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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, December 2, 2024
An analysis of the cross-sectional observational Caribbean Women’s Cancer Study revealed changes in reproductive patterns across four generations of Caribbean patients with breast cancer, according to Sophia George, PhD, of Sylvester Comprehensive Cancer Center, Miami, and colleagues. Their findings, which were published in the journal JAMA Network Open, also provide insight into the risk factors associated with diagnosis at a younger age.
“These changes [in reproductive patterns] are compounding the already known increased risk for developing these aggressive diseases,” commented Dr. George in an institutional press release.
A total of 995 patients with invasive breast cancer who were born in a Caribbean country (ie, The Bahamas, Barbados, Cayman Islands, Dominica, Haiti, Jamaica, and Trinidad and Tobago) were divided into four birth cohorts: born before 1950; born between 1950 and 1959; born between 1960 and 1969; and born in or after 1970. The proportions of patients who experienced menarche at age 12 or younger (33.0% vs 47.3% vs 45.5% vs 57.9%; P < .001), no pregnancies (6.8% vs 6.8% vs 10.5% vs 22.8%; P < .001), and nulliparity (8.6% vs 9.2% vs 13.9% vs 27.6%; P < .001) appeared to significantly differ across these cohorts.
Patients who experienced menarche at age 12 or younger vs 15 or older were diagnosed with breast cancer at a mean age of 45.0 vs 49.1 years, respectively. Compared with those who experienced at least three full-term pregnancies, nulliparous patients were found to be diagnosed at an earlier mean age (49.9 vs 42.1 years; P < .001). With every 1-year increase in age at first pregnancy, there seemed to be a 4% increase in the likelihood of being diagnosed with estrogen receptor–positive disease (odds ratio = 1.04; P = .02).
“Interventions targeting… dietary intake of fruits and vegetables, increased physical activity, weight loss, and decreased alcohol consumption are needed to compensate for the shift in reproductive patterns,” the investigators concluded.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
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