We investigated whether adiponectin or other biomarkers mediate the effect of body mass index (BMI) on postmenopausal BC risk in a cohort study nested in the IBIS-II Prevention Trial. We measured adiponectin, leptin, IGF-I, IGFBP-1, high-sensitivity C-reactive protein, glycemia, insulin, HOMA-IR index, and SHBG in baseline and 12-month serum samples from 123 cases and 302 matched controls in the placebo arm of the IBIS-II Prevention trial. We conducted the main mediation analysis considering baseline BMI as an exposure and the 12-month adiponectin increase as a mediator after adjustment for the Tyrer-Cuzick score and the lipid-lowering medications/supplements use. In the multivariable Cox model, both the 12-month adiponectin increase (HR, 0.60; 95%CI, 0.36-1.00) and BMI were associated with BC risk (HR, 1.05; 95%CI, 1.00-1.09), with a 40% reduction in women with a 12-month increase in adiponectin. A significantly higher cumulative hazard of BC events was observed in obese women (BMI > 30) with decreased adiponectin (p = 0.0087). No mediating effect of the adiponectin increase on the total effect of BMI on BC risk was observed (natural indirect effect: HR, 1.00; 95%CI, 0.98-1.02). Raising adiponectin levels might be an attractive target for postmenopausal BC prevention.


Assuntos
Adiponectina , Índice de Massa Corporal , Neoplasias da Mama , Obesidade , Pós-Menopausa , Humanos , Adiponectina/sangue , Feminino , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/sangue , Neoplasias da Mama/epidemiologia , Pós-Menopausa/sangue , Obesidade/sangue , Pessoa de Meia-Idade , Fatores de Risco , Estudos de Coortes , Idoso , Leptina/sangue , Biomarcadores/sangue , Modelos de Riscos Proporcionais , Fator de Crescimento Insulin-Like I/metabolismo , Fator de Crescimento Insulin-Like I/análise
12.
J Am Heart Assoc ; 13(14): e033295, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38979791

RESUMO

BACKGROUND: Cardiovascular disease and cancer share a common risk factor: chronic stress/allostatic load (AL). A 1-point increase in AL is linked to up to a 30% higher risk of major cardiac events (MACE) in patients with prostate cancer. However, AL's role in MACE in breast cancer, lung cancer, or colorectal cancer remains unknown. METHODS AND RESULTS: Patients ≥18 years of age diagnosed with the mentioned 3 cancers of interest (2010-2019) and followed up at a large, hybrid academic-community practice were included in this retrospective cohort study. AL was modeled as an ordinal measure (0-11). Adjusted Fine-Gray competing risks regressions estimated the impact of AL precancer diagnosis on 2-year MACE (a composite of heart failure, ischemic stroke, acute coronary syndrome, and atrial fibrillation). The effect of AL changes over time on MACE was calculated via piecewise Cox regression (before, and 2 months, 6 months, and 1 year after cancer diagnosis). Among 16 467 patients, 50.5% had breast cancer, 27.9% had lung cancer, and 21.4% had colorectal cancer. A 1-point elevation in AL before breast cancer diagnosis corresponded to a 10% heightened associated risk of MACE (adjusted hazard ratio, 1.10 [95% CI, 1.06-1.13]). Similar findings were noted in lung cancer (adjusted hazard ratio, 1.16 [95% CI, 1.12-1.20]) and colorectal cancer (adjusted hazard ratio, 1.13 [95% CI, 1.08-1.19]). When considering AL as a time-varying exposure, the peak associated MACE risk occurred with a 1-point AL rise between 6 and 12 months post- breast cancer, lung cancer, and colorectal cancer diagnosis. CONCLUSIONS: AL warrants investigation as a potential marker in these patients to identify those at elevated cardiovascular risk and intervene accordingly.


