RESUMO
Ultra-processed food intake has been linked to an increased risk of breast cancer in Western populations. No data are available in the Latin American population although the consumption of ultra-processed foods is increasing rapidly in this region. We evaluated the association of ultra-processed food intake to breast cancer risk in a case-control study including 525 cases (women aged 20-45 years) and 525 matched population-based controls from Chile, Colombia, Costa Rica and Mexico. The degree of processing of foods was classified according to the NOVA classification. Overall, the major contributors to ultra-processed food intake were ready-to-eat/heat foods (18.2%), cakes and desserts (16.7%), carbonated and industrial fruit juice beverages (16.7%), breakfast cereals (12.9%), sausages and reconstituted meat products (12.1%), industrial bread (6.1%), dairy products and derivatives (7.6%) and package savoury snacks (6.1%). Ultra-processed food intake was positively associated with the risk of breast cancer in adjusted models (OR T3-T1=1.93; 95% CI=1.11 to 3.35). Specifically, a higher risk was observed with oestrogen receptor positive breast cancer (ORT3-T1=2.44, (95% CI=1.01 to 5.90, P-trend=0.049), while no significant association was observed with oestrogen receptor negative breast cancer (ORT3-T1=1.87, 95% CI=0.43 to 8.13, P-trend=0.36). Our findings suggest that the consumption of ultra-processed foods might increase the risk of breast cancer in young women in Latin America. Further studies should confirm these findings and disentangle specific mechanisms relating ultra-processed food intake and carcinogenic processes in the breast.
RESUMO
This review highlights the increasing incidence of breast cancer world-wide and the increasing burden of breast cancer deaths experienced by lower-income countries. The causes of increasing incidence have been attributed to changes in the prevalence of reproductive risk factors, lifestyle changes, and genetic and biological differences between ethnic and racial groups. All these factors may contribute, but data linking etiological factors to increased risk in developing countries is lacking. The challenge for lower-income countries is developing effective strategies to reverse the trend of increasing mortality. Down-staging of breast cancer by early detection is a promising long-term strategy for preventing disease-related deaths but it is difficult to make the economic investment required to carry out broad screening programs. Successful strategies for addressing the growing breast cancer burden will therefore take political will, reliable data, public and medical community awareness, and partnerships between community advocates, governments, non-governmental organizations and biotechnology.
Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/prevenção & controle , Feminino , Saúde Global , Humanos , Incidência , Fatores de RiscoRESUMO
This review highlights the increasing incidence of breast cancer world-wide and the increasing burden of breast cancer deaths experienced by lower-income countries. The causes of increasing incidence have been attributed to changes in the prevalence of reproductive risk factors, lifestyle changes, and genetic and biological differences between ethnic and racial groups. All these factors may contribute, but data linking etiological factors to increased risk in developing countries is lacking. The challenge for lower-income countries is developing effective strategies to reverse the trend of increasing mortality. Down-staging of breast cancer by early detection is a promising long-term strategy for preventing disease-related deaths but it is difficult to make the economic investment required to carry out broad screening programs. Successful strategies for addressing the growing breast cancer burden will therefore take political will, reliable data, public and medical community awareness, and partnerships between community advocates, governments, non-governmental organizations and biotechnology.
Se destaca el aumento en la incidencia de cáncer de mama (CaMa) en el mundo y la creciente carga de muertes por la enfermedad en países en desarrollo. El aumento en la incidencia se atribuye a cambios en la prevalencia de factores de riesgo reproductivo, estilo de vida, y a diferencias biológicas entre grupos étnicos y raciales. Sin embargo, aún faltan datos que relacionen los factores etiológicos al incremento en el riesgo en países en desarrollo. El desafío es generar estrategias efectivas que reviertan la tendencia en la mortalidad. La detección en etapas más tempranas es una estrategia prometedora de largo plazo pero la inversión necesaria para los programas de tamizaje es muy alta. Las estrategias exitosas para hacer frente a la creciente carga de CaMa deben tener voluntad política, evidencia confiable, reconocimiento de la comunidad pública y médica; y la suma de esfuerzos entre activistas de la comunidad, gobierno, organizaciones no-gubernamentales y biotecnología.