Critical Appraisal Of A Journal Article Assignment 1
Critical Appraisal Of A Journal Article Assignment 1
Critically Apprise the Journal Article Entitled “Determinants of breast cancer in Saudi women from Makkah region: a case-control study (breast cancer risk factors among Saudi women) “using the check list provided.
Please kindly find the Journal Article and the Check List in the attached files.
Write a critical review of about 2 pages regarding the given article and fill the check list attached.
ORDER CUSTOM, PLAGIARISM-FREE PAPER
| Instructor name: | |
| Grade: | …. Out of 10 |
Release date: 19/March/2020
Due date: 02/April/2020
Guidelines:
1. Font should be 12 Times New Roman
2. Heading should be Bold
3. The text color should be Black
4. Line spacing should be 1.5
5. Avoid Plagiarism
6. Assignments must be submitted with the filled cover page
7. All assignments must carry the references using APA style. Please see below web link about how to cite APA reference style.
https://guides.libraries.psu.edu/apaquickguide/intext. Click or tap to follow the link.
Determinants of breast cancer in Saudi women from Makkah region: a case-control study (breast cancer risk factors among Saudi women) Fatmah J. Alsolami1, Firas S. Azzeh2*, Khloud J. Ghafouri2, Mazen M. Ghaith3, Riyad A. Almaimani4, Hussain A. Almasmoum3, Rwaa H. Abdulal5, Wesam H. Abdulaal6, Abdelelah S. Jazar2 and Sufyan H. Tashtoush7
Abstract
Background: There are various factors that play a major role in influencing the overall health conditions of women diagnosed with breast cancer. The population of women in Makkah region are diverse, therefore it is significant to highlight the possible determinants of breast cancer in this population. This is a case-control study that assessed determinants of breast cancer including socioeconomic factors, health-related characteristics, menstrual histories and breastfeeding among postmenopausal women in Makkah region in Saudi Arabia.
Methods: A total of 432 female participants (214 cases and 218 controls) were recruited for this study. A validated questionnaire was completed by trained dietitians at King Abdullah Medical City Hospital in the Makkah region of Saudi Arabia.
Results: Results displayed that determinants of breast cancer were associated significantly (P < 0.05) with unemployment, large family size, lack of knowledge and awareness about breast cancer, obesity, sedentary lifestyle, smoking, starting menarche at an early age, as well as hormonal and non-hormonal contraceptive use. There was no effect of diabetes, hypertension, hyperlipidemia, and duration of breastfeeding on the incidence of breast cancer.
Conclusion: In summary, the results of this study accentuate the possible effect of socioeconomic factors, health- related characteristics and menstrual history on the incidence of breast cancer in postmenopausal women in the Makkah region. Education programs should be applied to increase breast cancer awareness and possibly decrease its incidence.
Keywords: Breast cancer, Breastfeeding practices, Economic status, Lifestyle pattern, Menstruation
Background There has been an increasing prevalence of breast cancer among females around the world [1]. In Saudi Arabia, the recent statistics regarding women diagnosed with breast cancer are shocking. Even with the current advancements in the healthcare system and the breast cancer awareness campaign, the latest prevalence published by the Saudi Health Council in 2014 showed that breast cancer
accounted for 29% of all the cancer types diagnosed in women. Unfortunately, few women present with early stages of the disease, compared to a substantial proportion of women who present in the late stages of breast cancer, when the tumour has become metastatic [2]. Previous studies have reported that there are several
common factors present in women diagnosed with breast cancer, such as their ages, ages at menarche and menopause, family histories, lifestyles and oral contra- ceptive usage [3, 4]. However, the presentation of these factors varies among different populations of women. A greater number of breast cancer diagnoses have been
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Critical Appraisal Of A Journal Article Assignment 1
* Correspondence: fsazzeh@uqu.edu.sa 2Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, P.O. Box: 7067, Makkah 21955, Kingdom of Saudi Arabia Full list of author information is available at the end of the article
Alsolami et al. BMC Public Health (2019) 19:1554 https://doi.org/10.1186/s12889-019-7942-3
linked to variances in the lifestyle patterns and socioeco- nomic factors. From the point of view of epidemiological studies, exploring the predominant risk factors in a se- lected population of women can help to direct the per- spective of breast cancer prevention [4]. The population of women in the region of Makkah is
diverse, with different lifestyle patterns, economic sta- tuses and breastfeeding practices. These factors play sig- nificant roles in influencing the overall health conditions and make it an area of interest for investigating the de- terminants of breast cancer in this specific population. Furthermore, postmenopausal women were more likely to have breast cancer than premenopausal women [5]. Therefore, the aim of this study was to explore which of the socioeconomic factors, health-related characteristics, menstruation starting and ending ages and breastfeeding histories were determining factors for postmenopausal women diagnosed with breast cancer.
Methods Study design and setting This case-control study was conducted from June 2014 through November 2016 at King Abdullah Medical City Hospital (KAMC) in the Makkah region of Saudi Arabia. This hospital is the only centre that provides cancer screening and treatment for residents in Makkah region.
