Mashele Sizeka A, Zwane Thembekile B, Kuonza Lazarus, Muchengeti Mazvita M, Motsuku Lactatia
South African Field Epidemiology Training Program, National Institute for Communicable Diseases, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa.
National Cancer Registry, National Health Laboratory Services, 1 Modderfontein Road, Sandringham, Johannesburg 2192, South Africa.
Ecancermedicalscience. 2023 Aug 25;17:1593. doi: 10.3332/ecancer.2023.1593. eCollection 2023.
Breast cancer (BC) is the most common cancer among women in South Africa (SA), with an age-standardised incidence rate of 52.6 and an age-standardised mortality rate of 16.0 per 100,000 population. There is a paucity of evidence on the risk factors for BC among women of all races in SA. Given the rising prevalence of BC in SA, literature-based evidence is critical for the appropriate dissemination of preventative measures. This study aimed to identify the risk factors associated with the development of BC among women in Ekhuruleni Metropolitan Municipality.
An unmatched case-control study was conducted from 1 January 2017 to 31 December 2020 using secondary data extracted from the Ekurhuleni Population-Based Cancer Registry. Unconditional multivariable logistic regression analysis was carried out using the adjusted odds ratio (aOR). The variables race, employment, human immunodeficiency virus (HIV), smoking and alcohol status were included in the multivariable logistic regression model while the model was adjusted for age.
A total of 2,217 cases and 851 controls were enrolled in the study. The mean age (±SD) in years was 55.7 (±15.2). The White population group, being self-employed and being HIV positive was significantly associated with reduced odds of BC development. HIV-positive women were 61% less likely to have BC than women who were HIV-negative (aOR 0.39; 95% confidence interval (CI): 0.27‒0.57). White women were 65% less likely to have BC than women of other races (aOR 0.35; 95% CI: 0.29‒0.43). Self-employed women were 59% less likely to have BC than women who were formally employed (aOR 0.41; 95% CI: 0.18‒0.97). No evidence of association was observed between tobacco smoking and BC as well as alcohol consumption and BC.
There was a 65% reduction in BC risk among White women compared to other races. HIV-positive women demonstrated a 61% lower likelihood of BC while self-employed women showed a 59% reduced risk of developing BC. These findings suggest that being White, self-employed or HIV-positive may provide some protection against BC. However, additional research is needed to validate these results and establish the underlying reasons behind these associations.
乳腺癌（BC）是南非（SA）女性中最常见的癌症，年龄标准化发病率为每10万人口52.6例，年龄标准化死亡率为每10万人口16.0例。关于南非所有种族女性患乳腺癌的风险因素，证据不足。鉴于南非乳腺癌患病率不断上升，基于文献的证据对于适当传播预防措施至关重要。本研究旨在确定埃库鲁莱尼大都会市女性中与乳腺癌发生相关的风险因素。
2017年1月1日至2020年12月31日进行了一项非匹配病例对照研究，使用从埃库鲁莱尼人群癌症登记处提取的二手数据。采用调整后的优势比（aOR）进行无条件多变量逻辑回归分析。多变量逻辑回归模型纳入了种族、就业状况、人类免疫缺陷病毒（HIV）、吸烟和饮酒状况等变量，同时对年龄进行了调整。
该研究共纳入2217例病例和851例对照。平均年龄（±标准差）为55.7岁（±15.2岁）。白人人群、个体经营者和HIV阳性与患乳腺癌几率降低显著相关。HIV阳性女性患乳腺癌的可能性比HIV阴性女性低61%（aOR 0.39；95%置信区间（CI）：0.27‒0.57）。白人女性患乳腺癌的可能性比其他种族女性低65%（aOR 0.35；�5% CI：0.29‒0.43）。个体经营者患乳腺癌的可能性比正式就业女性低59%（aOR 0.41；95% CI：0.18‒0.97）。未观察到吸烟与乳腺癌以及饮酒与乳腺癌之间存在关联的证据。
与其他种族相比，白人女性患乳腺癌的风险降低了65%。HIV阳性女性患乳腺癌的可能性降低了61%，而个体经营者患乳腺癌的风险降低了59%。这些发现表明，白人、个体经营者或HIV阳性可能对乳腺癌有一定的预防作用。然而，需要进一步的研究来验证这些结果，并确定这些关联背后的潜在原因。
