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1.
Environ Res ; 216(Pt 3): 114740, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36356668

RESUMO

Air pollution with particulate matter is an established lung carcinogen. Studies have suggested an association with breast cancer, but the evidence is inconsistent. METHODS: From nationwide registers, we identified all breast cancer cases (n = 55 745) in Denmark between 2000 and 2014. We matched one control for each case on age and year of birth. We used a multi-scale dispersion model to estimate outdoor concentrations of particulate matter <2.5 µm (PM2.5), elemental carbon (EC) and nitrogen dioxide (NO2) as time-weighted average over all addresses up to 20 years prior to diagnosis. We calculated odds ratios (OR) and 95% confidence intervals (CI) by conditional logistic regression with adjustment for marital status, educational level, occupational status, personal income, region of origin, medication and area-level socio-economic indicators. RESULTS: A 10 µg/m3 higher PM2.5 was associated with an OR for breast cancer of 1.21 (95% CI: 1.11-1.33). The corresponding ORs for EC (per 1 µg/m3) and NO2 (per 10 µg/m3) were 1.03 (95% CI: 1.00-1.07) and 1.03 (95% CI: 1.01-1.06), respectively. In multi-pollutant models, the OR for PM2.5 changed only little, whereas ORs for EC or NO2 approached the null. In an analysis of persons below 55 years, PM2.5 was associated with an OR of 1.32 (95% CI: 1.09-1.60) per 10 µg/m3 increase. CONCLUSION: We found evidence of an association between the investigated air pollutants and breast cancer, especially PM2.5. There were indications that the association differed by age at diagnosis. We were not able to include all potential confounders and thus, results should be interpreted with caution.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Neoplasias da Mama , Humanos , Feminino , Dióxido de Nitrogênio/análise , Estudos de Casos e Controles , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/epidemiologia , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Material Particulado/análise , Poluentes Atmosféricos/toxicidade , Poluentes Atmosféricos/análise , Carbono/análise , Dinamarca/epidemiologia
2.
Environ Res ; 216(Pt 1): 114471, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36208787

RESUMO

BACKGROUND: Industrial complex (IC) residence is associated with higher cancer incidence in adults and children. However, the effect on young adults and the residence duration are not well described. Since the beginning of the 20th century, the Haifa bay area (HBA) has a major IC area with petrochemical industry complex and many other industries. The objectives of the current study were to estimate the association between IC residence and cancer incidence and to evaluate the effect of the residence duration. METHODS: This study is a registry-based cohort (N = 1,022,637) with a follow-up of 21 years. Cox regression models were used to evaluate the associations (hazards ratios (HR) and its 95% confidence intervals (CIs)) between HBA residence and incidence of all cancer sites (n = 62,049) and for site-specific cancer types including: lung cancer (n = 5398), bladder cancer (n = 3790), breast cancer (n = 11,310), prostate cancer (n = 6389) skin cancer (n = 4651), pancreatic cancer (n = 2144) and colorectal cancer (n = 8675). We evaluated the effect of the duration of exposure as categories of 7 years for those with 15 years of follow-up. RESULTS: IC residence was associated with higher risk for all cancer sites (HR:1.09, 95% CI: 1.06-1.12), for site-specific cancer incidence including: lung cancer (HR:1.14, 95% CI: 1.04-1.23), bladder cancer (HR:1.11, 95% CI: 1.01-1.23), breast cancer (HR:1.04, 95% CI: 0.98-1.10), prostate cancer (HR:1.07, 95% CI: 0.99-1.16), skin cancer (HR:1.22, 95% CI: 1.12-1.33) and colorectal cancer (HR:1.10, 95%CI: 1.03-1.17). Similar risk was also observed among young adults (HR: 1.10, 95% CI: 1.00-1.20). In the analyses for the duration of exposure, IC residence was associated with higher risk for all cancer site for the longest residence duration (15-21 years: HR: 1.08, 95% CI: 1.04-1.13). CONCLUSIONS: Harmful associations were found between IC residence and incidence of all cancer sites and site-specific cancers types. Our findings add to the limited evidence of associations between IC residence and cancer in young adults.


