Factors Increasing the Risk of Breast Cancer in Libyan Women
DOI:
https://doi.org/10.69667/lmj.2517331Keywords:
Breast Cancer, Risk Factor, Vitamin D, Hormone Replacement Therapy (HRT).Abstract
Libyan breast cancer research is limited. Thus, it is crucial to look into the risk factors for breast cancer in Libyan women, as this could improve our current knowledge of this significant problem. Recent years have seen an increase in the disease's incidence among women both globally and in Libya, with Libyan women receiving diagnoses earlier. As a result, it is crucial to identify the factors that may be contributing to this increase. This study aims to investigate and analyze different factors linked to an increased risk of breast cancer in Libyan women. This case-control study involved 102 Libyan women, conducted at the National Institute for Cancer Therapy in Gharian and Tripoli University Hospital in Tripoli, Libya. Participants were divided into two groups: 51 diagnosed with breast cancer matched with 51 healthy controls, and both groups completed a face-to-face questionnaire. Inclusion criteria: Libyan females with breast cancer at age 18 >. Exclusion criteria: males and any nationality other than Libyan. The study investigated risk factors associated with breast cancer among Libyan women using SPSS (27). Clinical results showed that most diagnoses were at stage II, and that left-sided cancers were more common. Metastasis was present in one-third of the patients. Breastfeeding habits, parity, body mass index (BMI), sociodemographic factors (education, marital status, and socioeconomic status), and reproductive and menopausal characteristics (age at menarche, age at first pregnancy, and menopausal status) did not show a significant correlation with the risk of breast cancer. Conversely, factors were significantly associated with increased breast cancer risk. Age showed a strong relationship, with incidence rising in women aged 40 years and above. Vitamin D insufficiency or deficiency was common among patients and significantly associated with breast cancer occurrence. Metabolic disorders also played an important role, as diabetes (20.4% vs. 4.0% of controls) and hypertension (18.0% vs. 2.0% of controls) were significantly linked to higher risk. Hormonal factors were particularly notable, with both hormonal replacement therapy (37.3% vs. 2.0%) and oral contraceptive pill use (14.0% vs. 2.1%) associated with breast cancer. Additionally, women without a history of oophorectomy or hysterectomy were at higher risk, suggesting a protective effect of these procedures. Finally, family history was a significant predictor, appearing in 21.6% of cases compared to 3.9% of controls. This study showed that no significant link exists between reproductive, menopausal, sociodemographic, or lifestyle factors and breast cancer risk, but identified age (over 40), vitamin D insufficiency, diabetes, hypertension, hormonal therapy, oral contraceptive use, absence of oophorectomy or hysterectomy, and family history as strongly associated with breast cancer risk.
References
Luo C, Li N, Lu B, Cai J, Lu M, Zhang Y, et al. Global and regional trends in incidence and mortality of female breast cancer and associated factors at national level in 2000 to 2019. Chin Med J (Engl). 2022;135(1):42-51.
Alramah MA. Standardized Breast Cancer Morbidity Ratio Mapping in Libya: A Geographic Statistical Analysis, 2015-2020. Al Jabal Sci J. 2022;5:16-26.
Abdulrahman GO, Rahman GA. Epidemiology of breast cancer in Europe and Africa. J Cancer Epidemiol. 2012;2012:915610.
McPherson K, Steel CM, Dixon JM. ABC of breast diseases: Breast cancer-epidemiology, risk factors, and genetics. BMJ. 2000;321(7261):624-8.
Akram M, Iqbal M, Daniyal M, Khan AU. Awareness and current knowledge of breast cancer. Biol Res. 2017;50(1):33.
Key TJ, Verkasalo PK, Banks E. Epidemiology of breast cancer. Lancet Oncol. 2001;2(3):133-40.
Metwaly W. Principle of General Surgery. 2nd ed. Dar Al-Kitab Al-Jamei; 2017.
Barros R. Diabetes and breast cancer: Is There a Link? PatientPower. 2024. Accessed [Date Accessed]. https://www.patientpower.info/breast-cancer/diabetes-and-breast-cancer
Han H, Guo W, Shi W, Yu Y, Zhang Y, Ye X, et al. Hypertension and breast cancer risk: a systematic review and meta-analysis. Sci Rep. 2017;7:44877.
Yousef FM, Jacobs ET, Kang PT, Hakim IA, Going S, Yousef JM, et al. Vitamin D status and breast cancer in Saudi Arabian women: case-control study. Am J Clin Nutr. 2013;98(1):105-10.
Aggarwal A, Feldman D, Feldman BJ. Identification of tumor-autonomous and indirect effects of vitamin D action that inhibit breast cancer growth and tumor progression. J Steroid Biochem Mol Biol. 2018;177:155-8.
Khaial FB, Bodalal Z, Elramli A, Elkhwsky F, Eltaguri A, Bendardaf R. A study of risk factors for breast cancer in a primary oncology clinic in Benghazi-Libya. Int J Stat Med Res. 2015;4(1):156-60.
Khedr MI, Sharaf SAF, Aal ANA, Dessouky IS, Soliman M. Serum 25-hydroxyvitamin D level and breast cancer risk in Egyptian females. Asian J Oncol. 2022;8(1):76-80.
Shamshirian A, Heydari K, Shams Z, Aref AR, Shamshirian D, Tamtaji OR, et al. Breast cancer risk factors in Iran: a systematic review and meta-analysis. Horm Mol Biol Clin Investig. 2020;41(1).
