1.The application of counter-matching design in epidemiological research.
Chinese Journal of Epidemiology 2005;26(9):723-725
OBJECTIVETo explore the application of counter-matching design in epidemiological research.
METHODSThrough elaboration of the study about gene-environment interactions in the etiology of breast cancer, methodology regarding counter-matching design and statistic methods was introduced.
RESULTSThis design improved the potential for detecting gene-environment interactions for diseases when both gene mutations and the environmental exposures of interest were rare in the general population.
CONCLUSIONCounter-matching appearsed to be more appropriate than most traditional epidemiologic methods for the study of interactions involving rare factors.
Breast Neoplasms ; epidemiology ; etiology ; genetics ; radiotherapy ; Epidemiologic Methods ; Humans ; Male
2.Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective.
Nina ROSWALL ; Elisabete WEIDERPASS
Journal of Preventive Medicine and Public Health 2015;48(1):1-9
The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.
*Alcohol Drinking
;
Breast Neoplasms/epidemiology/etiology/mortality
;
Colorectal Neoplasms/epidemiology/etiology/mortality
;
Female
;
Humans
;
Liver Neoplasms/epidemiology/etiology/mortality
;
Male
;
Mouth Neoplasms/epidemiology/etiology/mortality
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Neoplasms/epidemiology/*etiology/mortality
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Public Health
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Risk Factors
;
Sex Factors
3.Hormone Replacement Therapy and Risk of Breast Cancer in Korean Women: A Quantitative Systematic Review.
Journal of Preventive Medicine and Public Health 2015;48(5):225-230
OBJECTIVES: The epidemiological characteristics of breast cancer incidence by age group in Korean women are unique. This systematic review aimed to investigate the association between hormone replacement therapy (HRT) and breast cancer risk in Korean women. METHODS: We searched electronic databases such as KoreaMed, KMbase, KISS, and RISS4U as well as PubMed for publications on Korean breast cancer patients. We also conducted manual searching based on references and citations in potential papers. All of the analytically epidemiologic studies that obtained individual data on HRT exposure and breast cancer occurrence in Korean women were selected. We restricted the inclusion of case-control studies to those that included age-matched controls. Estimates of summary odds ratio (SOR) with 95% confidence intervals (CIs) were calculated using random effect models. RESULTS: One cohort and five case-control studies were finally selected. Based on the heterogeneity that existed among the six studies (I-squared=70.2%), a random effect model was applied. The summary effect size of HRT history from the six articles indicated no statistical significance in breast cancer risk (SOR, 0.983; 95% CI, 0.620 to 1.556). CONCLUSIONS: These facts support no significant effect of HRT history in the risk of breast cancer in Korean women. It is necessary to conduct a pooled analysis.
Breast Neoplasms/epidemiology/*etiology
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Databases, Factual
;
Female
;
*Hormone Replacement Therapy
;
Humans
;
Incidence
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Republic of Korea/epidemiology
;
Risk
4.Analysis of the risk factors of breast cancer.
Yan ZENG ; Mao-sheng XU ; Shi-qi TAN ; Liang YIN
Journal of Southern Medical University 2010;30(3):622-623
OBJECTIVETo explore the risk factors of breast cancer for better control and prevention of the malignancy.
METHODSThe clinical data of 232 patients with pathologically established breast cancer were investigated in this 1:1 case-control study to identify the risk factors of breast cancer.
RESULTSThe history of benign breast diseases, family history of carcinoma and multiple abortions were the statistically significant risk factors of breast cancer, while breast feeding was the protective factor.
CONCLUSIONA history of benign breast diseases, family history of carcinoma and multiple abortions are all risk factors of breast cancer.
Abortion, Habitual ; Adult ; Aged ; Breast Diseases ; complications ; Breast Feeding ; Breast Neoplasms ; epidemiology ; etiology ; Carcinoma ; complications ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Risk Factors ; Young Adult
5.A case-control study on risk factors of female breast cancer in Zhejiang province.
Xue-ying YAO ; Shan-shan NI ; Jun ZHOU ; Hui-yong HU ; Li-li LI ; Fang WAN ; Yi-ke WANG ; Yi-ding CHEN
Journal of Zhejiang University. Medical sciences 2012;41(5):512-518
OBJECTIVETo investigate the risk factors on female breast cancer in Zhejiang province.
METHODSA case-control study was conducted in 200 cases of female breast cancer with histopathological diagnosis and 200 matched controls from Zhejiang province.