Assuntos
Neoplasias da Mama , Neoplasias Colorretais , Neoplasias Pulmonares , Neoplasias , Neoplasias da Próstata , Neoplasias Cutâneas , Neoplasias da Bexiga Urinária , Adulto Jovem , Criança , Masculino , Humanos , Seguimentos , Neoplasias da Bexiga Urinária/epidemiologia , Israel/epidemiologia , Neoplasias/epidemiologia , Incidência , Sistema de Registros , Neoplasias da Mama/epidemiologia , Neoplasias Pulmonares/epidemiologia , Fatores de Risco
3.
Hematol Oncol Clin North Am ; 37(1): 1-15, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36435603

RESUMO

There has been a 40% decline in breast cancer age-adjusted death rate since 1990. Black American women have not experienced as great a decline; indeed, the Black-White disparity in mortality in the United States is greater today than it has ever been. Certain states (areas of residence), however, do not see such dramatic differences in outcome by race. This latter finding suggests much more can be done to reduce disparities and prevent deaths. Interventions to get high-quality care (screening, diagnostics, and treatment) involve understanding the needs and concerns of the patient and addressing those needs and concerns. Patient navigators are 1 way to improve outcomes.


Assuntos
Neoplasias da Mama , Estados Unidos/epidemiologia , Feminino , Humanos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Brancos , Afro-Americanos , Programas de Rastreamento
4.
Clin Imaging ; 93: 34-38, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36371852

RESUMO

PURPOSE: To determine what patient factors are associated with a high or an accurate perceived personal risk (PPR) for breast cancer. METHODS: An IRB-approved survey study of women with dense breasts presenting for annual screening mammography was previously conducted from March 2017 to February 2018. Patients were asked to estimate their personal risk for breast cancer and to answer questions about prior breast care-related medical interactions. Survey data were combined post hoc with demographic and clinical data, including breast cancer risk status, and socioeconomic data imputed for each patient from census data. Logistic regression was used to determine which patient factors were associated with a high or accurate PPR. RESULTS: Surveys were completed by 508 women with dense breasts (median age 59.0 years). A high PPR was independently associated with younger age (AOR, 1.71 [95% CI, 1.13, 2.60]), family history of breast cancer (AOR 4.27 [95% CI, 2.81-7.34]), having a clinical "high-risk" designation (AOR, 3.43 [95% CI, 1.13-10.39], and having been called back from screening (AOR, 1.94 [95% CI, 1.14-3.32]). A lower accuracy of PPR was independently associated with a family history of breast cancer (AOR, 0.25 [95% CI, 0.14-0.42]) and having been called back from screening (AOR, 0.58 [95% CI, 0.35-0.98]). CONCLUSION: Women with dense breasts who had a family history of breast cancer or who had been called back from screening had a higher but less accurate PPR. Women with a "high-risk" clinical designation had a higher PPR, even when controlling for family history.


Assuntos
Neoplasias da Mama , Mamografia , Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Densidade da Mama , Detecção Precoce de Câncer , Mama/diagnóstico por imagem , Programas de Rastreamento , Fatores de Risco
5.
Sci Rep ; 12(1): 18629, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36329109

RESUMO

Several studies have demonstrated the cost-effectiveness of genetic testing for surveillance and treatment of carriers of germline pathogenic variants associated with hereditary breast/ovarian cancer syndrome (HBOC). In Brazil, seventy percent of the population is assisted by the public Unified Health System (SUS), where genetic testing is still unavailable. And few studies were performed regarding the prevalence of HBOC pathogenic variants in this context. Here, we estimated the prevalence of germline pathogenic variants in BRCA1, BRCA2 and TP53 genes in Brazilian patients suspected of HBOC and referred to public healthcare service. Predictive power of risk prediction models for detecting mutation carriers was also evaluated. We found that 41 out of 257 tested patients (15.9%) were carriers of pathogenic variants in the analyzed genes. Most frequent pathogenic variant was the founder Brazilian mutation TP53 c.1010G > A (p.Arg337His), adding to the accumulated evidence that supports inclusion of TP53 in routine testing of Brazilian HBOC patients. Surprisingly, BRCA1 c.5266dupC (p.Gln1756fs), a frequently reported pathogenic variant in Brazilian HBOC patients, was not observed. Regarding the use of predictive models, we found that familial history of cancer might be used to improve selection or prioritization of patients for genetic testing, especially in a context of limited resources.


