An Assessment of Risk Factors for Breast Cancer Among Women Attending Breast Cancer Screening in Saudi Arabia. Open Access

Abstract

Background: Breast cancer is the most common malignancy among women worldwide. In Saudi Arabia, the age-adjusted incidence rates for breast cancer have been increasing over time; however, disease etiology remains poorly understood. We performed a secondary data analysis to assess risk factors for breast cancer among Saudi women through analyzing data from the National Breast Cancer Early Detection Program (NBCEDP).

Methods: Data was collected by the NBCEDP between January 2012 and July 2016. During this period, 45,000 women were screened for breast cancer out of which 300 were diagnosed with invasive breast cancer. Our analysis included 8365 screened women (60 confirmed cases and 8305 non-cases) who had data on risk factors collected under a pilot research study conducted by the program. Logistic regression was used to identify associations for breast cancer risk factors with disease risk.

Results: Well-established breast cancer risk factors (such as reproductive factors, personal or family history of breast cancer, overweight or obesity) were not found to vary significantly between cases and non-cases. The only factors to show statistically significant associations with breast cancer risk were level of education (Odds Ratio [OR] for primary, secondary or high school education= 0.13, 95% CI= 0.02 – 0.71; OR for college or postgraduate education= 0.34, 95% CI 0.07 – 1.53, compared to illiteracy) and time spent doing physical activity [hours per week] (OR = 1.03, 95% CI 1.01 – 1.05).

Conclusion: Additional studies using a larger number of cases and employing a longitudinal design are needed to confirm our findings of no association with established risk factors and to further investigate novel risk factors for breast cancer among Saudi women. 

Table of Contents

Chapter I. Introduction................................................................................................................... 1

Chapter II. Literature Review.......................................................................................................... 4

Breast Cancer Epidemiology........................................................................................................... 4

Breast Cancer Etiology.................................................................................................................... 4

Breast Cancer Screening................................................................................................................. 23

Problem Statement......................................................................................................................... 24

Purpose Statement and Research Question.................................................................................... 25

Significance Statement................................................................................................................... 25

Chapter III. Manuscript................................................................................................................... 26

Abstract .......................................................................................................................................... 26

Introduction.................................................................................................................................... 27

Methods.......................................................................................................................................... 30

Results............................................................................................................................................ 38

Discussion....................................................................................................................................... 42

Figures............................................................................................................................................. 47

Tables............................................................................................................................................... 49

Chapter IV. Implications and Recommendations............................................................................. 53

 

References........................................................................................................................................ 55

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Breast cancer risk factors Breast cancer screening analysis Saudi Arabia
Committee Chair / Thesis Advisor	Farhat, Ghada, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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