Tanner Lara Theresa Annette, Cheung Kwok Leung
School of Medicine, University of Nottingham, Nottingham NG5 1PB, United Kingdom.
World J Clin Oncol. 2020 Apr 24;11(4):217-242. doi: 10.5306/wjco.v11.i4.217.
In the six Gulf Cooperation Council countries (GCCCs), Bahrain, Saudi Arabia, Kuwait, Oman, Qatar and the United Arab Emirates, breast cancer (BC) is the greatest cause of cancer incidence and mortality. Obesity and physical inactivity are established risk factors for BC globally and appear to be more of a problem in high income countries like the GCCCs.
To determine whether obesity and physical inactivity are associated with BC incidence in the GCCCs using the United Kingdom as a comparator.
This systematic review was carried out according to PRISMA guidelines. A cancer registry and a statistical data search was done to identify the BC incidence over the past two decades and the prevalence of obesity and physical inactivity in the GCCCs. Additionally, a systematic search of the databases, MEDLINE, Web of Science, and PubMed between 1999 and 2019 was performed to determine whether obesity and physical inactivity are risk factors for BC in the GCCCs. All papers were critically appraised according to their research methods and were assessed for quality and risk of bias.
BC was the top malignancy in each GCC country. Women tended to be diagnosed with BC at a younger age than women in the United Kingdom. The greatest 10-year increase in BC incidence was seen in Saudi Arabia (54.2%), approximately seven times the rate of increase seen in the United Kingdom (7.6%). The prevalence of obesity and physical inactivity was greater in all the GCCCs in comparison to the United Kingdom. A total of 155 full studies were reviewed of which 17 were included. Of those, eight looked at the prevalence of obesity and physical inactivity in the Gulf States and nine looked at these as risk factors for BC. Only one study found an association between BC and obesity (odds ratio = 2.29). No studies looked solely at the link between physical inactivity and BC.
The prevalence of obesity and physical inactivity was high within the GCCCs, but the majority of the included studies found no positive correlation between obesity or physical inactivity and BC. A high proportion of women in this study were pre-menopausal which could contribute to the negative findings.
在六个海湾合作委员会国家（GCCCs），即巴林、沙特阿拉伯、科威特、阿曼、卡塔尔和阿拉伯联合酋长国，乳腺癌（BC）是癌症发病率和死亡率的最大成因。肥胖和缺乏体育活动是全球公认的乳腺癌风险因素，在像海湾合作委员会国家这样的高收入国家似乎更是一个问题。
以英国作为对照，确定肥胖和缺乏体育活动是否与海湾合作委员会国家的乳腺癌发病率相关。
本系统评价按照PRISMA指南进行。开展了癌症登记和统计数据搜索，以确定过去二十年中海湾合作委员会国家的乳腺癌发病率以及肥胖和缺乏体育活动的患病率。此外，对1999年至2019年间的数据库MEDLINE、科学网和PubMed进行了系统检索，以确定肥胖和缺乏体育活动是否是海湾合作委员会国家乳腺癌的风险因素。所有论文均根据其研究方法进行严格评估，并对质量和偏倚风险进行评估。
乳腺癌是每个海湾合作委员会国家的头号恶性肿瘤。与英国女性相比，海湾合作委员会国家的女性被诊断出患有乳腺癌的年龄往往更小。乳腺癌发病率增长最快的是沙特阿拉伯，10年间增长了54.2%，约为英国增长率（7.6%）的7倍。与英国相比，所有海湾合作委员会国家的肥胖和缺乏体育活动的患病率都更高。共审查了155项完整研究，其中17项被纳入。其中，8项研究关注海湾国家肥胖和缺乏体育活动的患病率，9项研究将其视为乳腺癌的风险因素。只有一项研究发现乳腺癌与肥胖之间存在关联（优势比 = 2.29）。没有研究专门探讨缺乏体育活动与乳腺癌之间的联系。
海湾合作委员会国家肥胖和缺乏体育活动的患病率很高，但大多数纳入研究未发现肥胖或缺乏体育活动与乳腺癌之间存在正相关。本研究中很大一部分女性处于绝经前，这可能是导致阴性结果的原因。