Participants A total of 432 female participants (214 cases and 218 controls) were recruited for this study. We included postmenopausal Saudi women of Arabic ethnicity aged > 45 years from the Makkah region who were newly di- agnosed with breast cancer that was biopsy confirmed by a cancer pathologist in KAMC. Studies have showed that factors associated to breast cancer differs in racial groups [6, 7]. Therefore, we excluded women of any other nationality and African-Asians ethnicity. We also not included any breast cancer women diagnosed with any other type of cancer and who had a metastatic (stage IV) and/or recurrent breast cancer. Any woman stopped her menstrual periods within the last 12 months was de- fined as postmenopausal. The women in the control group were made up of hospital workers and the pa- tients’ companions and friends. The controls were se- lected from the same region of cases and matched on a single year of age for both groups. Based on the above exclusion and inclusion criteria, 214 out of 229 cases were included in this study. However, some patients and healthy individuals were not recruited in this study due to; non-Saudi nationality (n = 7 cases and 12 controls), African-Asians ethnicity (n = 3 cases and 4 controls), premenopausal women and/or aged < 45 years (n = 2 cases), metastatic breast cancer diagnosis (n = 1 case), Critical Appraisal Of A Journal Article Assignment 1
recurrent breast cancer (n = 1 case), and diagnosis of multiple cancer types (n = 1 case).
Data collection Convenience sampling was used to collect the data for this study. As a routine work in the hospital, all newly diagnosed cancer patients should meet a registered dietitian to evaluate his/her nutritional status. During this evaluation, a self-administered questionnaire was completed by each of the participants via a face-to-face interview. The socioeconomic factors, health-related characteristics, menstrual histories as well as breastfeed- ing duration tested in this study were part of a previ- ously validated questionnaire developed by Wilson et al. (2013) [8] that focused on well-known determinants as- sociated with breast cancer in postmenopausal women. Each participant’s body mass index (BMI; kg/m2) was calculated after measuring the weight and height in the hospital and at the time of the data collection. Any par- ticipant with a BMI < 18.5 kg/m2 was classified as under- weight, normal weight was 18.5–24.9 kg/m2, overweight was 25–29.9 kg/m2 and obese was > 30 kg/m2.
Statistical analysis All of the statistical tests were completed using IBM SPSS Statistics for Windows version 20.0 (IBM Corp., Armonk, NY, USA), and a P-value < 0.05 was set for the significant differences. The Kolmogorov-Smirnov nor- mality test was used to determine the normality of distri- bution. The P-value for each parameter was determined using a suitable test, which is mentioned as a footnote in each table. In order to ascertain the differences between the cases and the controls, the data from the participants was stratified using a case-control status. A chi squared test and t-test were conducted for the parametric and nonparametric variables to determine the differences in the socioeconomic factors, health-related characteristics, menstrual histories and breastfeeding durations. To determine the possible risk factors related to breast
cancer, the odds ratio (OR), 95% confidence interval (95% CI) and β-coefficient were determined by using a logistic regression test. All of the variables were adjusted for potential confounders; age (continuous), BMI (con- tinuous), employment, family income, education, family size, marital status, physical activity, smoking, family his- tory of breast cancer, other health problems, contracep- tive use, age at menarche, age at menopause, and breastfeeding duration.
Results An overview of the socioeconomic characteristics of the participants is presented in Table 1. The participants’ ages ranged from 45 to 75 years old, and the mean ages for the case and control groups were 57 ± 7.3 years old
Alsolami et al. BMC Public Health (2019) 19:1554 Page 2 of 8
and 56.9 ± 8.6 years old, respectively. The results showed significant differences regarding some of the socioeco- nomic factors (P < 0.001), such as employment, income, education and family size. The highest employment status percentage in both
groups was 81.7% employed participants in the control group, with 73.8% unemployed in the case group. Nearly one-half of the participants in the case group (43.9%) fell in the low-income category of < 5000 Saudi Riyal (SR) of monthly income (~ 1333.17 American Dollar) when compared to the control group (9.6%). Both groups had low percentages in the highest income category of > 20, 000 SR (~ 5332.70 USD): 14.7% for the control group and 3.8% for the case group. The illiteracy rate was higher among the cases (15%)
when compared to the control group (0.9%). All of the participants in both groups reported varied results in obtaining an education, with a higher result for postsec- ondary education of 87.1% for the control group,
compared to 22.3% for the case group for the same level of education. Having a large family size (6 or more fam- ily members) was more common in the case group (81.3%), while the control group showed no noticeable difference in the percentages of having small or large family sizes (52.3 and 47.7%, respectively). There were no significant differences in the marital statuses in either group (P > 0.05); the percentages of married participants were fairly high in both groups (87.6% for the controls and 94.1% for the cases). With regard to the health-related characteristics for the
participants in this study Critical Appraisal Of A Journal Article Assignment 1