Assuntos
Neoplasias da Mama , Síndromes Neoplásicas Hereditárias , Neoplasias Ovarianas , Feminino , Humanos , Brasil/epidemiologia , Prevalência , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/diagnóstico , Predisposição Genética para Doença , Proteína BRCA2/genética , Proteína BRCA1/genética , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama/diagnóstico , Carcinoma Epitelial do Ovário , Atenção à Saúde , Mutação em Linhagem Germinativa , Proteína Supressora de Tumor p53/genética
6.
Br J Sports Med ; 56(20): 1157-1170, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36328784

RESUMO

OBJECTIVES: Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics. METHODS: We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (nsnps=5) or sedentary time (nsnps=6), or accelerometer-measured (nsnps=1) or self-reported (nsnps=5) vigorous physical activity. RESULTS: Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;~8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (~7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger). CONCLUSION: Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women.


Assuntos
Neoplasias da Mama , Exercício Físico , Comportamento Sedentário , Feminino , Humanos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único , Fatores de Risco
7.
Breast Cancer Res ; 24(1): 77, 2022 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-36369105

RESUMO

BACKGROUND: Associations of birthweight, childhood body size and pubertal timing with breast cancer risks by menopausal status and tumor receptor subtypes are inconclusive. Thus, we investigated these associations in a population-based cohort of Danish women. METHODS: We studied 162,419 women born between 1930 and 1996 from the Copenhagen School Health Records Register. The register includes information on birthweight, measured childhood weights and heights at the age of 7-13 years, and computed ages at the onset of the growth spurt (OGS) and at peak height velocity (PHV). The Danish Breast Cancer Cooperative Group database provided information on breast cancer (n = 7510), including estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2) and menopausal status. Hormone replacement therapy use came from the Danish National Prescription Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regression. RESULTS: We found that birthweight was not associated with any breast cancer subtypes. While childhood BMI was not statistically significantly associated with ER+ tumors nor consistently with ER- tumors among pre-menopausal women, consistent inverse associations were found among postmenopausal women. At the age of 7 years, the HRs for postmenopausal ER+ and ER- tumors were 0.90 (95% CI 0.87-0.93) and 0.84 (95% CI 0.79-0.91) per BMI z-score, respectively. Similarly, childhood BMI was inversely associated with pre- and postmenopausal HER2- tumors, but not with HER2+ tumors. Childhood height was positively associated with both pre- and postmenopausal ER+ tumors, but not with ER- tumors. At the age of 7 years, the HRs for postmenopausal ER+ and ER- tumors were 1.09 (95% CI 1.06-1.12) and 1.02 (95% CI 0.96-1.09) per height z-score, respectively. In general, childhood height was positively associated with HER2+ and HER2- tumors among pre- and postmenopausal women. Ages at OGS and PHV were not associated with any breast cancer subtypes. CONCLUSIONS: We showed that a high BMI and short stature in childhood are associated with reduced risks of certain breast cancer subtypes. Thus, childhood body composition may play a role in the development of breast cancer.


Assuntos
Neoplasias da Mama , Feminino , Humanos , Criança , Adolescente , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Neoplasias da Mama/metabolismo , Receptores de Progesterona/metabolismo , Índice de Massa Corporal , Fatores de Risco , Receptores de Estrogênio/metabolismo , Pré-Menopausa , Estatura , Peso ao Nascer , Puberdade
8.
Breast Cancer Res ; 24(1): 78, 2022 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-36376974

