Relationships between Breast Cancer and Common Non-Communicable Disease Risk Factors: an Ecological Study

  • Abbastabar, Hedayat (Department of Epidemiology, Schools of Health and Nutrition, Shiraz University of Medical Science) ;
  • Hamidifard, Parvin (BSc of Environmental Health, Tehran University of Medical Science) ;
  • Roustazadeh, Abazar (Department of Biochemistry, Jahrom University of Medical Sciences) ;
  • Mousavi, Seyyed Hamid (Department of Education, Hormozgan University of Medical Sciences) ;
  • Mohseni, Shokrallah (Department of Education, Hormozgan University of Medical Sciences) ;
  • Sepandi, Mojtaba (Department of Epidemiology, Schools of Health and Nutrition, Shiraz University of Medical Science) ;
  • Barouni, Mohsen (Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences) ;
  • Alizadeh, Ali (Research Center for Social Determinants in Health Promotion, Department of Research and Technology, Hormozgan University of Medical Sciences)
  • Published : 2013.09.30


Background: Breast cancer is one the most common cause of cancer-related deaths among women worldwide. The aims of this study were to investigate the impact of dietary factors and health status indicators on breast cancer (BC) incidence. Materials and Methods: Risk factor data (RFD) of 89,404 individuals (15-64 years old) were gathered by questionnaire and laboratory examinations through a cross sectional study from the Non-Communicable Disease Surveillance Centre (NCDSC) of Iran. BC incidences of all provinces through 2001-2006 segregated by age and gender were obtained from the Cancer Registry Ministry of Health (CRMH). Results: a significant positive relationship was seen between diabetes mellitus, fish comsupmption, percent of academic education and non-consumption of fruit, and breast cancer in women. However, non fish consumption, percent age illiteracy and taking fruit showed a significant negative relationship with the incidence of breast cancer. In addition, multiple linear regression analysis showed associations among percentage with academic education, fruit consumption and diabetes. Conclusions: We conclude that dietary factors such as fish and furit consumption, dairy products, health status indicators, academic education, and some diseases like diabetes mellitus can affect the BC incidence, although the results of ecologic studies like this must naturally be interpreted with caution.


Breast cancer;risk factors;correlation;linear regression;ecological study


  1. Abdulrahman GO Jr, Rahman GA (2012). Epidemiology of breast cancer in Europe and Africa. J Cancer Epidemiol, 2012, 915610.
  2. Alegre MM, Knowles MH, Robison RA, O'Neill KL (2013). Mechanics behind breast cancer prevention - focus on obesity, exercise and dietary fat. Asian Pac J Cancer Prev, 14, 2207-12.
  3. Alimohammadian M, Ghorbani A, Malekzadeh AR, Nouraie M, Sadjadi M (2009). Epidemiology of breast cancer in the Islamic Republic of Iran: forst results from a population based cancer registry. East Mediterr Health J, 15, 1426-31.
  4. Ayotte JD, Baris D, Cantor KP, et al (2006). Bladder cancer mortality and private well use in New England: an ecological study. J Epidemiol Community Health, 60, 168-72.
  5. Azizi F (2003). Epidemiology and control of common disorders in Iran. Third Edition ed. Tehran: Khosravi Publications, 201-5.
  6. Boffetta P, De Stefani E, Ronco AL, et al (2006). Food patterns and risk of breast cancer: a factor analysis study in Uruguay. Int J Cancer, 119, 1672-8.
  7. Barcenas CH, Chong D, Wells J, et al (2010). Race as an independent risk factor for breast cancer survival: breast cancer outcomes from the medical college of georgia tumor registry. Clin Breast Cancer, 10, 59-63.
  8. Becker N (2003). Epidemiology of colorectal cancer. Radiology, 43, 98-104.
  9. Blount A, Ford ME, Hill DD, et al (2002). Modifying a breast cancer risk factor survey for African American women. Oncol Nurs Forum, 29, 827-34.
  10. Cai L, Ye WM, Yi YN, Yu SZ (2000). Fish sauce and gastric cancer:an ecological study in Fujian Province, China. World J Gastroenterol, 6, 671-5.
  11. Cullinane CA, Lubinski J, Neuhausen SL, et al (2005). Effect of pregnancy as a risk factor for breast cancer in BRCA1/ BRCA2 mutation carriers. Int J Cancer, 117, 988-91.
  12. El-Zaemey S, Nagi N, Fritschi L, Heyworth J (2012). Breast cancer among Yemeni women using the National Oncology Centre Registry 2004-2010. Cancer Epidemiol, 36, 249-53.
  13. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al (2013). Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer, 49, 1374-403.
  14. Greene MH, Kazerouni N, Lacey JV, Mink PJ, Schairer C (2006), Family history of breast cancer as a risk factor for ovarian cancer in a prospective study. Cancer, 107, 1075-83.
  15. Helyer LK, Le LW, Leong W, McCready D, Varnic M (2010). Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients. Breast J, 16, 48-54.
  16. Merlo DF, Ceppi M, Filiberti R, et al (2012). Breast cancer incidence trends in European women aged 20-39 years at diagnosis. Breast Cancer Res Treat, 134, 363-70.
  17. Kaushal M, Mishra AK, Raju BS, et al (2010). Betel quid chewing as an environmental risk factor for breast cancer. Mutat Res, 20, 1-11.
  18. Kim WS, Lee J, Lee SS, et al (2005). Extranodal nasal type NK/T-cell lymphoma: elucidating clinical prognostic factors for risk-based stratufication of therapy. Eur J Cancer, 41, 1402-8.
  19. Kruk J, Marchlewicz M (2013). Dietary fat and physical activity in relation to breast cancer among polish women. Asian Pac J Cancer Prev, 14, 2495-502.
  20. Youlden DR, Cramb SM, Dunn NA, et al (2012). The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol, 36, 237-48.

Cited by

  1. Relation of Alcohol/Tobacco use with Metastasis, Hormonal (Estrogen and Progesterone) Receptor Status and c-erbB2 Protein in Mammary Ductal Carcinoma vol.15, pp.14, 2014,
  2. Incidence and Mortality of Breast Cancer and their Relationship to Development in Asia vol.16, pp.14, 2015,
  3. Comparison of patient-reported need of psycho-oncologic support and the doctor's perspective: how do they relate to disease severity in melanoma patients? vol.25, pp.11, 2015,