乳腺癌与环境:尼日利亚妇女试点研究

Suellen Li, D. Huo, O. Ojengbede, O. Olopade
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引用次数: 0

摘要

癌症仍然是全世界妇女癌症的主要病因,其发病率在非洲显著增加。非洲血统的女性不仅在更早的时候患上癌症,而且患上更具侵袭性的乳腺癌,TP53突变和癌症三阴性的患病率更高。尽管环境诱导的TP53突变在肝癌和肺癌中已有很好的描述,但很少有研究探讨其在癌症中的作用。此外,大多数先前的研究都是在白人群体中进行的,缺乏对其他祖先女性的推广性。这项初步研究旨在调查环境风险因素与体细胞突变状态之间的关系。次级目标是评估基于问卷的方法收集环境暴露数据的可行性和有效性。参与尼日利亚癌症乳腺癌研究的20名癌症患者和33名来自尼日利亚伊巴丹的患者被联系,以完成一份环境风险问卷,评估家庭空气污染、饮食、职业危害和睡眠习惯。问卷被翻译成约鲁巴语,并由当地口译员进行,口译员获得了所有参与者的知情同意。芝加哥大学和伊巴丹大学的机构审查委员会都批准了该项目。结果显示,病例更有可能报告居住在主要道路、垃圾焚烧炉或工厂附近(P=.046)。职业也存在显著差异(P=.000),病例更可能报告专业职业。他们也更有可能报告职业接触矿尘、废气、化学品和内分泌干扰物;夜班工作;以及对熟肉的偏好,尽管这些都没有达到统计学意义。这项研究表明,检查环境风险因素的暴露可能是未来癌症研究的一个有希望的途径。研究设计限制了比较病例和对照组暴露的有效性,但表明基于问卷的方法在收集环境暴露数据方面既可行又有效。未来的研究将受益于更正式的访谈者培训,以提高数据收集的质量,更具文化相关性的问题,以评估压力生活事件,以及减少回忆偏见和随访损失的前瞻性设计。
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Breast Cancer and the Environment: A Pilot Study of Nigerian Women
Breast cancer remains the leading cause of cancer in women throughout the world, and its incidence has been increasing markedly in Africa. Women of African ancestry not only develop breast cancer at earlier ages but also have more aggressive breast cancers, with higher prevalence of TP53 mutations and triple-negative breast cancer. Although environment-induced TP53 mutagenesis has been well described in liver and lung cancers, few studies have explored its role in breast cancer. In addition, most prior studies were done in white populations and lacked generalizability to women of other ancestries. This pilot study aimed to investigate the association between environmental risk factors and somatic mutation status. A sub-aim was to evaluate the feasibility and effectiveness of a questionnaire-based method for gathering environmental exposure data. Twenty-nine patients with breast cancer and 33 patients from Ibadan, Nigeria, who had participated in the Nigerian Breast Cancer Study, were contacted to complete an environmental risks questionnaire that assessed household air pollution, diet, occupational hazards, and sleep habits. The questionnaire was translated into Yoruba and conducted with local interpreters, who obtained informed consent from all participants. Both the institutional review boards at the University of Chicago and the University of Ibadan approved the project. The results showed that cases were more likely to report living close to a major road, waste incinerator, or factory ( P = .046). There were also significant differences in occupation ( P = .000), with cases more likely to report professional occupations. They were also more likely to report occupational exposures to mineral dust, exhaust, chemicals, and endocrine disruptors; night shift work; and preference for well-done meat, although these did not reach statistical significance. This study suggests that examining exposures to environmental risk factors may be a promising avenue for future breast cancer research. The study design limited the validity of comparing exposures between cases and controls but demonstrated that a questionnaire-based method is both feasible and effective at gathering environmental exposure data. Future studies would benefit from more formal interviewer training to improve the quality of the data collection, more culturally relevant questions to assess stressful life events, and a prospective design to reduce recall bias and loss to follow-up.
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期刊介绍: The Journal of Global Oncology (JGO) is an online only, open access journal focused on cancer care, research and care delivery issues unique to countries and settings with limited healthcare resources. JGO aims to provide a home for high-quality literature that fulfills a growing need for content describing the array of challenges health care professionals in resource-constrained settings face. Article types include original reports, review articles, commentaries, correspondence/replies, special articles and editorials.
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