Behavioral risk factors of breast cancer in Bangui of Central African Republic: A retrospective case-control study

Abstract

Breast cancer is recognized as a major public health problem in developing countries; however, there is very little evidence of behavioral factors associated with breast cancer risk. This study was conducted to identify lifestyles as risk factors for breast cancer among Central African women. A case-control study was conducted with 174 cases confirmed histologically by the pathology unit of the National Laboratory and 348 age-matched controls. Data collection tools included a questionnaire with interviews and medical records of patients. Data were analyzed using SPSS software version 20. Odd ratio (OR) and 95% confidence intervals (95% CI) were obtained by unconditional logistic regression. In total, 522 women were studied with a mean age of 45.8 (SD = 13.4) years. By unconditional logistic regression model, women with breast cancer were more likely to have attained illiterate and elementary education level [11.23 (95% CI, 4.65–27.14) and 2.40 (95% CI, 1.15–4.99)], married [2.09 (95% CI, 1.18–3.71)], positive family history [2.31 (95% CI, 1.36–3.91)], radiation exposure [8.21 (95% CI, 5.04–13.38)], consumption charcuterie [10.82 (95% CI, 2.39–48.90)], fresh fish consumption [4.26 (95% CI, 1.56–11.65)], groundnut consumption [6.46 (95% CI, 2.57–16.27)], soybean consumption [16.74 (95% CI, 8.03–39.84)], alcohol [2.53 (95% CI, 1.39–4.60)], habit of keeping money in bras[3.57 (95% CI, 2.24–5.69)], overweight [5.36 (95% CI, 4.46–24.57)] and obesity [3.11(95% CI, 2.39–20.42)]. However, decreased risk of breast cancer was associated with being employed [0.32 (95% CI, 0.19–0.56)], urban residence [0.16 (95% CI, 0.07–0.37)], groundnut oil consumption [0.05 (95% CI, 0.02–0.14)], wine consumption [0.16 (95% CI, 0.09–0.26)], non habit of keeping cell phone in bras [0.56 (95% CI, 0.35–0.89)] and physical activity [0.71(95% CI, 0.14–0.84)]. The study showed that little or no education, marriage, positive family history of cancer, radiation exposure, charcuterie, fresh fish, groundnut, soybean, alcohol, habit of keeping money in bras, overweight and obesity were associated with breast cancer risk among Central African women living in Bangui. Women living in Bangui should be more cautious on the behavioral risk associated with breast cancer.

Sociodemographic and Reproductive Risk Factors for Breast Cancer: A Case-Control Study in the Setif Province, Northern Algeria

“…In this case-control study, we observed that a higher education level was inversely associated with BC risk as in some studies (Balekouzou et al, 2017;Goldberg et al, 2015), whereas illiterates or low educated women were at lower risk of BC in other studies (Hosseinzadeh et al, 2014;Cunningham et al, 2010). The risk of BC tended to increase among married or divorced/widowed women as compared to never married women, as in previous studies (Balekouzou et al, 2017;Bhadoria et al, 2013). It is thus possible that higher education or never married women may have more opportunities of gaining awareness of BC risk factors and practice a healthier lifestyle.…”

“…Considering that women were diagnosed at a young age (i.e., the mean age was 45 years) and that the increase in risk following a pregnancy runs around 3-4 years, it is merely possible that the parity-induced protection in BC risk was attenuated in this population (Albrektsen et al, 1994;Mathelin et al, 2007). Worldwide, a positive association between abortion and BC has been frequently reported by case-control studies (Balekouzou et al, 2017;Hosseinzadeh et al, 2014), but not by prospective studies (Clavel-Chapelon, et al, 2002;Guo et al, 2015). Findings from this case-control study highlighted an association with the number of spontaneous abortions, but not with induced abortions, in line with other similarly designed studies.…”

Estimating the incidence of breast cancer in Africa: a systematic review and meta-analysis

“…However, these estimates have wide uncertainty intervals, possibly reflecting the limited data in the region, and the substantial variation and imprecision in reported figures already noted across African countries [ 10 , 72 ]. Some authors have reported the lack of data in Central Africa as a major factor mitigating against the estimation of disease burden and ensuring evidence-based interventions in the region [ 12 , 73 , 74 ]. Balekouzou and colleagues specifically noted that the epidemiology of breast cancer in Central Africa remain poorly understood, owing to sparse data on cancer in the region [ 75 ].…”

Tree nut, peanut, and peanut butter intake and risk of postmenopausal breast cancer: The Netherlands Cohort Study

“…In Mexico, risk of breast cancer was significantly inversely related to the consumption frequency of peanuts, walnuts, and almonds [ 26 ]. Studies in Iran and the Central African Republic showed positive associations between (ground)nut intake and breast cancer, but no confounder adjustment was made [ 27 , 28 ].…”