Investigating Breast Cancer Risk Factors and Prevention Measures - Research Paper Example

Investigating Breast Cancer Risk Factors and Prevention Measures: A Case Control Study Author’s Name Institutional Affiliation Investigating Breast Cancer Risk Factors and Prevention Measures: A Case Control Study Project Summary Cancer has been a scourge that has affected millions of people and billions of others associated with them. Though various types of cancers have been identified, breast cancer is one that has afflicted women more than any other. However, this cancer is not restricted to women only; men too can be victims. The scourge is leading cancer among women with approximately 25% of all cases; experts attribute this to the fact that the disease is related to hormones. Each year approximately a million people are diagnosed with the disease, and as the world continues to develop, the cases continue to increase causing the authorities to be concerned if there is a direct link. Research has been initiated to identify the causes of the disease and the appropriate treatment and preventative measures to help combat the disease. The rush for results is driven by the socio-economic effects the disease has on the community and economies as a whole. Globally, the scourge ravages the lives of many especially in the developing nations where the rate of new diagnosis has been on the rise. However, this has been exacerbated by the lack of proper medical facilities, rapidly changing lifestyles and lack of proper sensitization on the disease. Lack of proper education on the illness is the leading reason for the rise in the death toll as sufferers are late in identifying the disease making treatment difficult. Developed nations such as Australia have a large number of breast cancer patient, and despite good and developed medical services, there is a rise in the rate of new cases. Previous researchers have prescribed some preventative measures such as exercise, proper diet and breastfeeding to help combat the disease and its effects. The research being proposed hopes to find whether the breastfeeding is an effective breast cancer preventative measure concentrating on the Melbourne territory. Rationale Australia has one of the world’s largest population of cancer patients, like many developed nations the country it has tried to put in place measures that may help curb an increase in numbers. The nation currently has an estimated rate of new diagnosis of breast cancer of 16000 annually according to statistics from Breast Cancer Network Australia. 200 of these new cases are men. The nation though has a well-established medical sector that has helped reduce the number of fatalities associated with this disease and all other cancers. Patients can be able to identify the disease quickly and seek treatment early increasing their chances of survival. Each of the countries regions has initiated steps aimed at raising awareness of the disease and sensitizes people on the present preventative measures. Melbourne being one of the most developed and a populous region in the country is the most appropriate region to conduct the study. This study is specifically done in Melbourne and more regarding breastfeeding relation to breast cancer. As the disease has been associated with hormones especially about menopause, it is necessary to understand the factors that can target mothers in the country. Of the measures prescribed by medical professionals, breastfeeding has been the most appropriate for mothers in high-risk groups. Melbourne being home to approximately 4.5 million people has a comparatively high birthrate in Australia translating to many new mothers each year. With a focus on these mothers, the city should consider raising awareness on best motherhood practices that may help reduce the incidence rate of the disease. One of the primal motherhood practices is breastfeeding. Previous research has emphasized the benefits of breastfeeding and when especially done for the advised period of at least six months. Such benefits include boosting the immunity of babies and preventing diseases like cervical and breast cancer. Most mothers often breastfeed their children for short periods of time thus preceding the benefits of long-term breastfeeding. Indeed, this has been attributed to the availability of alternatives such as baby formulas that are manufactured specifically for infants. Critics and skeptics of this measure have explained that it does not significantly reduce the breast cancer risk and that it the measure is increasingly impractical in some cases. This study aims to find out whether this narrative is true. Aims and Objectives This study seeks to highlight the various benefits of breastfeeding while also gathering information on breastfeeding trends in the city. The research results will be able to shed more light on the matter of breastfeeding hoping to reverse the negative changes to the habit and promote best practices that will help future mothers and their children too. The results may also serve to update current knowledge of the disease while improving on previous studies previously conducted on the subject of breastfeeding. Updating existing knowledge will help ensure that necessary policies and preventative measures