RESULTSUnivariate conditional logistic regression showed that family history of malignant tumor and breast cancer, housing decoration in last 10 years, mammary hyperplasia, adverse life events, bra with steel rings, sleeping with bra, high fat and pickle intake, poor sleep were positively related to breast cancer; whereas environmental friendly decoration materials, long decoration time interval, workplace condition, more lactation and parity, high fruits intake, sufficient sleep were negatively related to breast cancer. Multivariate conditional logistic regression analysis showed that the risk factors included family history of other tumors [odds ratio (OR)= 1.571,95% confidence interval(CI):1.029-2.396],mammary hyperplasia (OR=3.066,95%CI:1.834-5.126), job-related life events (OR=4.575,95%CI:1.690-12.390),the death of a loved one (OR=2.555,95%CI:1.475-4.424), wearing bra at night (OR=1.902,95%CI:1.177-3.072),high fat intake (OR=2.709,95%CI:1.546-4.749) and salted food (OR=2.460,95%CI:1.300-4.653). Factors as environmental friendly decoration materials (OR=0.517,95%CI:0.339-0.789),workplaces condition (OR=0.430,95%CI:0.243-0.762),more lactation (OR=0.109,95%CI:0.013-0.896),enough sleep (OR=0.424,95%CI:0.205-0.880) were protective factors.
CONCLUSIONHereditary,psychological factors,lifestyle,environment and diet related factors are significantly associated with risk of breast cancer.
Breast Neoplasms ; etiology ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Multivariate Analysis ; Risk Factors
6.Development and validation of risk prediction model for new-onset cardiovascular diseases among breast cancer patients: Based on regional medical data of Inner Mongolia.
Yun Jing ZHANG ; Li Ying QIAO ; Meng QI ; Ying YAN ; Wei Wei KANG ; Guo Zhen LIU ; Ming Yuan WANG ; Yun Feng XI ; Sheng Feng WANG
Journal of Peking University(Health Sciences) 2023;55(3):471-479
OBJECTIVE:
To develop and validate a three-year risk prediction model for new-onset cardiovascular diseases (CVD) among female patients with breast cancer.
METHODS:
Based on the data from Inner Mongolia Regional Healthcare Information Platform, female breast cancer patients over 18 years old who had received anti-tumor treatments were included. The candidate predictors were selected by Lasso regression after being included according to the results of the multivariate Fine & Gray model. Cox proportional hazard model, Logistic regression model, Fine & Gray model, random forest model, and XGBoost model were trained on the training set, and the model performance was evaluated on the testing set. The discrimination was evaluated by the area under the curve (AUC) of the receiver operator characteristic curve (ROC), and the calibration was evaluated by the calibration curve.
RESULTS:
A total of 19 325 breast cancer patients were identified, with an average age of (52.76±10.44) years. The median follow-up was 1.18 [interquartile range (IQR): 2.71] years. In the study, 7 856 patients (40.65%) developed CVD within 3 years after the diagnosis of breast cancer. The final selected variables included age at diagnosis of breast cancer, gross domestic product (GDP) of residence, tumor stage, history of hypertension, ischemic heart disease, and cerebrovascular disease, type of surgery, type of chemotherapy and radiotherapy. In terms of model discrimination, when not considering survival time, the AUC of the XGBoost model was significantly higher than that of the random forest model [0.660 (95%CI: 0.644-0.675) vs. 0.608 (95%CI: 0.591-0.624), P < 0.001] and Logistic regression model [0.609 (95%CI: 0.593-0.625), P < 0.001]. The Logistic regression model and the XGBoost model showed better calibration. When considering survival time, Cox proportional hazard model and Fine & Gray model showed no significant difference for AUC [0.600 (95%CI: 0.584-0.616) vs. 0.615 (95%CI: 0.599-0.631), P=0.188], but Fine & Gray model showed better calibration.
CONCLUSION
It is feasible to develop a risk prediction model for new-onset CVD of breast cancer based on regional medical data in China. When not considering survival time, the XGBoost model and the Logistic regression model both showed better performance; Fine & Gray model showed better performance in consideration of survival time.
Humans
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Female
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Adult
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Middle Aged
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Adolescent
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Breast Neoplasms/epidemiology*
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Cardiovascular Diseases/etiology*
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Proportional Hazards Models
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Logistic Models
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China/epidemiology*
7.Population-attributable risk estimates for breast cancer in Chinese females.
Xiao-feng HU ; Yong JIANG ; Chen-xu QU ; Jian-bing WANG ; Wan-qing CHEN ; Hui LI ; You-lin QIAO
Chinese Journal of Oncology 2013;35(10):796-800
OBJECTIVETo estimate the contribution of known identified risk factors to breast cancer incidence and mortality in China, and provide evidence to support the prevention and control of breast cancer for Chinese females.
METHODSWe calculated the proportion of breast cancer attributable to specific risk factors. Data on exposure prevalence were obtained from Meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were obtained from Meta-analyses and large-scale prospective studies. Cancer mortality and incidence were taken from the Third National Death Survey and from cancer registries in China.
RESULTSThe first 5 risk factors of breast cancer in China were benign breast disease (RR = 2.62), family history of breast cancer (RR = 2.39), smoking (RR = 1.86), overweight (RR = 1.60) and age at menarche (RR = 1.54). The proportion of breast cancer deaths attributable to reproductive factors, lifestyle factors, benign breast disease, the use of external hormone and family history of breast cancer was 27.84%, 23.55%, 15.09%, 3.60% and 2.49%, respectively. The total population attributable fraction (PAF) was 55.95% for risk factors in our study. Overall, we estimated that 79 862 breast cancer cases and 22 456 deaths were attributed to the five risk factors in China in 2005.
