Alsayer Rawabi M, De Vol Edward B, Almeharish Amani, Alfattani Areej, Alghamdi Alaa J, AlBehlal Luluh Behlal, Alhaddab Shatha, Altwaijri Yasmin
Population, Public and Environmental Health, Ministry of Defense Health Services (MODHS), Riyadh, Saudi Arabia.
Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Breast Cancer (Dove Med Press). 2024 Sep 2;16:545-554. doi: 10.2147/BCTT.S463193. eCollection 2024.
Breast cancer is the most common cancer among women in the Saudi Arabia, and over 50% of the cases are detected at a late stage. This study aimed to estimate population attributable risk percentage (PAR%) of modifiable lifestyle risk factors for breast cancer in Saudi Arabia.
A secondary analysis of previously published papers was performed . Relative risks (RR) and odds ratios (OR) were obtained from published international epidemiological studies, and the prevalence of each risk factor in Saudi Arabia was obtained from various sources (eg, national surveys and published literature) to calculate PAR%. A nomogram was used to visually translate the RRs/ORs and their prevalence into PAR% using a practical tool.
Seven modifiable lifestyle risk factors for breast cancer were identified in Saudi Arabia. The identified risk factors included lack of physical activity (sedentary lifestyle), oral contraception (current use), obesity (postmenopausal), hormone replacement therapy (current use), passive smoking, age at first birth (≥ 35 years), and tobacco smoking (current or daily smoking). The PAR% for these risk factors ranged from 0.5% for tobacco smoking to 23.1% for a lack of physical activity. Few modifiable lifestyle risk factors were excluded from this study, due to limited nor unavailable data in Saudi Arabia (eg, alcohol consumption, breastfeeding patterns and childbearing patterns, obesity according to menopausal status, and night-shift work).
Physical inactivity has the most significant modifiable health impact and is a major risk factor for breast cancer. Removing this risk factor would reduce the prevalence of breast cancer in the Saudi population by 23%. There is an immense need to prioritize cancer control strategies based on local needs, current data on cancer risk factors, and the disease burden.
乳腺癌是沙特阿拉伯女性中最常见的癌症，超过50%的病例在晚期才被发现。本研究旨在估计沙特阿拉伯可改变的生活方式风险因素对乳腺癌的人群归因风险百分比（PAR%）。
对先前发表的论文进行二次分析。相对风险（RR）和比值比（OR）来自已发表的国际流行病学研究，沙特阿拉伯各风险因素的患病率则从各种来源（如全国性调查和已发表文献）获取，以计算PAR%。使用列线图这一实用工具将RRs/ORs及其患病率直观转化为PAR%。
在沙特阿拉伯确定了七个可改变的乳腺癌生活方式风险因素。确定的风险因素包括缺乏体育活动（久坐生活方式）、口服避孕药（当前使用）、肥胖（绝经后）、激素替代疗法（当前使用）、被动吸烟、初产年龄（≥35岁）以及吸烟（当前或每日吸烟）。这些风险因素的PAR%范围从吸烟的0.5%到缺乏体育活动的23.1%。由于沙特阿拉伯的数据有限或无法获取（如饮酒、母乳喂养模式和生育模式、根据绝经状态的肥胖情况以及夜班工作），本研究排除了一些可改变的生活方式风险因素。
缺乏体育活动对健康的可改变影响最为显著，是乳腺癌的主要风险因素。消除这一风险因素将使沙特人群中乳腺癌的患病率降低23%。迫切需要根据当地需求、当前癌症风险因素数据和疾病负担，对癌症控制策略进行优先排序。