Assuntos
Alostase , Neoplasias da Mama , Doenças Cardiovasculares , Neoplasias Colorretais , Neoplasias Pulmonares , Humanos , Feminino , Neoplasias Colorretais/epidemiologia , Neoplasias da Mama/epidemiologia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/diagnóstico , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Idoso , Doenças Cardiovasculares/epidemiologia , Alostase/fisiologia , Medição de Risco , Fatores de Risco , Estresse Psicológico/complicações
13.
Magy Onkol ; 68(2): 95-112, 2024 Jul 16.
Artigo em Húngaro | MEDLINE | ID: mdl-39013084

RESUMO

The objective of our study was to map county differences in incidence and mortality by cancers and examine their changes over time. Based on the database of National Cancer Registry and Central Statistical Office, age-standardized incidence and mortality rates per 100,000 person-years were calculated for each county for 15 cancer types and 3 time periods. East-West divide was apparent in incidence and mortality of lung cancer, with larger weight in East (Borsod-Abaúj-Zemplén, Heves, Jász-Nagykun-Szolnok, Békés counties). Concentration of lip and oral cavity malignancies was identified in the northeastern periphery (Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg counties). Breast cancer incidence was the highest in Budapest. As a conclusion, changes in cancer incidence and mortality over time were similar to developed countries; however, values were higher. Differences in spatial distribution follow territorial pattern of social deprivation, which correspond to higher prevalence of health risk factors. Our study contributes to planning of public health programs by pinpointing regional inequalities in different cancer types.


Assuntos
Neoplasias , Sistema de Registros , Humanos , Hungria/epidemiologia , Incidência , Feminino , Neoplasias/mortalidade , Neoplasias/epidemiologia , Masculino , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/epidemiologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/epidemiologia , Fatores de Risco , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/epidemiologia , Mortalidade/tendências , Adulto , Idoso , Neoplasias Labiais/epidemiologia , Neoplasias Labiais/mortalidade , Distribuição por Sexo
14.
Sci Rep ; 14(1): 15274, 2024 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-38961238

RESUMO

Screening is a key component of breast cancer early detection programs that can considerably reduce relevant mortality rates. The purpose of this study was to determine the breast cancer screening behavioral patterns and associated factors in women over 40 years of age. In this descriptive­analytical cross­sectional study, 372 over 40 years of age women visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling. The data were collected using the sociodemographic characteristics questionnaire, breast cancer perception scale, health literacy for Iranian adults scale, and the Breast Cancer Screening Behavior Checklist. The obtained data were analyzed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (univariate and multivariate logistic regression analyses). In total, 68.3% of all participants performed breast self­examination (BSE) (9.9% regularly, once per month), 60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year), 51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwent sonography (3.8% regularly, twice per year). The findings also showed that women with benign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21; P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography (OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderate breast cancer perception scores were more likely to perform BSE than women with high breast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women who had a history of benign breast disease were more likely to perform screening behaviors than others (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 were more likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE (OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participation of women in regular breast cancer screening, it is suggested that health care providers highlight the need for screening at the specified intervals in their training programs. In addition, health authorities are recommended to use reminder systems to remind women, especially those over 40 years of age, of the best time for breast screening. Moreover, health care providers must seek to improve breast cancer knowledge, attitudes, and perceptions of women who visit health centers, which are the first level of contact with the healthcare system for the general population.


Assuntos
Neoplasias da Mama , Autoexame de Mama , Detecção Precoce de Câncer , Mamografia , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/estatística & dados numéricos , Adulto , Estudos Transversais , Autoexame de Mama/psicologia , Autoexame de Mama/estatística & dados numéricos , Mamografia/estatística & dados numéricos , Mamografia/psicologia , Idoso , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento
15.
Acta Oncol ; 63: 552-556, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38967249

