Breast cancer in Kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk

Breast cancer in Kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk

Breast cancer in the Middle-East occurs in relatively young women and frequently presents as advanced disease. A protective effect of multiparity is not apparent, and high familial risk is reported in some countries. This study investigates breast cancer rates and clinical stage related to age in th...

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Published in:BMC women's health Vol. 9; no. 1; p. 33
Main Authors: Majid, Runnak A, Mohammed, Hazha A, Saeed, Heshu M, Safar, Banaz M, Rashid, Rekawt M, Hughson, Michael D
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 11-12-2009
BioMed Central
BMC
Subjects:
Adult
Age Distribution
Breast cancer
Breast Neoplasms - ethnology
Breast Neoplasms - genetics
Breast Neoplasms - pathology
Cancer
Care and treatment
Case-Control Studies
Demographic aspects
Diagnosis
Family Characteristics
Family Health - ethnology
Female
Humans
Incidence
Iran - epidemiology
Islam
Mass Screening
Medical History Taking
Middle Aged
Neoplasm Staging
Parity
Patient Acceptance of Health Care - ethnology
Pregnancy
Premenopause
Research article
Risk factors
Women's Health - ethnology
Iran
Iraq
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Summary:Breast cancer in the Middle-East occurs in relatively young women and frequently presents as advanced disease. A protective effect of multiparity is not apparent, and high familial risk is reported in some countries. This study investigates breast cancer rates and clinical stage related to age in the Kurdish region of Iraq and evaluates risk associated with parity and family history. Findings are compared with nearby countries and the West. Sulaimaniyah Directorate of Health records identified 539 women diagnosed with breast cancer during 2006-2008. Clinical survey forms were completed on 296 patients and on 254 age-matched controls. Age specific incidence rates were calculated from Directorate of Health population estimates. Average patient age was 47.4 +/- 11 years and 59.5% were pre-menopausal. Diagnosis was at clinical stage 1 for 4.1%, stage 2 for 43.5%, stage 3 for 26.0%, and stage 4 for 8.1% of patients. For 18.2%, stage was unknown. Annual breast cancer incidence rates per 100,000 women peaked at 168.9 at age 55 to 59 and declined to 57.3 at 60 and above. Patients had an average of 5.0 +/- 3.3 children compared to 5.4 +/- 3.5 for controls, P = 0.16. A first degree family member had breast cancer among 11.1% of patients and 2.1% of controls (P < 0.001) with > 50% of these patients and controls being > or =50 years old. No statistically significant relationship was found between tumor stage and age, P = 0.59. In Kurdish Iraq, breast cancer is predominantly a disease of pre-menopausal women having multiple pregnancies. For younger patients, breast cancer incidence was similar to the West and possibly higher than many Middle-Eastern countries, but unlike the West, the estimated rates declined markedly in the elderly. The familial breast cancer risk for both older and younger women was within the general population risk of Western countries. Clinical stages were advanced and indicated delays in diagnosis that were unrelated to patient age.
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ISSN:1472-6874
1472-6874
DOI:10.1186/1472-6874-9-33