Shama Virani1, Elizabeth C Wetzel2, Suphawat Laohawiriyakamol3, Pleumjit Boonyaphiphat4, Alan Geater5, Celina G Kleer6, Judy Pang6, Katie M Rentschler2, Justin A Colacino2, Carlos F Mendes de Leon7, Laura S Rozek8, Hutcha Sriplung9. 1. Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI USA. 2. Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI USA. 3. Department of Surgery Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. 4. Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. 5. Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. 6. Department of Pathology University of Michigan, Ann Arbor, MI USA. 7. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. 8. Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI USA. Electronic address: rozekl@umich.edu. 9. Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. Electronic address: hutcha.s@psu.ac.th.
Abstract
BACKGROUND: Breast cancer has the highest incidence in women of all cancers and its burden is expected to continue to increase worldwide, especially in middle-income countries such as Thailand. The southern region of Thailand is unique in that it is comprised of 30% Muslims, whereas the rest of Thailand is 95% Buddhist. Breast cancer incidence and survival differ between these religious groups, but the association between clinical subtype of breast cancer and survival has not yet been assessed. METHODS: Here we characterized differences in breast cancer survival with consideration to clinical subtype by religious group (Muslim Thai and Buddhist Thai women). We compared distributions of age, stage and clinical subtype and assessed overall survival by religion. RESULTS: Our findings show that Muslim Thai women with breast cancer are diagnosed at a younger age, at later stages and have shorter overall survival times compared to Buddhist Thai women with breast cancer. We also observe a higher proportion of triple negative tumors characterized in Muslim Thai women. CONCLUSIONS: Our findings confirm previous studies that have shown lower survival rates in Muslim Thai women compared to Buddhist women with breast cancer and offer novel information on subtype distribution. To date, this is the first study assessing clinical subtypes in southern Thailand by religious status. IMPACT: Our findings are critical in providing information on the role of clinical subtype in cancer disparities and provide evidence from the Southeast Asian region for global studies on breast cancer survival.
BACKGROUND:Breast cancer has the highest incidence in women of all cancers and its burden is expected to continue to increase worldwide, especially in middle-income countries such as Thailand. The southern region of Thailand is unique in that it is comprised of 30% Muslims, whereas the rest of Thailand is 95% Buddhist. Breast cancer incidence and survival differ between these religious groups, but the association between clinical subtype of breast cancer and survival has not yet been assessed. METHODS: Here we characterized differences in breast cancer survival with consideration to clinical subtype by religious group (Muslim Thai and Buddhist Thai women). We compared distributions of age, stage and clinical subtype and assessed overall survival by religion. RESULTS: Our findings show that Muslim Thai women with breast cancer are diagnosed at a younger age, at later stages and have shorter overall survival times compared to Buddhist Thai women with breast cancer. We also observe a higher proportion of triple negative tumors characterized in Muslim Thai women. CONCLUSIONS: Our findings confirm previous studies that have shown lower survival rates in Muslim Thai women compared to Buddhist women with breast cancer and offer novel information on subtype distribution. To date, this is the first study assessing clinical subtypes in southern Thailand by religious status. IMPACT: Our findings are critical in providing information on the role of clinical subtype in cancer disparities and provide evidence from the Southeast Asian region for global studies on breast cancer survival.
Authors: Hawar Hasan Ali Ghalib; Dawan Hiwa Ali; Sherko Abdullah Molah Karim; Mohammed Ibrahim Mohialdeen Gubari; Saman Ahmed Mohammed; Diyar Hassan Marif; Hawsar Mohammed Othman Journal: J Family Med Prim Care Date: 2019-12-10