RESUMO

BACKGROUND AND PURPOSE: We have recently demonstrated that screen-detected invasive breast cancers had more favourable tumour characteristics than non-screen-detected. The objective of the study was to analyse differences in breast cancer treatment between screen-detected and non-screen-detected cases by age at diagnosis, with and without adjustment for tumour (T) and nodal (N) status, within a nationwide, population-based mammography screening programme utilising register data. MATERIAL AND METHODS: Data spanning 2008-2017 were collected from the National Quality Register for Breast Cancer. Multivariable logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for treatment disparities between screen-detected and non-screen-detected breast cancer. RESULTS: Among 46,481 women diagnosed with invasive breast cancer aged 40-74 and invited for mammography screening, significant differences in treatment were observed. Screen-detected cases showed higher likelihoods of partial mastectomy compared to mastectomy, endocrine therapy, and radiotherapy, whereas chemotherapy and antibody therapy were less likely compared to non-screen-detected cases. However, when adjusting for surgery type, screen-detected cases showed lower likelihoods of radiotherapy. Age at diagnosis significantly influenced treatment odds ratios, with interactions observed for all treatments except radiotherapy adjusted for surgery. Differences increased with age, except for endocrine therapy. Radiotherapy adjusted for surgery type showed no age-related interaction. Adjusting for T and N did not alter these patterns. INTERPRETATION: In general, screen-detected cases received less aggressive treatment, such as mastectomy, chemotherapy, and antibody therapy, compared to non-screen-detected cases. Disparities increased with age, except for endocrine therapy and radiotherapy adjusted for surgery. Differences persisted after adjusting for T and N, suggesting that these factors cannot solely explain the results.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Mamografia , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Neoplasias da Mama/epidemiologia , Pessoa de Meia-Idade , Suécia/epidemiologia , Idoso , Adulto , Mamografia/estatística & dados numéricos , Detecção Precoce de Câncer/estatística & dados numéricos , Fatores Etários , Mastectomia/estatística & dados numéricos , Sistema de Registros , Disparidades em Assistência à Saúde/estatística & dados numéricos
16.
J Glob Health ; 14: 04142, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39026460

RESUMO

Background: Breast cancer in young women (BCY) is much less common but has significant health sequelae and societal costs. We aimed to evaluate the global and regional burden of breast cancer in women aged 15-39 years from 1990 to 2019. Methods: We collected detailed data on breast cancer from the Global Burden of Disease Study 2019 (GBD 2019) Data Resources. The age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR), age-standardised disability-adjusted life years rate (ASDR), and estimated annual percentage change (EAPC) were used to assess the disease burden of BCY. The Bayesian Age-Period-Cohort model was used to forecast disease burden from 2020 to 2030. Results: From 1990 to 2019, significant increases in ASIR were found for BCY (EAPC = 0.59, 95% confidence interval (CI) = 0.5 to 0.68), whereas decreases in ASMR (EAPC = -0.41, 95% CI = -0.53 to -0.3) and ASDR (EAPC = -0.35, 95% CI = -0.46 to -0.24). Across countries with varying sociodemographic indexes (SDI), all regions showed an upward trend in BCY morbidity, except for countries with a high SDI. While mortality and DALYs rates have decreased in countries with high, high-middle, and middle SDI, they have increased in countries with low-middle and low SDI. Countries with lower SDIs are projected to bear the greatest burden of BCY over the next decade, including both low and low-middle categories. Alcohol use was the main risk factor attributed to BCY deaths in most countries, while exposure to second hand smoke was the predominant risk factor for BCY deaths in middle and low-middle SDI countries. Conclusions: The burden of breast cancer in young women is on the rise worldwide, and there are significant regional differences. Countries with a low-middle or low SDI face even more challenges, as they experienced a more significant and increasing BCY burden than countries with higher SDIs.