RESUMO

BACKGROUND: Breast tumor immune infiltration is clearly associated with improved treatment response and outcomes in breast cancer. However, modifiable patient factors associated with breast cancer immune infiltrates are poorly understood. The Nurses' Health Study (NHS) offers a unique cohort to study immune gene expression in tumor and adjacent normal breast tissue, immune cell-specific immunohistochemistry (IHC), and patient exposures. We evaluated the association of body mass index (BMI) change since age 18, physical activity, and the empirical dietary inflammatory pattern (EDIP) score, all implicated in systemic inflammation, with immune cell-specific expression scores. METHODS: This population-based, prospective observational study evaluated 882 NHS and NHSII participants diagnosed with invasive breast cancer with detailed exposure and gene expression data. Of these, 262 women (training cohort) had breast tumor IHC for four classic immune cell markers (CD8, CD4, CD20, and CD163). Four immune cell-specific scores were derived via lasso regression using 105 published immune expression signatures' association with IHC. In the remaining 620 patient evaluation cohort, we evaluated association of each immune cell-specific score as outcomes, with BMI change since age 18, physical activity, and EDIP score as predictors, using multivariable-adjusted linear regression. RESULTS: Among women with paired expression/IHC data from breast tumor tissue, we identified robust correlation between novel immune cell-specific expression scores and IHC. BMI change since age 18 was positively associated with CD4+ (ß = 0.16; p = 0.009), and CD163 novel immune scores (ß = 0.14; p = 0.04) in multivariable analyses. In other words, for each 10 unit (kg/m2) increase in BMI, the percentage of cells positive for CD4 and CD163 increased 1.6% and 1.4%, respectively. Neither physical activity nor EDIP was significantly associated with any immune cell-specific expression score in multivariable analyses. CONCLUSIONS: BMI change since age 18 was positively associated with novel CD4+ and CD163+ cell scores in breast cancer, supporting further study of the effect of modifiable factors like weight gain on the immune microenvironment.


Assuntos
Neoplasias da Mama , Enfermeiras e Enfermeiros , Humanos , Feminino , Adolescente , Índice de Massa Corporal , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Dieta , Biomarcadores , Genômica , Microambiente Tumoral
9.
JCO Clin Cancer Inform ; 6: e2100191, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36417684

RESUMO

PURPOSE: With earlier detection and an increasing number of breast cancer (BCa) survivors, more women are living with side effects of BCa treatment. A predictive approach to studying treatment-related adverse events (AEs) may generate proactive strategies; however, many studies are descriptive in nature. Focusing on short-term AEs, we determine the performance of prediction models of disease- or treatment-related AEs among women diagnosed with BCa. METHODS: We used administrative claims data from the Blue Health Intelligence National Data Repository. The study sample included female individuals age 18 years and older who were diagnosed with BCa and received cancer-directed treatment between January 1, 2014, and August 1, 2019. Using the information available in the claims data, we constructed longitudinal patient histories and identified disease- and treatment-related AEs occurring within 6 months of treatment. The following prediction models were developed: logistic regression, Lasso regression, gradient boosted tree (GBT), and random forest (RF). We compared models using the area under the receiver operating characteristic curve and its CI, among other metrics. RESULTS: Data were extracted for 267,473 members meeting study inclusion criteria. The area under the curve for the logistic regression model was 0.82 (0.82-0.86), compared with 0.89 (0.87-0.90) for the Lasso, 0.91 (0.89-0.93) for the GBT, and 0.90 (0.93-0.89) for the RF models. The sensitivity was 0.96 for the GBT, Lasso, and RF models, whereas the specificity was 0.42, 0.44, and 0.39 for the GBT, Lasso, and RF models, respectively. Positive predictive values were 0.96 across all three models. CONCLUSION: Prediction models developed using big data methods and grounded in a clinically guided framework have the potential to reliably predict short-term treatment-related AEs among women diagnosed with BCa.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Adolescente , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Detecção Precoce de Câncer , Curva ROC , Modelos Logísticos , Valor Preditivo dos Testes
10.
J Med Life ; 15(10): 1318-1321, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36420288

RESUMO

Breast cancer is the primary type of cancer affecting women. Patients with hormone receptor-positive cells have lower mortality rates. Both chemotherapy and hormone therapy can improve the survival rate. This study aimed to evaluate the hormonal receptor status in female breast cancer and assess the relationship with the patient's age and family history in Najaf, Iraq. A prospective study of two-hundred and fifty-one women with mastectomies (for cancers) was performed at AL Sader Medical City from January 2019 to January 2021. We collected and analyzed data regarding the age of patients, site and size of the tumor, number of pregnancies, family history, weight, smoking, and hormone receptor status. The average age of patients was 48 years, and the peak incidence was in the 40-49 age group (30.27% of patients). Of all age groups, 48.6% (122 patients) were negative for all hormone receptors (triple negative), and only 22.70% had a positive family history. The peak incidence of cancer in our study was in the 40-49 years group. A high proportion of the hormone receptors for patients were negative (triple-negative), and most patients had a negative family history.


