Oncomedicine 2019; 4:27-34. doi:10.7150/oncm.32297 This volume
Epidemiological profile of female breast cancer in reproductive age-group and its association with maternal characteristics: -A population-based observational study in India
Perumal Vanamail, M.Sc., Ph.D., Department of Obstetrics and Gynaecology, All India Institute of Medical Science, New Delhi, India.
Vanamail P. Epidemiological profile of female breast cancer in reproductive age-group and its association with maternal characteristics: -A population-based observational study in India. Oncomedicine 2019; 4:27-34. doi:10.7150/oncm.32297. Available from http://www.oncm.org/v04p0027.htm
Purpose: Even though the cancer incidence rate in India is lower than in developed countries, the mortality rate among cancer patients stood at 50%. Further, India topped the list for mortality of breast and cervical cancers. In this scenario studying the epidemiological profile of women-based breast cancer among the reproductive age group (15-49 years) and determination of risk causes remains unknown.
Methods: Breast cancer data from 27 centres of the National Cancer Registry Programme in India during 2012-2014, provided the age-standardised incidence rate per 100,000 population and comparative incidence ratio (CIR) for different regions. Using all possible risk causes got from National Family Health Survey-4 report as covariates, Poisson regression model on cases provided incidence risk ratio (IRR) with 95% confidence interval (CI).
Results: Around 8.33 (14.2% of the population) crores females under surveillances formed into six regions based on the geographical location of each centre. Overall breast cancer incidence rate was 22.72 (CI: 22.41-23.04) and varied between 10.46 in the North-eastern region and 33.86 in North region. About 40% of breast cancers formed in the reproductive age group and incidence rate was 16.5 (CI: 16.1- 16.8). For women using IUD or with blood sugar more than 160 mg/dl, IRR was 1.06 (CI: 1.04 -1.08) and 1.19 (CI: 1.11-1.28) respectively. Women with unmet need for spacing or with higher empowerment index were likely to be at lower risk. IRR for these two types of women was 0.97 (CI: 0.96 - 0.98) and 0.17 (CI: 0.10-0.28) respectively.
Conclusion: Population-based observational study from India, which contributes about 18% of the total world population revealed that IUD usage and high blood sugar are significant risk factors. On the other hand, higher empowerment index emerged as a significant protective factor. Therefore, by approving the women for their health status and creating awareness using existing mobile-based social media such as WhatsApp, Facebook and Twitter on the importance of early detection followed by treatment, the chances of reducing maternal mortality associated with breast cancer will be possible.
Keywords: Breast cancer, reproductive age group, observational studies, risk factors, -Comparative Incidence ratio, incidence risk ratio, India.