scholarly journals The impact of lifecourse socio-economic position and individual social mobility on breast cancer risk

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eloïse Berger ◽  
Noële Maitre ◽  
Francesca Romana Mancini ◽  
Laura Baglietto ◽  
Vittorio Perduca ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Mobility ◽  
Reproductive Factors ◽  
Health Behaviours ◽  
Large Set ◽  
Hazard Ratios ◽  
The Social ◽  
Replication Strategy ◽  
Cox Proportional Hazard Models ◽  
The Impact

Abstract Background Women with an advantaged socioeconomic position (SEP) have a higher risk of developing breast cancer (BC). The reasons for this association do not seem to be limited to reproductive factors and remain to be understood. We aimed to investigate the impact of lifecourse SEP from childhood and social mobility on the risk of BC considering a broad set of potential mediators. Methods We used a discovery-replication strategy in two European prospective cohorts, E3N (N = 83,436) and EPIC-Italy (N = 20,530). In E3N, 7877 women were diagnosed with BC during a median 24.4 years of follow-up, while in EPIC-Italy, 893 BC cases were diagnosed within 15.1 years. Hazard ratios (HR) were estimated using Cox proportional hazard models on imputed data. Results In E3N, women with higher education had a higher risk of BC (HR [95%CI] = 1.21 [1.12, 1.30]). This association was attenuated by adjusting for reproductive factors, in particular age at first childbirth (HR[95%CI] = 1.13 [1.04, 1.22]). Health behaviours, anthropometric variables, and BC screening had a weaker effect on the association. Women who remained in a stable advantaged SEP had a higher risk of BC (HR [95%CI] = 1.24 [1.07; 1.43]) attenuated after adjustment for potential mediators (HR [95%CI] = 1.13 [0.98; 1.31]). These results were replicated in EPIC-Italy. Conclusions These results confirm the important role of reproductive factors in the social gradient in BC risk, which does not appear to be fully explained by the large set of potential mediators, including cancer screening, suggesting that further research is needed to identify additional mechanisms.

Abstract 1193: The impact of rapid changes in reproductive factors on the increased incidence of breast cancer in Korea

2018 ◽  
Author(s):  
Seho Park ◽  
Hyunsoon Cho ◽  
Jee Ye Kim ◽  
Hyung Seok Park ◽  
Seung Il Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Reproductive Factors ◽  
Rapid Changes ◽  
The Impact

scholarly journals Reproductive Factors and Breast Cancer Risk in Lithuanian Women: A Population-Based Cohort Study

2020 ◽  
Vol 28 (2) ◽  
pp. 29-34
Author(s):  
Laura Steponavičienė ◽  
Rasa Vansevičiūtė ◽  
Lina Zabulienė ◽  
Domantas Jasilionis ◽  
Vincas Urbonas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Proportional Hazards ◽  
Reproductive Factors ◽  
Population Based ◽  
Number Of Children ◽  
Nulliparous Women ◽  
Hazard Ratios ◽  
Former Ussr

 Background. Although the relationship between reproductive factors and breast cancer is internationally proved, reliable data on former USSR countries are scarce. This study examines the association of parity, age at the first childbirth, number of children, and breast cancer risk in Lithuanian women.Methods. The study that included women from 40 to 79 years old was based on a dataset that was made up linking all records from the 2001 census, all cancer incidence records from the Lithuanian Cancer Registry and all death records from Statistics Lithuania between 6th April 2001 and 31st December 2009. Cox’s proportional hazards regression models were used to estimate the hazard ratios (HRs) for parity, age at the first childbirth, and number of children.Results. If compared to nulliparous women, parous women had a lower risk of breast cancer (HR=0.84, 95% CI 0.78–0.89) and this risk further decreased with an increasing number of children. Women who gave birth after the age of 25 had a significantly higher risk of breast cancer. This disadvantage became statistically insignificant or decreased after controlling for total number of children.Conclusions. Parity and age at the first childbirth are strong predictors of breast cancer risk among Lithuanian women.

Compliance With Consensus Recommendations for Systemic Therapy Is Associated With Improved Survival of Women With Node-Negative Breast Cancer

2004 ◽  
Vol 22 (18) ◽  
pp. 3685-3693 ◽  
Author(s):  
Nicole Hébert-Croteau ◽  
Jacques Brisson ◽  
Jean Latreille ◽  
Michèle Rivard ◽  
Nadia Abdelaziz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Systemic Therapy ◽  
Administrative Databases ◽  
Minimal Risk ◽  
Node Negative ◽  
Consensus Recommendations ◽  
Hazard Ratios ◽  
Node Negative Breast Cancer ◽  
The Impact

Purpose The impact of consensus recommendations for systemic therapy on outcome of disease is unclear. We evaluated if compliance with guidelines for systemic adjuvant treatment is associated with improved survival of women with node-negative breast cancer. Patients and Methods The study population included women diagnosed with invasive node-negative breast cancer in Québec, Canada, in 1988 to 1989, 1991 to 1992, and 1993 to 1994. Information was collected by chart review, linkage with administrative databases, and queries to attending physicians. Guidelines from the 1992 St Gallen conference were used as standard of care. Survival was estimated by Kaplan-Meier and Cox proportional hazards analyses. Results Among 1,541 women, 358 died before December 1999. Median follow-up was 6.8 years. Seven-year event-free and overall survivals were 66% and 81%, respectively. Survival was 88%, 84%, and 74% in women at minimal, moderate, or high risk of recurrence. Virtually all women at minimal risk were treated according to the consensus (98.4% of 370). In comparison, adjusted hazard ratios of death were 1.0 (95% CI, 0.6 to 1.7) and 2.3 (95% CI, 1.3 to 4.0) among women at moderate risk treated according to the consensus or not, respectively. Among women at high risk, adjusted hazard ratios of death were 2.0 (95% CI, 1.4 to 2.8) and 2.7 (95% CI, 1.9 to 3.9), respectively. Both risk category (P < .0005) and compliance with guidelines (P < .0005) were independent significant predictors of survival. Conclusion Treatment according to consensus recommendations is associated with improved survival of women with breast cancer in the community. Promoting the adoption of guidelines for treatment is an effective strategy for disease control.