Assuntos
Neoplasias da Mama , Gravidez , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Incidência , Estudos Prospectivos , Iraque/epidemiologia , Hormônios
11.
Colomb Med (Cali) ; 53(1): e2014966, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36415597

RESUMO

Background: Uruguay has the highest cancer incidence and mortality rates in Latin America. The National Cancer Registry of Uruguay, which has been in operation since 1992, provides epidemiological information on incidence and mortality at the country level. Objective: The objective of this article is to update the incidence and mortality figures by reporting the information for the period 2013-2017. Methods: All incident cases of invasive neoplasias except non melanoma of the skin and all cancer deaths occurred in from 2013 to 2017 were analyzed. Age standardized rates were calculated by the direct method, using the world standard population. Complementary, incidence (2002-2017) and mortality (1990-2017) trends were studied for the leading sites. Results: Among females, the most common cancers are breast, colon and rectum, lung, cervix and thyroid. The most frequent cancers in males are prostate, lung, colon and rectum, bladder and kidney. Lung, prostate and colorectal cancer are the leading causes of cancer death in males while breast cancer is the first cause of cancer death among females. Conclusions: Although cancer mortality has declined monotonously since 1990, cancer control is a challenge for Uruguay, wherein breast, lung and prostate cancer have very high incidence while the country must still make an effort to reduce other cancers that are very common in economically less favored countries.


Antecedentes: Uruguay tiene las mayores tasas de incidencia y mortalidad por cáncer en América Latina. El Registro Nacional de Cáncer de Uruguay, que ha estado en funcionamiento desde 1992 provee información epidemiológica sobre incidencia y mortalidad de todo el país. Objetivo: El objetivo de este artículo es actualizar las cifras de incidencia y mortalidad reportando la información para el período 2013-2017. Métodos: Se analizaron todos los casos incidentes de neoplasias invasivas excluyendo el cáncer de piel no melanoma y todas las muertes por cáncer del período 2013-2017. Se calcularon las tasas estandarizadas por edad según el método directo, utilizando como estándar la población mundial. En forma complementaria, se estudiaron las tendencias de incidencia (2002-2017) y de mortalidad (1990-2017) para los sitios más frecuentes. Resultados: Entre las mujeres, los cánceres más frecuentes son mama, colorrecto, pulmón, cérvix y tiroides. Los cánceres más frecuentes en hombres son próstata, pulmón colorrecto, vejiga y riñón. Los cánceres de pulmón, próstata y colorrecto ocupan los primeros lugares en las muertes por cáncer en hombres, mientras que en mujeres el cáncer de mama ocupa el primer lugar. Conclusiones: Si bien la mortalidad por cáncer ha disminuído de manera monótona desde 1990, el control del cáncer es un desafío para Uruguay dónde los cánceres de mama, pulmón y próstata tienen una incidencia muy alta, a la vez que aún se debe hacer un esfuerzo para reducir otros cánceres que son muy comunes en los países económicamente menos favorecidos.


Assuntos
Neoplasias da Mama , Neoplasias da Próstata , Masculino , Humanos , Incidência , Uruguai/epidemiologia , Sistema de Registros , Neoplasias da Próstata/epidemiologia , Neoplasias da Mama/epidemiologia
13.
J Cancer Res Ther ; 18(6): 1776-1781, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36412443

RESUMO

Context: Cervical and breast cancer is the most leading cause of death among women globally. Cervical and breast cancer can be cured if detected early. Aims: The aim of the study was to compare the knowledge and awareness of cervical and breast cancer among medical and nonmedical students of a private institution in South India. Settings and Design: A cross-sectional study was done on 600 female students of a private institution comprising both medical and nonmedical for a period of 6 months. Subjects and Methods: A study was done to assess the awareness and knowledge on cervical and breast cancer by using a standardized questionnaire. Statistical Analysis Used: The data were statistically analyzed with Mann-Whitney test by using GraphPad prism. Results: Out of the 600 female students, there were each of 300 female students in medical and nonmedical. Majority of the student population was seen in 17-19 years: 143 (47.6%) in medical and 206 (68.6%) in nonmedical. A total of 235 (78.3%) medical students have heard of cervical cancer and its screening (164 [54.6%]). Many nonmedical students have never heard of cervical cancer (248 [82.6%]) and its screening (283 [94.3%]). Nearly 61% of the medical students and 1.1% nonmedical have heard of Pap smear. Both medical students (276 [92%]) and nonmedical students (179 [53.2%]) were aware of the breast cancer but have less awareness about the age of occurrence. Awareness on breast self-examination was poor among medical (137 [45.6%]) and nonmedical (19 [5.6%]) students. The P < 0.0001 (<0.05) showed a statistically significant difference between the medical and nonmedical students. Conclusions: Through the findings of our study, we analyzed that the knowledge and awareness of cervical and breast cancer among medical students was better than that of the nonmedical students.