AlShaibani S, Bu-Alayyan S, Habiba S, Sorkhou E, Al-Shamali N, Al-Qallaf B. Risk Factors of Breast Cancer in Kuwait: Case-Control Study. Iran J Med Sci. 2006;31(2):61-4.
Bashamakha G, bin Sumait H, Bashamakha M, Al Serouri A, Khader Y. Risk factors of breast cancer in Hadramout Valley and Desert, Yemen. Int J Prev Med. 2019;10:161.
Arafat HM, Omar J, Muhamad R, Al-Astani TAD, Shafii N, Al Laham N, et al. Breast cancer risk from modifiable and non-modifiable risk factors among Palestinian women: a systematic review and meta-analysis. Asian Pac J Cancer Prev. 2021;22(7):1987-95.
Alyasir A, Bojazyah A, Elyseir I. Exploring Breast Cancer Dynamics: Understanding Risk Factors, Health Behaviors, and Treatment Trends among Women in Derna, Libya. Alq J Med App Sci. 2024;7(1):377-84.
DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women. CA Cancer J Clin. 2016;66(1):31-42.
Imtiaz S, Siddiqui N, Raza SA, Loya A, Muhammad A. Vitamin D deficiency in newly diagnosed breast cancer patients. Indian J Endocrinol Metab. 2012;16(3):409-13.
Bertone-Johnson ER, Chen WY, Holick MF, Hollis BW, Colditz GA, Willett WC, et al. Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 2005;14(8):1991-7.
Jacobs ET, Thomson CA, Flatt SW, Al-Delaimy WK, Hibler EA, Jones LA, et al. Vitamin D and breast cancer recurrence in the Women’s Healthy Eating and Living (WHEL) Study. Am J Clin Nutr. 2011;93(1):108-17.
Edvardsen K, Veierød MB, Brustad M, Braaten T, Engelsen O, Lund E. Vitamin D-effective solar UV radiation, dietary vitamin D and breast cancer risk. Int J Cancer. 2011;128(6):1425-33.
Visvanathan K, Mondul AM, Zeleniuch-Jacquotte A, Wang M, Gail MH, Yaun SS, et al. Circulating vitamin D and breast cancer risk: an international pooling project of 17 cohorts. Eur J Epidemiol. 2023;38(1):11-29.
Largent JA, Bernstein L, Horn-Ross PL, Marshall SF, Neuhausen S, Reynolds P, et al. Hypertension, antihypertensive medication use, and breast cancer risk in the California Teachers Study cohort. Cancer Causes Control. 2010;21(10):1615-24.
Pereira A, Garmendia ML, Alvarado ME, Albala C. Hypertension and the risk of breast cancer in Chilean women: a case-control study. Asian Pac J Cancer Prev. 2012;13(11):5829-34.
Goon PK, Messerli FH, Lip GY. Hypertension and breast cancer: an association revisited? J Hum Hypertens. 2006;20(9):722-4.
Motie MR, Besharat S, Torkjazi R, Shojaa M, Besharat M, Keshtkar A, et al. Modifiable risk of breast cancer in northeast iran: hope for the future. a case-control study. Breast Care (Basel). 2011;6(6):453-6.
Shaukat N, Jaleel F, Moosa FA, Qureshi NA. Association between vitamin D deficiency and breast cancer. Pak J Med Sci. 2017;33(3):645-9.
Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-Janys D, et al. Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer—results of a large case–control study. Carcinogenesis. 2008;29(1):93-9.
Boyle P, Boniol M, Koechlin A, Robertson C, Valentini F, Coppens K, et al. Diabetes and breast cancer risk: a meta-analysis. Br J Cancer. 2012;107(9):1608-17.
Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121(4):856-62.
Wolf I, Sadetzki S, Catane R, Karasik A, Kaufman B. Diabetes mellitus and breast cancer. Lancet Oncol. 2005;6(2):103-11.
Esquinas E, Guinó E, Castano-Vinyals G, Pérez-Gómez B, Llorca J, O'Callaghan-Gordo C, et al. Association of diabetes and diabetes treatment with incidence of breast cancer. Acta Diabetol. 2016;53(1):99-107.
Barańska A, Błaszczuk A, Kanadys W, Malm M, Drop K, Polz-Dacewicz M. Oral contraceptive use and breast cancer risk assessment: a systematic review and meta-analysis of case-control studies, 2009–2020. Cancers (Basel). 2021;13(22):5654.
Kumle M, Weiderpass E, Braaten T, Persson I, Adami HO, Lund E. Use of oral contraceptives and breast cancer risk: The Norwegian-Swedish Women’s Lifestyle and Health Cohort Study. Cancer Epidemiol Biomarkers Prev. 2002;11(11):1375-81.
Claus EB, Stowe M, Carter D. Oral contraceptives and the risk of ductal breast carcinoma in situ. Breast Cancer Res Treat. 2003;81(2):129-36.
Chen CL, Weiss NS, Newcomb P, Barlow W, White E. Hormone replacement therapy in relation to breast cancer. JAMA. 2002;287(6):734-41.
Opatrny L, Dell'Aniello S, Assouline S, Suissa S. Hormone replacement therapy use and variations in the risk of breast cancer. BJOG. 2008;115(2):169-75.
Breyer JZ, Wendland EM, Kops NL. Assessment of potential risk factors for breast cancer in a population in Southern Brazil. Breast Cancer Res Treat. 2018;169(1):125-31.
Khetresh MMT, Belliel IEM. Evaluation of knowledge among Libyan women in western region about breast cancer and its risk factors. Libyan Int Med Univ J. 2022;16:89-96
