J Breast Cancer.  2013 Jun;16(2):214-219. 10.4048/jbc.2013.16.2.214.

Breast Cancer Risk Factors in a Defined Population: Weighted Logistic Regression Approach for Rare Events

Affiliations
  • 1Department of Biostatistics, Research Center of Fertility and Infertility, Shiraz University of Medical Sciences School of Medicine, Shiraz, Iran.
  • 2Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  • 3Department of Biostatistics, Jahrom University of Medical Sciences, Jahrom, Iran. heidaryt@sums.ac.ir
  • 4Ministry of Health and Medical Education, Women's Affairs Office, Tehran, Iran.

Abstract

PURPOSE
This study aimed to determine out risk factors for female breast cancer in a low socioeconomic population in Iran.
METHODS
Between 2007 and 2009, a total of 25,592 women who were ensured by the Imam Khomeini Relief Foundation participated in this screening program. The characteristics of patients diagnosed with breast cancer (n=111) were compared with those of control cases (n=25,481). In this study, we used relogit analysis (rare event logistic regression) with a weighting method using program Zelig.
RESULTS
Of 25,592 women, 3.9/1,000 had breast cancer, from which 38 were diagnosed during screening and 73 had already been diagnosed. The mean and standard deviation of age in breast cancer patients and in healthy controls were 49.18+/-8.86 years and 46.65+/-9.40 years, respectively. The findings based on the multivariate model revealed that the past history of ovarian cancer, hormone therapy, and first relatives with breast cancer were associated with increased risk for breast cancer. However, the use of oral contraceptive pills was found to be associated with reduced risk for breast cancer.
CONCLUSION
Due to the rarity of the event in the population, relogit with a weighting method was used to investigate the major risk factors for breast cancer. These factors include oral contraceptive pill use, a history of ovarian cancer of the person under study, first relatives with breast cancer and hormone therapy.

Keyword

Breast neoplasms; Logistic models; Risk factors; Screening program

MeSH Terms

Breast
Breast Neoplasms
Female
Humans
Logistic Models
Mass Screening
Ovarian Neoplasms
Risk Factors

Reference

1. Heydari ST, Mehrabani D, Tabei SZ, Azarpira N, Vakili MA. Survival of breast cancer in southern Iran. Iran J Cancer Prev. 2009; 2:51–54.
2. Samah AA, Ahmadian M. Socio-demographic correlates of participation in mammography: a survey among women aged between 35-69 in Tehran, Iran. Asian Pac J Cancer Prev. 2012; 13:2717–2720.
Article
3. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011; 61:69–90.
Article
4. Rezaianzadeh A, Heydari ST, Hosseini H, Haghdoost AA, Barooti E, Lankarani KB. Prevalence of breast cancer in a defined population of iran. Iran Red Crescent Med J. 2011; 13:647–650.
5. Zare N, Doostfatemeh M, Rezaianzadeh A. Modeling of breast cancer prognostic factors using a parametric log-logistic model in Fars province, Southern Iran. Asian Pac J Cancer Prev. 2012; 13:1533–1537.
Article
6. Babu GR, Samari G, Cohen SP, Mahapatra T, Wahbe RM, Mermash S, et al. Breast cancer screening among females in Iran and recommendations for improved practice: a review. Asian Pac J Cancer Prev. 2011; 12:1647–1655.
7. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: an epidemiological review. Breast J. 2007; 13:383–391.
Article
8. Harirchi I, Kolahdoozan S, Karbakhsh M, Chegini N, Mohseni SM, Montazeri A, et al. Twenty years of breast cancer in Iran: downstaging without a formal screening program. Ann Oncol. 2011; 22:93–97.
Article
9. Ozmen V, Ozcinar B, Karanlik H, Cabioglu N, Tukenmez M, Disci R, et al. Breast cancer risk factors in Turkish women: a University Hospital based nested case control study. World J Surg Oncol. 2009; 7:37.
10. King G, Zeng L. Logistic regression in rare events data. Polit Anal. 2001; 9:137–163.
Article
11. Imai K, King G, Lau O. Zelig: everyone's statistical software. R package version 3.4-5. 2009. Accessed December 23rd, 2012. http://projects.iq.harvard.edu/zelig/software.
12. Korpraphong P, Tritanon O, Tangcharoensathien W, Angsusinha T, Chuthapisith S. Ultrasonographic characteristics of mammographically occult small breast cancer. J Breast Cancer. 2012; 15:344–349.
Article
13. Fletcher SF. Patient information: risk factors for breast cancer (beyond the basics). UpToDate, Inc;2011. Accessed December 23rd, 2012. http://www.uptodate.com/contents/risk-factors-for-breast-cancer-beyond-the-basics.
14. Ebrahimi M, Vahdaninia M, Montazeri A. Risk factors for breast cancer in Iran: a case-control study. Breast Cancer Res. 2002; 4:R10.
Article
15. Okobia M, Bunker C, Zmuda J, Kammerer C, Vogel V, Uche E, et al. Case-control study of risk factors for breast cancer in Nigerian women. Int J Cancer. 2006; 119:2179–2185.
Article
16. Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E. Breast cancer in young women: clinicopathological features and biological specificity. Breast. 2003; 12:247–250.
Article
17. Yankaskas BC. Epidemiology of breast cancer in young women. Breast Dis. 2005-2006; 23:3–8.
Article
18. Beji NK, Reis N. Risk factors for breast cancer in Turkish women: a hospital-based case-control study. Eur J Cancer Care (Engl). 2007; 16:178–184.
Article
19. Van Hoften C, Burger H, Peeters PH, Grobbee DE, Van Noord PA, Leufkens HG. Long-term oral contraceptive use increases breast cancer risk in women over 55 years of age: the DOM cohort. Int J Cancer. 2000; 87:591–594.
Article
20. Lotfi MH, Charkhatti S, Shobairi S. Breast cancer risk factors in an urban area of Yazd City-Iran, 2006. Acta Med Iran. 2008; 46:258–264.
21. Rosenberg LU, Magnusson C, Lindström E, Wedrén S, Hall P, Dickman PW. Menopausal hormone therapy and other breast cancer risk factors in relation to the risk of different histological subtypes of breast cancer: a case-control study. Breast Cancer Res. 2006; 8:R11.
Article
22. Lee SA, Ross RK, Pike MC. An overview of menopausal oestrogen-progestin hormone therapy and breast cancer risk. Br J Cancer. 2005; 92:2049–2058.
Article
23. Vogel VG. Epidemiology, genetics, and risk evaluation of postmenopausal women at risk of breast cancer. Menopause. 2008; 15:782–789.
Article
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