Ethnic differences in the time trend of female breast cancer incidence: Singapore, 1968 – 2002 (original) (raw)
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BMC Cancer, 2012
Background: Gail and others developed a model (GAIL) using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in SouthEast Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Methods: Data from the Singapore Breast Screening Programme (SBSP) are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E) with the observed (O) by the ratio (E/O) and 95% confidence interval (CI) and the respective concordance statistics estimated.
British journal of cancer, 2004
South Asian women in England have a lower breast cancer risk than their English-native counterparts, but less is known about variations in risk between distinct South Asian ethnic subgroups. We used the data from a population-based case-control study of first-generation South Asian migrants to assess risks by ethnic subgroup. In all, 240 breast cancer cases, identified through cancer registries, were individually matched on age and general practitioner to two controls. Information on the region of origin, religious and linguistic background, and on breast cancer risk factors was obtained from participants. Breast cancer odds varied significantly between the ethnic subgroups (P=0.008), with risk increasing in the following order: Bangladeshi Muslims (odds ratio (OR) 0.33, 95% confidence interval (CI): 0.10, 1.06), Punjabi Hindu (OR 0.59, 95% CI: 0.33, 1.27), Gujarati Hindu (1=reference group), Punjabi Sikh (OR 1.23, 95% CI: 0.72, 2.11) and Pakistani/Indian Muslims (OR 1.76, 95% CI: 1...
International Journal of Cancer, 2012
We determined the incidences of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) subtypes among breast cancer cases in Sarawak, Malaysia and their correlation with various risk factors in the three ethnic groups: Chinese, Malay and native. Subtype status was ascertained for 1,034 cases of female breast cancer (93% of all cases diagnosed since 2003), and the age-standardized incidence rates (ASRs) of each subtype were inferred. Case-case comparisons across subtypes were performed for reproductive risk factors. We found 48% luminal A (ER1/PR1/ HER22), 29% triple-negative (ER2/PR2/HER22), 12% triple-positive (ER1/PR1/HER21) and 11% HER2-overexpressing (ER2/ PR2/HER21) subtypes, with ASRs of 10.6, 6.0, 2.8 and 2.8 per 100,000, respectively. The proportions of subtypes and ASRs differed significantly by ethnic groups: HER2-positive cases were more frequent in Malays (29%; 95% CI [23;35]) than Chinese (22%; [19;26] and natives (21%; [16;26]); triple-negative cases were less frequent among Chinese (23%; [20;27]) than Malays (33%; [27;39]) and natives (37%; [31;43]). The results of the case-case comparison were in accordance with those observed in western case series. Some uncommon associations, such as between triple-negative subtype and older age at menopause (OR, 1.59; p < 0.05), were found. The triple-negative and HER21 subtypes predominate in our region, with significant differences among ethnic groups. Our results support the idea that the risk factors for different subtypes vary markedly. Westernized populations are more likely to have factors that increase the risk for the luminal A type, while risk factors for the triple-negative type are more frequent in local populations.
Ethnicity and Breast Cancer Risk: An Indian Perspective
2017
Breast cancer (BC) is the most common cancer in females globally whereas in India BC is the second most common cancer in females. Population based cancer registries in North Eastern (NE) region of India show clear heterogeneity in the incidence rates of BC. Clinical and epidemiological studies have shown that anthropogenic measures, female reproductive status, circulatory steroid hormones, hormone receptor status, use of birth control pills, food habits are significantly associated with the increased risk of BC globally along with genetic heterogeneity and epigenetic alternations in females. In the present review we aim to explore various risk factors of BC in Indian females across different ethnic groups. Early onset of menarche, late age of marriage, late age at first full term pregnancy, low parity status, short span of lifetime duration of lactation, late age of menopause are significantly associated with the increased risk of BC in Indian females which strongly follow ethnic va...
