Breast cancer risk factors in countries with different sociodemographic indices (SDIs) and culture: A systematic review

Abstract

Objective: To identify risk factors of breast cancer (BC) in countries with different sociodemographic index (SDI) levels and cultures, with a focus on the USA, Kingdom of Saudi Arabia (KSA), and Pakistan.

Method: Inclusion criteria were original articles about breast cancer risk factors from USA, KSA, and Pakistan, from last 10 years. Search was done with PubMed and Google Scholar. Total of 43 articles were selected. AMSTAR 2 was used for the quality assessment of the review. This systematic review was registered with INPLASY on 12th December 2023, under the registration number INPLASY2023120049, with DOI number 10.37766/inplasy2023.12.0049. 

Results: Different genes were associated with BC in USA, KSA, and Pakistan. Obesity and low physical activity were risk factors in studies from USA, KSA, and Pakistan. Red meat intake in USA, and a high fat intake and chicken in Pakistan were found to be associated with BC. Alcohol was a risk factor for BC in USA, but no such relationship was found in KSA and Pakistan. Studies from USA, KSA, and Pakistan showed cigarette smoke as a risk factor for breast cancer. Studies from USA, KSA, and Pakistan also showed a relationship between hormonal therapy and BC, in both pre-and post-menopausal women. Early menarche, late menopause, nulliparity, unmarried status, no breastfeeding, and low Vitamin D levels were also risk factors for BC in Saudi and Pakistani women. Studies from USA found a relationship between hair dye use and BC risk. A study from Pakistan suggested the use of low-quality hair dye or henna as a risk factor for breast cancer.

Conclusion: In conclusion, different risk factors were prevalent for BC in different cultures and countries of SDI levels. Every country needs to focus on prevention and control of its respective risk factors.