Breast cancer research in Asia: Adopt or adapt Western knowledge?

Abstract

The incidence and mortality of breast cancer continues to rise rapidly in Asian countries. However, most of our current knowledge on breast cancer has been generated in Western populations. As the socio-economic profile, life style and culture of Asian and Western women are substantially different, and genetic backgrounds vary to some extent, we need to answer the question on whether to 'adopt' or 'adapt' Western knowledge before applying it in the Asian setting. It is generally accepted that breast cancer risk factors, which have mainly been studied in Western populations are similar worldwide. However, the presence of gene-environment or gene-gene interactions may alter their importance as causal factors across populations. Diagnostic and prognostic study findings, including breast cancer prediction rules, are increasingly shown to be 'setting specific' and must therefore be validated in Asian women before implementing them in clinical care in Asia. Interventional research findings from Caucasian patients may not be applicable in patients in Asia due to differences in tumour biology/profiles, metabolism of drugs and also health beliefs which can influence treatment acceptance and adherence. While breast cancer research in Asia is warranted in all domains of medical research, it is felt that for Asian breast cancer patients, needs are highest for diagnostic and prognostic studies. International clinical trials meanwhile need to include breast cancer patients from various Asian settings to provide an insight into the effectiveness of new treatment modalities in this part of the world.

The incidence, age at diagnosis of breast cancer in the Iraqi Kurdish population and comparison to some other countries of Middle-East and West

“…The age-standardized rate was 17.9/ 100,000 Kurdish women population, this incidence rate is lower than the rates reported from Middle-East countries and west as shown in Fig. 2 [4,5,9,11,13,19e23] The incidence rate in Asia and Africa is low, such as Thailand, India, Chinese, Nigeria, and North Africa [1,12,24,25], but in Iraqi Kurdish is lower We have no statistical data to clarify the real cause of this phenomenon, because the data are considerably scarce and not publically available. However, the overall this low incidence rate could be partially explained by the effect of differences in environment, social, cultural, and lifestyle factors which could result in this significant difference of incidence rate.…”

An Emerging Role of Pharmacist in Pre-chemotherapy Counseling Among Breast Cancer Patients

“…However, 17% of the patient did not recognize the source of information given, which may be attributed to the perception of patient who sees the pharmacist as a medication distributor [33] or the limited role of pharmacist in the primary health care system in Asian countries, particularly in Malaysia [2] . Apart from that, a few patients in the current study did not agree that pharmacist helped to understand and remember the medication for chemotherapy to overcome the sideffects.…”

“…Incidence and prevalence of breast cancer have been increasing in Asian countries [1][2][3] . In Malaysia, there were about 18 219 new cancer cases diagnosed in 2007, which involved 8123 (44.6%) males and 10 096 (55.4%) females [4] .…”

Breast health in developing countries

“…The results of such research may not be applicable to developing countries 37 to suggest that there are any major differences in the behavior of breast cancer associated with different ethnic groups 38 . However, there are some differences in the molecular types of breast cancer in different ethnicities 39 .…”