Assuntos
Neoplasias da Mama , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Universidades , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Estudantes
14.
JCO Glob Oncol ; 8: e2200289, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36351212

RESUMO

PURPOSE: A nationwide lockdown was enforced in Brazil starting in March 2020 because of the COVID-19 pandemic when cancer screening activities were reduced. In this study, we evaluated the impact of the COVID-19 pandemic on breast cancer (BC) diagnosis. METHODS: We extracted data from the medical records of patients age older than 18 years who were diagnosed with BC and started treatment or follow-up in private oncology institutions in Brazil between 2018 and 2021. The primary objective was to compare the stage distribution during the COVID-19 pandemic (2020-2021) with a historical prepandemic control cohort (2018-2019). Early BC was defined as stage I-II and advanced disease as stage IV. RESULTS: We collected data for 11,753 patients with an initial diagnosis of BC, with 6,493 patients in the pandemic (2020-2021) and 5,260 patients in the prepandemic period (2018-2019). We observed a lower prevalence of early-stage BC (63.6% v 68.4%) and a higher prevalence of advanced-stage BC (16.9 v 12.7%), after the onset of the pandemic (both P < .01). This pattern was similar for both estrogen receptor-positive/human epidermal growth factor receptor 2-negative and human epidermal growth factor receptor 2-positive tumors: significantly decreased in the early stage from 69% to 67% and 68% to 58%, respectively, and a considerable increase in advanced-stage disease from 13% to 15% and 13% to 20%, respectively. For triple-negative BC, there was a significantly higher percentage of patients with advanced-stage disease during the pandemic (17% v 11%). Overall, age 50 years or older and postmenopausal status were associated with a greater risk of advanced stage at diagnosis during the pandemic period. CONCLUSION: We observed a substantial increase in the number of cases of advanced-stage BC in Brazil during the COVID-19 pandemic.


Assuntos
Neoplasias da Mama , COVID-19 , Humanos , Adolescente , Pessoa de Meia-Idade , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Estadiamento de Neoplasias , Pandemias/prevenção & controle , Brasil/epidemiologia , Controle de Doenças Transmissíveis
15.
BMC Cancer ; 22(1): 1147, 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36348356

RESUMO

BACKGROUND: The incidence of breast cancer (BC) in Thailand has been rising at an alarming rate. The annual incidence of BC in Thailand has doubled over a span of 15 years. A retrospective study was conducted with the primary objective of assessing and comparing survival rates of patients with BC, stratified by subtype of BC. METHODS: A retrospective study was implemented for a cohort of women receiving a diagnosis of invasive BC with the objective of assessing and comparing their overall survival, stratified by BC subtype. Thai women receiving a diagnosis of their first primary invasive BC between January 2006 and December 2015 at Chiang Mai University Hospital were studied with 3,150 cases meeting the eligible criteria. RESULTS: The median follow-up time was 4.9 years (Inter Quartile Range: 2.8-7.7). The most common diagnosed subtype was luminal B-like (n = 1,147, 36.4%). It was still the most prevalent subtype (35.8%) in women younger than 40 years and the 40-60 age-group, The proportion of patients with TNBC is the highest in women aged less than 40 years with 19.3% compared to the other age categories. Finally, among women older than 60 years, the proportion of each subtype was relatively uniform. Most women received a diagnosis of stage II disease. Triple negative subtype increased overall mortality in advanced staging (stages III and IV) (aHR:1.42, 95% CI: 0.96-2.11). The 5-year overall survival rate was found in luminal A-like at 82.8%, luminal B-like at 77.6%, HER-2 enriched at 66.4% and triple negative subtype at 64.2%. CONCLUSION: The histologic subtype, correlated with age and staging influenced the OS. Our results confirmed the association of triple negative BC with poor prognosis especially in advanced stage. The adjuvant medical treatment in our country could not be accessible in some group of patients, so the results of treatment and survival especially HER-2 enriched are lower than other countries without treatment barrier.


Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Neoplasias da Mama/diagnóstico , Tailândia/epidemiologia , Estudos Retrospectivos , Receptor ErbB-2 , Neoplasias de Mama Triplo Negativas/patologia , Taxa de Sobrevida , Estudos de Coortes , Prognóstico
16.
J Womens Health (Larchmt) ; 31(11): 1547-1556, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36356184

RESUMO

Objective: Little is known about women's confidence in their breast cancer screening. We sought to characterize breast cancer screening confidence by imaging modality and clinically assessed breast density. Materials and Methods: We undertook a cross-sectional survey of women ages 40-74 years who received digital mammography (DM), digital breast tomosynthesis (DBT), and/or breast magnetic resonance imaging (MRI) with a normal screening exam in the prior year. The main outcome was women's confidence (Very, Somewhat, A little, Not at all) in their breast cancer screening detecting any cancer. Multivariable logistic regression identified correlates of being very confident in breast cancer screening by screening modality group: Group 1) DM vs. DBT and Group 2) DM or DBT alone vs. with supplemental MRI. Results: Overall, 2329 of 7439 (31.3%) invitees participated, with 30%-61% being very confident in their screening across modality and density subgroups. Having dense versus nondense breasts was associated with lower odds of being very confident (Group 1: odds ratio [OR]: 0.58; 95% confidence interval [CI]: 0.46-0.79; Group 2: OR: 0.56; 95% CI: 0.40-0.79). There were no differences by modality within Group 1, but for Group 2, women undergoing MRI had higher odds of being very confident (OR: 1.69; 95% CI: 1.21-2.37). Other correlates of greater screening confidence were as follows: Group 1-being offered a screening test choice and cost not influencing modality received, and Group 2-decision satisfaction and worry. Conclusions: Women with dense breasts had lower screening confidence regardless of screening modality and those undergoing MRI had higher confidence regardless of density. The importance of informing women about screening options is underscored by observed associations between screening choice, decision satisfaction, and screening confidence. ClinicalTrials.gov: NCT02980848.


Assuntos
Densidade da Mama , Neoplasias da Mama , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer/métodos , Estudos Transversais , Mamografia , Programas de Rastreamento/métodos
17.
Cancer Control ; 29: 10732748221140206, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36373740

RESUMO

OBJECTIVES: Though menstrual and reproductive factors have been associated with the risk of breast cancer in many populations, very few studies have been conducted among Vietnamese women. This study aimed to assess the association between menstrual and reproductive factors and the risk of breast cancer in Vietnamese women. METHODS: A retrospective case-control study of 490 breast cancer cases and 468 controls was conducted in Northern Vietnam. Unconditional logistic regression models adjusting for confounders were used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) for the associations of menstrual and reproductive factors with the risk of breast cancer; overall and by cancer subtype. RESULTS: Among breast cancer patients, the luminal B subtype was the most frequent (48.6%), followed by HER2-overexpressing (24.5%), luminal A (16.7%), and triple-negative breast cancer (TNBC; 10.2%). Among menopausal women, menopausal age at 50 years or older (OR = 1.71, 95% CI: 1.15-2.57 vs. <50 y) was associated with an increased risk of breast cancer. Earlier age at menarche (<13 y) was associated with a significantly increased risk of breast cancer (OR = 2.66, 95% CI: 1.08-7.51) among premenopausal women only and the luminal A subtype of breast cancer (OR = 3.06, 95% CI: 1.04-8.16). Having more than two children was associated with a reduced risk of premenopausal (OR = .42, 95%CI: .21-.83), luminal B (OR = .43, 95% CI: .24-.79), and TNBC (OR = .34, 95% CI: .14-.89). Later menopause was positively associated with the risk of breast cancer with HER2 overexpression (OR = 2.19, 95% CI: 1.14-4.23). CONCLUSION: Associations of menstrual and reproductive factors with breast cancer among Vietnamese women, particularly for among premenopausal women and for the luminal A subtype, are generally consistent with those reported from other countries. These findings suggest that changes in menstrual and reproductive patterns among young Vietnamese women may contribute to the recent rising incidence of breast cancer in Vietnam.


Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Criança , Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/complicações , Estudos de Casos e Controles , Neoplasias de Mama Triplo Negativas/epidemiologia , Estudos Retrospectivos , Vietnã/epidemiologia , Fatores de Risco , Asiáticos , Receptores de Progesterona , Receptor ErbB-2
18.
Cancer Control ; 29: 10732748221140691, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36382426

RESUMO

BACKGROUND: Multimorbidity is common in patients with breast cancer, thus increasing the complexity of cancer care and economic burden, worsening their prognosis and quality of life. The prevalence of multimorbidity and its influence on psychological distress among patients with breast cancer have not been well characterized. OBJECTIVES: To examine the prevalence of multimorbidity and its associations with anxiety and depression among newly diagnosed patients with breast cancer. METHODS: We conducted a retrospective observational cohort study using a large administrative claims database. Patients with breast cancer (ICD-10-CM: C50.x) were identified during the study period (1/1/2017-12/31/2020). The index date was defined as the diagnosis date of breast cancer. Demographics and comorbid conditions were assessed using data within 12 months prior to the index date. Multimorbidity was defined as the presence of ≥2 comorbid conditions. Anxiety and depression were examined using data within 12 months after the index date. Multivariable logistic regressions were performed to examine the associations between multimorbidity and anxiety and depression, adjusting for sociodemographic factors. RESULTS: Of the 6392 patients with newly diagnosed breast cancer, 86.9% had multimorbidity at the time of breast cancer diagnosis. The median number of comorbid conditions was 5. Overall, 27.7% experienced anxiety, and 21.9% experienced depression in the first year following breast cancer diagnosis. An increased number of comorbid conditions was associated with elevated prevalence of both anxiety and depression. After adjusting for possible confounding factors, number of comorbid conditions was significantly associated with risk of anxiety (adjusted odds ratio [95% confidence interval (CI)]: 1.17 [1.15-1.19]), and depression (1.24 [1.21-1.26]); all P < .0001. CONCLUSIONS: Multimorbidity was highly prevalent among patients with breast cancer and was strongly associated with increased risk of anxiety and depression in the first year following breast cancer diagnosis. The presence of multimorbidity, anxiety, and depression should be considered in the context of clinical decision making to optimize cancer care and improve mental health and quality of life.


Assuntos
Neoplasias da Mama , Medicare Part C , Humanos , Idoso , Estados Unidos/epidemiologia , Feminino , Multimorbidade , Depressão/diagnóstico , Depressão/epidemiologia , Estudos Retrospectivos , Qualidade de Vida , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Ansiedade/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-36361442

RESUMO

Breast cancer (BC) is one of the most dangerous health problems affecting women. Lifestyle-associated determinants like physical activity (PA) play an important role in BC treatment outcomes. Studies suggest that oncology patients are insufficiently physically active. One of the potential barriers is kinesiophobia-fear of movement due to expected pain and fatigue. The aim of this cross-sectional study is to investigate the level of kinesiophobia among women one year after BC hospital treatment depending on socio-demographic variables, stage and type of BC, lifestyle, and comorbidities. Polish women after BC (n = 138, age 46.5 ± 9.2, BMI 24.6 ± 4.0) participated in the study and the Tampa Scale of Kinesiophobia (TSK) questionnaire was used in the diagnostic survey. The study results show that women suffer from kinesiophobia after BC. Moreover, every third woman (32.6%) does not practice sport regularly one year after BC treatment. The lifestyle before BC diagnosis impacts the level of kinesiophobia after treatment-women who were not physically active before BC diagnosis declared higher levels than previously active women. The study result shows that a high level of kinesiophobia correlates with a low level of PA among women after BC. Women with obesity and diabetes also declared higher levels of kinesiophobia than women without comorbidities. The type and stage of BC have no influence on the level of kinesiophobia; however, in terms of socio-demographic variables, a direct association between kinesiophobia and age has been found-the greater the age, the higher the level of kinesiophobia. Further research on fear of movement in oncology is required in order to effectively eliminate hypokinetic attitudes in every type of female and male cancer.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Neoplasias da Mama/epidemiologia , Inquéritos e Questionários , Hospitais
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