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

Date Published: February 8, 2017

Publisher: Public Library of Science

Author(s): Augustin Balekouzou, Ping Yin, Henok Kessete Afewerky, Cavin Bekolo, Christian Maucler Pamatika, Sylvain Wilfrid Nambei, Marceline Djeintote, Antoine Doui Doumgba, Christian Diamont Mossoro-Kpinde, Chang Shu, Minghui Yin, Zhen Fu, Tingting Qing, Mingming Yan, Jianyuan Zhang, Shaojun Chen, Hongyu Li, Zhongyu Xu, Boniface Koffi, Natarajan Aravindan.

http://doi.org/10.1371/journal.pone.0171154

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.

Partial Text

Breast cancer (BC) is one of the commonly diagnosed cancers that leads to mortality and morbidity in women worldwide [1]. Nowadays, it is the leading cause of cancer death in women with 198,000 deaths per year, representing 15.4% of deaths in developed regions after that of lung [2]. Furthermore, in developing countries, it is the first leading cause of death among women with 324,000 deaths which represents for 14.3% of all deaths [3]. Moreover, in 2012, this rate varied between 6 and 20 per 100,000 in East Asia and West Africa [4].

This case control study was carried out in the pathology unit of the National Laboratory, and the general surgery and gynecology services of two tertiary care institutions in Bangui, CAR.

In total, 174 cases and 348 controls matched for ages were included. The response rate was 85.99% (522/607). The age at diagnosis for the cases ranged from 16 to 90 years with a mean of 45.83 (SD = 13.5) years. The mean age for the control was 45.79 (SD = 13.3) years (Table 1).

The present study shows that education level, marital status, positive family history of cancer, radiation exposure, consumption of: charcuterie, fresh fish, peanut, soybean and alcohol, habit of keeping money in brassiere and high a BMI are risk factors for BC in CAR. Occupation, residence, consumption of wine and groundnut oil, no habit of keeping cell phones in bras, physical activities and unsweetened coffee consumption were protective against BC.

Findings of this study have shown that educational level, marriage, positive family history of cancer, radiation exposure, consumption of charcuterie, groundnut, soybean, alcohol, habit of keeping money in bras, overweight and obesity were associated with BC risk among Central African women in Bangui. Women living in this region should be more cautious on the risk associated with BC. Further studies are needed to investigate other unknown determinants of BC. Finally, a public awareness concerning schooling, occupation, residence area, groundnut oil consumption, physical activities, wine consumption and no habit of keeping cell phone in bras which are protective factors against BC will be useful for the prevention and reduction in the incidence rate.

 

Source:

http://doi.org/10.1371/journal.pone.0171154

 

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