scholarly journals Outcomes of changing systemic therapy in patients with relapsed breast cancer and 1 to 3 brain metastases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Omar Alhalabi ◽  
Zaid Soomro ◽  
Ryan Sun ◽  
Elshad Hasanov ◽  
Aya Albittar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Systemic Therapy ◽  
Local Treatment ◽  
Progression Free Survival ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Extracranial Disease ◽  
Initiation Of Therapy ◽  
The Impact

AbstractThe development of brain metastases (BMs) in breast cancer (BC) patients remains a challenging complication. Current clinical practice guidelines recommend local treatment of BMs without changing systemic therapy (CST) in patients with stable extracranial disease. We retrospectively investigated the impact of CST (when applicable as per treating physician’s discretion) following the diagnosis and management of oligometastatic (1–3) BMs in patients without extracranial metastases on the progression-free survival time (PFS), and overall survival (OS). Hazard ratios (HRs) were calculated using the Cox proportional hazard model. Among the 2645 patients with BC and BMs treated between 2002 and 2015, 74 were included for analysis. 40.5% of patients had HER2 + disease. Median time from diagnosis of BC to BMs was 17.6 months. 54%, 8%, and 38% of BMs were managed by radiation, craniotomy, or combination, respectively. Following the primary management of BMs, we observed that CST occurred in 26 (35.5%) patients, consisting of initiation of therapy in 13.5% and switching of ongoing adjuvant therapy in 22%. Median PFS was 6.6 months among patients who had CST compared to 7.1 months in those who did not (HR = 0.88 [0.52–1.47], p = 0.62). Median OS was 20.1 months among patients who had CST compared to 15.1 months in those who did not (HR = 0.68 [0.40–1.16], p = 0.16). Upon the successful local management of oligometastatic BMs in patients without extracranial disease, we did not find a significant difference in survival between patients who experienced a change in systemic therapy as compared to those who did not.

Mobility Mechanisms

Uneven Odds ◽  
2018 ◽  
pp. 207-227
Author(s):  
Divya Vaid
Keyword(s):  
Social Mobility ◽  
Upward Mobility ◽  
Critical Role ◽  
Social Origin ◽  
Major Question ◽  
The Social ◽  
And Gender ◽  
The Impact ◽  
Determining Factor

The relative and absolute rates of mobility are significant in their own regard, however, it leaves open the question of the ‘processual effects’ of industrialization, or in other words what are the drivers of this mobility. This chapter studies the impact of education on social mobility. The major question posed here is whether education acts as a mediator of mobility or not. Or, are the social origin or inherited characteristics (caste and class) the primary determining factor where the chances of social mobility are concerned? Finally, whether the impact of education varies by community. We find that education mediates the origin-destination relation, with those with higher levels of education able to secure more chances of upward mobility. The critical role of caste and gender is underlined.

Mortality by education, occupational class and income in Finland in the 1990s and 2000s

2020 ◽  
Vol 11 (4) ◽  
pp. 551-585
Author(s):  
Rasmus Hoffmann ◽  
Hannes Kröger ◽  
Lasse Tarkiainen ◽  
Pekka Martikainen
Keyword(s):  
Age Groups ◽  
Income Quintile ◽  
Occupational Class ◽  
Hazard Ratios ◽  
Multiple Dimensions ◽  
Gender And Age ◽  
The Social ◽  
Cox Proportional Hazard Models ◽  
Indicator Functions ◽  
Inequalities In Mortality

Differences in mortality by socio-economic position (SEP) are well established, but there is uncertainty as to which dimension of SEP is most important in what context. This study compares the relationship between three SEP dimensions and mortality in Finland, during the periods 1990–97 and 2000–07, and to existing results for Sweden. We use an 11% random sample from the Finnish population with information on education, occupational class, individual income and mortality (age groups 35–59 and 60–84) (n = 810,902; 274,316 deaths). Cox proportional hazard models produce hazard ratios (HR) for categories of SEP variables in bivariate and multivariate models. Multivariate HRs are smaller than bivariate HRs, but all dimensions have a net effect on mortality. Overall, income shows the steepest mortality gradient: HR = 2.49 among men in the lowest income quintile aged 35–59 in the 1990s. The importance of the various SEP dimensions is modified by gender and age group, reflecting the significance of gendered life course differences in analyses of health inequality. Except for the declining disadvantage of poor men aged 35–59, inequalities are very stable over time and similar between Finland and Sweden. In such studies, the use of only one SEP indicator functions well as a broad marker of SEP. However, only analyses of multiple dimensions allow for comprehensive measurements of SEP, take into account the fact that some SEP dimensions are mediated by others, and provide insights into the social mechanisms underlying the stable structure of inequalities in mortality.

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