CONCLUSIONSThe prevention and control of unhealthy lifestyle factors may significantly reduce the number and death of breast cancer in China.
Breast Diseases ; complications ; Breast Neoplasms ; epidemiology ; etiology ; genetics ; China ; epidemiology ; Female ; Genetic Predisposition to Disease ; Humans ; Menarche ; Meta-Analysis as Topic ; Overweight ; complications ; Risk Factors ; Smoking ; adverse effects
8.The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis.
Yu Tong WANG ; Kui Ru HU ; Jian ZHAO ; Fei Ling AI ; Yu Lin SHI ; Xue Wei WANG ; Wen Yi YANG ; Jing Xin WANG ; Li Mei AI ; Xia WAN
Biomedical and Environmental Sciences 2023;36(1):24-37
OBJECTIVE:
To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population.
METHODS:
We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort).
RESULTS:
In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women.
CONCLUSION
The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.
Child
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Female
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Humans
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Asthma/epidemiology*
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Breast Neoplasms
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East Asian People
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Lung Neoplasms/etiology*
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Tobacco Smoke Pollution/adverse effects*
;
China
9.Comprehensive evaluation and trend prediction of risk factors on breast cancer.
Chinese Journal of Epidemiology 2003;24(7):611-614
OBJECTIVETo comprehensively analyse and evaluate the risk factors and to predict the trend of breast cancer in China.
METHODSCollecting the articles on case-control studies related to breast cancer in the last 10 years in China. Calculating the relative risk (OR) and 95% confidence interval (95%CI) of risk factors by the random effect model of Meta-analysis to estimate present and future population attributable risk percent (PARP) based on the exposure rate of risk factor and to predict the change of incidence rates of breast cancer during the following 5 years with the change of exposure rates.
RESULTSTwenty-two articles referred to case-control studies on breast cancer were selected. The OR and its 95%CI of the first 5 risk factors of breast cancer in China were benign breast lesion 3.39 (2.97 - 3.86), psychological stimulation 2.36 (2.09 - 2.67), breast-feeding 1.95 (1.54 - 2.47), family history of tumor 1.84 (1.63 - 2.08) and menstruation 1.65 (1.44 - 1.89). The factors with higher PRAP were benign breast lesion, breast-feeding, psychological stimulation with PRAR 15.47%, 15.17%, 13.76%, respectively. Their PRAP would have decreased to 12.77%, 11.32%, 12.52% and 9.90%, 8.74%, 9.69% respectively if the exposure rates had decreased 20% and 40% in the next 5 or 10 years. Factors contributing to the change of incidence rate of breast cancer would include benign breast lesion, breast-feeding, psychological stimulation along with the change of exposure rate. The incidence rates of breast cancer would then have become 3.09%, 2.75%, 3.03% and 6.19%, 5.50%, 6.07% respectively if their exposure rate had decreased 20% and 40% in the next 5 or 10 years.
CONCLUSIONDecreasing benign breast lesion, avoiding psychological stimulation, advocating on breast-feeding seemed to be the effective measures to control the occurrence and development of breast cancer.
Adult ; Age Factors ; Aged ; Body Weight ; Breast Diseases ; complications ; Breast Feeding ; Breast Neoplasms ; epidemiology ; etiology ; genetics ; Case-Control Studies ; China ; epidemiology ; Female ; Genetic Predisposition to Disease ; epidemiology ; Humans ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Stress, Psychological ; complications
10.Exploratory study on related factors of sexual dysfunction among breast cancer patients.
Xuenong OUYANG ; Wenwu WANG ; Yonghai PENG
National Journal of Andrology 2004;10(7):509-511
OBJECTIVETo investigate the factors related to sexual dysfunction among breast cancer patients so as to improve the prevention and treatment of the disorder as well as the life quality of the patients.
METHODSSixty-five breast cancer patients during the rehabilitation period were interviewed by questionnaire on the sexual function before and after treatment.
RESULTSAge and perception of sex were two important factors for the significant difference in the rate of sexual dysfunction among the patients. In the groups of 45-55 and 56-65 years, the rates of sexual dysfunction were 66.7% and 73.9%, respectively. Compared with the < 45-year group (33.3%), the findings were statistically significant (P < 0.01), and the difference was statistically significant between the incorrect perception group (70.3%) and the correct one (47.6%) (P < 0.05). Of all the factors analyzed in the research, the stage of cancer, treatment methods, vaginal dryness, decreased libido, dyspareunia and sex perception had significant correlation with newly developed sexual dysfunction (P < 0.05).
CONCLUSIONThe stage of cancer, treatment methods, sex perception, vaginal dryness et al had significant correlation with sexual dysfunction of breast cancer patients after treatment. To treat and prevent sexual dysfunction among breast cancer patients, oncology professionals should initiate communication about sexual difficulties, perform comprehensive assessments, and educate and counsel patients about the management of these difficulties.
Adult ; Age Factors ; Aged ; Breast Neoplasms ; complications ; psychology ; Female ; Humans ; Incidence ; Middle Aged ; Quality of Life ; Sexual Dysfunctions, Psychological ; epidemiology ; etiology