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Urban–rural differences in breast cancer incidence by hormone receptor status across 6 years in Egypt

  • Epidemiology
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Abstract

Breast cancer incidence is higher in developed countries with higher rates of estrogen receptor positive (ER+) tumors. ER+ tumors are caused by estrogenic exposures although known exposures explain approximately 50% of breast cancer risk. Unknown risk factors causing high breast cancer incidence exist that are estrogenic and development-related. Xenoestrogens are such risk factors but are difficult to study since developed countries lack unexposed populations. Developing countries have urban–rural populations with differential exposure to xenoestrogens. This study assessed urban–rural breast cancer incidence classified by hormone receptor status using data from Gharbiah population-based cancer registry in Egypt from 2001 to 2006. Urban ER+ incidence rate (per 100,000 women) was 2–4 times (IRR = 3.36, 95% CI = 4.84, 2.34) higher than rural incidence rate. ER−incidence rate was 2–3 times (IRR = 1.86, 95% CI = 2.38, 1.45) higher in urban areas than in rural areas. Our findings indicate that urban women may probably have a higher exposure to xenoestrogens.

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Acknowledgments

We are grateful to Dr. Hoda Gad, Mr. Khaled Daboos and other personnel of Tanta Cancer Center and Gharbiah Cancer Society for the valuable assistance they provided for this project. The authors declare that they have no commercial or other associations that might pose a conflict of interest in connection with this article. Funding This work was supported by the Middle East Cancer Consortium, National Cancer Institute, Bethesda [R25 CA112383, R03 CA117350,5 P30 CA46592], the Burroughs Wellcome Fund [SDM], and the Breast Cancer Research Foundation [SDM]. Block Grant of the Department of Epidemiology, University of Michigan School of Public Health; and the Travel Grant of the Rackham Graduate School of the University of Michigan to [S. Dey].

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of Michigan, 109 Observatory Street, Ann Arbor, MI, 48109, USA

    Subhojit Dey, Amr S. Soliman & Mark L. Wilson

  2. Gharbiah Cancer Society, Tanta, Gharbiah, Egypt

    Ahmad Hablas & Kadry Ismail

  3. Tanta Cancer Center, Tanta, Gharbiah, Egypt

    Ibrahim A. Seifeldin, Mohamed Ramadan & Hesham El-Hamzawy

  4. Department of Biostatistics, School of Public Health, University of Michigan, 109 Observatory Street, Ann Arbor, MI, USA

    Mousumi Banerjee

  5. International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon, France

    Paolo Boffetta

  6. Office of International Affairs, National Cancer Institute, Bethesda, MD, USA

    Joe Harford

  7. University of Michigan Comprehensive Cancer Center, 1500 East Medical Center Drive, Ann Arbor, MI, USA

    Sofia D. Merajver

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  1. Subhojit Dey
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Correspondence to Amr S. Soliman.

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Dey, S., Soliman, A.S., Hablas, A. et al. Urban–rural differences in breast cancer incidence by hormone receptor status across 6 years in Egypt. Breast Cancer Res Treat 120, 149–160 (2010). https://doi.org/10.1007/s10549-009-0427-9

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