Medical Journal of Indonesia, 1999
Penelitian kasus kontrol kanker payudara dalam aspek epidemiologi, khuswnya tentang faktor risiko telah dun kali dilakukan di Indonesia. Pertama kali daLam tahun 1980-1981 (selama satu tahun) di Fakubas Kedokteran Universitas Indonesia, dalam hal ini kerjasama antara Bagian Kedokteran Komunitas dan Bagian Bedahyang melibatkut 90 kasus kanker payudara, 90 kasw kontol. Penelitian ked.ua, yaitu yang terakhir ini, dengan inisiator dari International Collaborative Study on Breast Cancer antara T'i,m Universitas Intlonesia dengan Tim Jepang (Nagoya University dan Tokyo Cancer Institute) yang melibatkan lebih banyak kasus, yaitu 300 kasus kanker payudara dan 600 kontrol. Sturly banàing yang dilakukan antara kedua penelitian ini memperoleh hasil sebagai berikut; diperkirakan beLum ada perubahan pergeseran distribusi umur penderita kanker payurlara dengan peak of age yaitu parla usia 40-49 tahun. Juga belum tampak perubahan yang berarti dalam distribusi stadium kanker payudara, walaupun sejak awal tahun 1970-an swlah dilakukan program deteksi dini yang dipelopori oleh YKI (Yayasan Kanker Indonesia). Perbedaan I0 tahun belum memperLihatkan pula perubahan distribusi pendidikan dari penderita kanker payuàara. Tentang faktor risiko ditemukan bahwa pada studi pertama, radiasi dan riwayat trauma merupakanfaktor risiko yang signifikan secara statistik, sementara obesity (kegemukan), status perkawinan, kehami-Ian dan laktasi merupakan faktor risiko yang tidak signifikan secara statistik. Pada studi kedun, ditemukan hasil bahwa perkawinan dan radiasi mempunyai efek proteksi terhadap terjadinya kanker payudara. Sebaliknya, perceraian, menjan^da, kehamilan, laktasi dan trauma merupakan faktor yang dapat meningkatkan risiko terjadinya kanker payudara. Diperlukan penelitian lebih lanjut untuk mendapatkan hasil yang lebih bermakna. Abstract A case control study of epidemiologicaL aspect of breast cancer especially concerning the riskfactors and lifestyles in breast cancer patients had been carried out twice in Indonesia. Firstly in 1980-1981 (one year), perfurmed by the awl 90 cases of breast cancer were compared to 90 controls.
Risk factors for breast cancer in postmenopausal Caucasian and Chinese-Canadian women
Breast Cancer Research, 2010
Introduction: Striking differences exist between countries in the incidence of breast cancer. The causes of these differences are unknown, but because incidence rates change in migrants, they are thought to be due to lifestyle rather than genetic differences. The goal of this cross-sectional study was to examine breast cancer risk factors in populations with different risks for breast cancer. Methods: We compared breast cancer risk factors among three groups of postmenopausal Canadian women at substantially different risk of developing breast cancer-Caucasians (N = 413), Chinese women born in the West or who migrated to the West before age 21 (N = 216), and recent Chinese migrants (N = 421). Information on risk factors and dietary acculturation were collected by telephone interviews using questionnaires, and anthropometric measurements were taken at a home visit. Results: Compared to Caucasians, recent Chinese migrants weighed on average 14 kg less, were 6 cm shorter, had menarche a year later, were more often parous, less often had a family history of breast cancer or a benign breast biopsy, a higher Chinese dietary score, and a lower Western dietary score. For most of these variables, Western born Chinese and early Chinese migrants had values intermediate between those of Caucasians and recent Chinese migrants. We estimated five-year absolute risks for breast cancer using the Gail Model and found that risk estimates in Caucasians would be reduced by only 11% if they had the risk factor profile of recent Chinese migrants for the risk factors in the Gail Model. Conclusions: Our results suggest that in addition to the risk factors in the Gail Model, there likely are other factors that also contribute to the large difference in breast cancer risk between Canada and China.
International Journal of Cancer, 2005
Breast cancer incidence in Sweden has always been approximately twice as high as in Singapore. In recent years, this difference is limited to postmenopausal women. The aim of this study was to explore the reasons behind these differences through the use of age-period-cohort modeling. This population-based study included all breast cancer cases reported to the Swedish and the Singapore cancer registries from 1968 to 1997, with a total of 135,581 Swedish and 10,716 Singaporean women. Poisson regression using age-period and age-cohort models was used to determine the effects of age at diagnosis, calendar period and birth cohort. Incidence rate ratios were used to summarize these effects. An age-cohort model provided the best fit to the data in both countries, indicating that changes over lifetime, rather than recent differences in medical surveillance, might account for the observed differences in these 2 populations. The changes over birth cohort were much greater among Singaporean women. The relative effect of age was very similar in the 2 countries. Analyses show that age and cohort effects may explain the differences in trends of female breast cancer incidence between Sweden and Singapore. The larger cohort effect seen in Singaporean women may be attributed to more rapid changes in reproduction and lifestyle patterns than that of Swedish women during the period studied. The incidence of breast cancer in postmenopausal women in Singapore will probably continue to rise in the coming decades to match the current Swedish rates.
Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer.
JNCI Journal of the National Cancer Institute, 2008
One-fifth of the world's women live in China. Incidence rates of breast cancer in most of China are currently low compared with those in Western countries. For example, the age-standardized incidence rate of breast cancer in the rural county of Qidong is 12.8 per 100 000 women, which is approximately one-tenth that of white women in the United States ( 1 ). However, Shanghai ( 2 ), Hong Kong ( 3 ), Japan ( 4 ), and Singapore ( 5 ) have recently experienced rapid increases in breast cancer incidence rates, and breast cancer is now the most common cancer among women in these regions. Furthermore, breast cancer incidence among Asian-American women is increasing ( 6 ): Rates in Japanese-American women have surpassed the age-specific incidence rates in white US women ( 2 ). These trends have been attributed to strong cohort effects that have arisen because of shifts in risk factor profiles of younger women ( 3 -5 , 7 ).