Assuntos
Neoplasias da Mama , Previsões , Carga Global da Doença , Saúde Global , Humanos , Feminino , Neoplasias da Mama/mortalidade , Neoplasias da Mama/epidemiologia , Adolescente , Adulto Jovem , Carga Global da Doença/tendências , Adulto , Fatores de Risco , Saúde Global/estatística & dados numéricos , Fatores Sociodemográficos , Incidência , Anos de Vida Ajustados por Deficiência
17.
PLoS One ; 19(7): e0307283, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39028722

RESUMO

INTRODUCTION: Breast cancer continues to be the most common malignancy and the leading cause of cancer-related deaths in Ethiopia. The poor prognosis and high mortality rate of breast cancer patients in the country are largely caused by late-stage diagnosis. Hence, understanding the epidemiology of late-stage diagnosis is essential to address this important problem. However, previous reports in Ethiopia indicated inconsistent findings. Therefore, this literature review was conducted to generate dependable evidence by summarizing the prevalence and determinants of late-stage diagnosis among breast cancer patients in Ethiopia. METHODS: Pertinent articles were retrieved by systematically searching on major electronic databases and gray literature. Data were extracted into an Excel spreadsheet and analyzed using the STATA 17 statistical software. The pooled estimates were summarized using the random effect meta-analysis model. Heterogeneity and small study effect were evaluated using the I2 statistics and Egger's regression test in conjunction with the funnel plot, respectively. Meta-regression, sub-group analysis, and sensitivity analysis were also employed. Protocol registration number: CRD42024496237. RESULTS: The pooled prevalence of late-stage diagnosis after combining reports of 24 studies with 8,677 participants was 65.85 (95% CI: 58.38, 73.32). Residence (adjusted OR: 1.92; 95% CI: 1.45, 2.53), patient delay at their first presentation (adjusted OR: 2.65; 95% CI: 1.56, 4.49), traditional medicine use (adjusted OR: 2.54; 95% CI: 1.89, 3.41), and breast self-examination practice (adjusted OR: 0.28; 95% CI: 0.09, 0.88) were significant determinants of late-stage diagnosis. CONCLUSION: Two-thirds of breast cancer patients in Ethiopia were diagnosed at an advanced stage. Residence, delay in the first presentation, traditional medicine use, and breast self-examination practice were significantly associated with late-stage diagnosis. Public education about breast cancer and its early detection techniques is crucial to reduce mortality and improve the survival of patients. Besides, improving access to cancer screening services is useful to tackle the disease at its curable stages.


Assuntos
Neoplasias da Mama , Diagnóstico Tardio , Humanos , Etiópia/epidemiologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Feminino , Prevalência , Estadiamento de Neoplasias
18.
Cancer Med ; 13(14): e7397, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39030995

RESUMO

BACKGROUND: Interventions aimed at upstream factors contributing to late-stage diagnoses could reduce disparities and improve breast cancer outcomes. This study examines the association between measures of housing stability and contemporary mortgage lending bias on breast cancer stage at diagnosis among older women in the United States. METHODS: We studied 67,588 women aged 66-90 from the SEER-Medicare linked database (2010-2015). The primary outcome was breast cancer stage at diagnosis. Multinomial regression models adjusted for individual and neighborhood socio-economic factors were performed using a three-category outcome (stage 0, early stage, and late stage). Key census tract-level independent variables were residence in the same house as the previous year, owner-occupied homes, and an index of contemporary mortgage lending bias. RESULTS: In models adjusted for individual factors, higher levels of mortgage lending bias were associated with later stage diagnosis (RR = 1.10, 95% CI 1.02-1.20; RR = 1.31, 95% CI 1.16-1.49; RR = 1.41, 95% CI 1.24-1.60 for least to high, respectively). In models adjusted for individual and neighborhood socio-economic factors, moderate and high levels of mortgage lending bias were associated with later stage diagnosis (RR = 1.16, 95% CI 1.02-1.33 for moderate and RR = 1.18, 95% CI 1.02-1.37 for high). Owner occupancy and tenure were not associated with later stage diagnosis in adjusted models. CONCLUSIONS: Contemporary mortgage lending bias demonstrated a significant gradient relationship with later stage at diagnosis of breast cancer. Policy interventions aimed at reducing place-based mortgage disinvestment and its impacts on local resources and opportunities should be considered as part of an overall strategy to decrease late-stage breast cancer diagnosis and improve prognosis.


Assuntos
Neoplasias da Mama , Habitação , Estadiamento de Neoplasias , Programa de SEER , Humanos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Neoplasias da Mama/epidemiologia , Feminino , Estados Unidos , Idoso , Idoso de 80 Anos ou mais , Fatores Socioeconômicos , Características da Vizinhança , Medicare
19.
J Egypt Natl Canc Inst ; 36(1): 19, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38825656

RESUMO

BACKGROUND: Breast cancer remains a complex disease and leading cause of cancer-related death in Nigerian women. Recently, the role of nutrition has been highlighted in the etiology of breast cancer. METHODS: The aim of this research was to evaluate the nutrition-related knowledge, attitude, and practices of female university students. We also investigated the correlation between their demographic characteristics and their knowledge and attitudes of the survey participants. A descriptive cross-sectional study was carried out among female students at the Federal University of Oye (FUOYE), Nigeria. Participants completed self-administered questionnaires designed to assess their knowledge, attitude, and practices concerning cancer prevention. Statistical analysis was performed using SPSS 20, and significance was set at p < 0.05. RESULTS: Out of the 402 students who received the questionnaire, 300 completed it. The average age of the participants was 21.26 years with a standard deviation of 2.68. There was generally limited knowledge regarding breast cancer risk factors, with 45% of participants citing family history as the most recognized risk factor. Overall, knowledge level was influenced by the participants' permanent place of residence and course of study. Attitudes towards the impact of maternal and paternal nutrition on breast cancer prevention were notably low. Additionally, less than half of the participants demonstrated good dietary practices. CONCLUSION: This study revealed low levels of nutrition-related knowledge concerning cancer prevention, accompanied by poor dietary habits among the participants. These results suggest a possible link between inadequate knowledge about breast cancer prevention and the observed poor dietary practices among the participants. The frequent consumption of unhealthy foods among the participants may be a pointer to higher risk of breast cancer in the future, emphasizing a need for health education targeted at this group.


Assuntos
Neoplasias da Mama , Conhecimentos, Atitudes e Prática em Saúde , Estudantes , Humanos , Feminino , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/epidemiologia , Nigéria/epidemiologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Adulto Jovem , Universidades , Adulto , Estudos Transversais , Inquéritos e Questionários , Estado Nutricional , Adolescente , Fatores de Risco
20.
J Health Care Poor Underserved ; 35(2): 672-691, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38828588

RESUMO

This study explores the association between health system changes over the last decade and women's preventive care utilization in Illinois. A cross-sectional analysis using Illinois Behavioral Risk Factor Surveillance System (BRFSS) data from 2012-2020 among women aged 21-75 (n=21,258) examined well-woman visit (WWV) receipt and breast and cervical cancer screening overall and over several time periods. There was an increase in the prevalence of receiving a WWV for Illinois women overall from 2012-2020. However, the overall adjusted prevalence difference was only significant for the 2020 versus 2015-2019 comparison and not for 2015-2019 versus 2012-2014. The COVID-19 pandemic was not associated with a decrease in the prevalence of mammogram use but was manifest for cervical cancer screening, particularly for Black women. Finally, those reporting having a WWV in the past year had a significantly higher prevalence of being up to date with screening compared with those not reporting a WWV.


Assuntos
COVID-19 , Patient Protection and Affordable Care Act , Humanos , Feminino , Illinois/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pessoa de Meia-Idade , Adulto , Idoso , Estudos Transversais , Adulto Jovem , Sistema de Vigilância de Fator de Risco Comportamental , Serviços Preventivos de Saúde/estatística & dados numéricos , Detecção Precoce de Câncer/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Neoplasias do Colo do Útero/prevenção & controle , Mamografia/estatística & dados numéricos , Neoplasias da Mama/epidemiologia
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