are put in place by the relevant authorities to curtail the growth of the disease. A reduction of the new cases of cancer can help reduce the burdens associated with the disease on the individual, their family, community, and country as a whole. These burdens often take an economic face as a cancer treatment is often expensive, and this affects the dependents significantly as they have to sacrifice their needs to cater for the patient. The research also aims to collect as much data as possible to help understand the disease better through a controlled case study. The data collected will be useful to other parties in the future and help fellow researchers update the data that currently present. The uniqueness of every case makes it imperative that new data be collected to expand the understanding of the disease. The new data may help improve the cancer awareness initiatives that are in place to make them more efficient. The results will be integrated with the treatment and preventative measures given or advised to patients by medical practitioners. The information gathered will also be crucial to validating or invalidating the current medical study results. New research is especially crucial since they often improve on the shortcomings of previous studies on the subject. Hypothesis That breastfeeding is an effective breast cancer is an effective breast cancer preventative measure. Research Plan Study Design The research will employ the use of a case-control study method to help identify the connection between breastfeeding and the reduction of risk of acquiring breast cancer. This type of study is appropriate when one considers the target group and the aims of the study. It poses low or no risk to the people involved, and the information is readily available. For diseases such as breast cancer are considered to have long latency periods, this sort of study is advisable as it allows for follow-up on the cases and controls involved in the survey. Follow up is important if researchers are to be able to monitor the conditions of the participants in the study sufficiently. The study does not require much funding compared to other types of studies thus saving on monetary resources, the effort required here too is minimal as it is an observational sort of study. Information on the cases and control, their historical data is also readily available thus helping to reduce the cost and effort to obtain this highly relevant information that will be crucial in mapping the disease. Study Population Plans for recruitment and Research Population The study will involve about 300 cases and an equal number of matched controls with all of them being mothers at one point in their lives. The mean age of this study population will be 42.9 for the cases and 44.3 for the controls. The low mean age of the cases will be due to the inclusion of many premenopausal women who make up 62% of the study population. To help assess the association of reduction of risk of breast cancer with breastfeeding techniques researchers would employ the use of logistic regression. Recruitment of the cases and controls will be from the various hospitals in the city such as Royal Melbourne Hospital, St. Vincent Private Hospital, and Austin Hospital. Researchers will ensure that they seek approval for the protocols and consent forms to be used by the various relevant ethics and research regulators. The breast cancer prevalent and incidence cases found within the hospitals chosen will make up the cases. For the controls, the age-matched and hospital-based individuals will be recruited while on their regular hospital visits together with hospitalized patients in the wards of the hospitals engaged in the study. The patients’ medical history according to their records will be used to select the participants of the study, the chosen will then have the study explained to them, and the willing will be asked to reach out to the research team for further information. All the participants in the study will be female citizens of the city who fit the criteria of motherhood, age, and risk. Measurements Category Variable Measurement Demographic Characteristics 1) Age and Sex 2) Socio-economic status (Education, Occupation, Income 3) Cancer Status Household interview & Interviewer-administered questionnaire Family and Medical History 1) Family History 2) Breastfeeding 3) Chronic Health Conditions 4) Women’s Health Interviewer-administered questionnaires Lifestyle-related Factors 1) General Health and Well-being 2) Alcohol/ Cigarette 3) Physical Activity 4) Diet Questionnaire Interviewer-administered questionnaires Dietary Questionnaire (self-administered) Physical Measurements 1) Height 2) Weight 3) Waist and Hip Circumference 4) Blood pressure 5) ECG Stadiometer Weight scales Tape measure Dinamap Data Management Data will be collected by using techniques such as questionnaires interviews and one on one test. Individuals are going to be given breastfeeding questionnaires that inquire about their every day breastfeeding habits. These forms will be filled over a period, and when the individual is done, she will return them to the hospital in which they regularly attend and would leave it with a research team staff who would then interview her on certain aspects of her daily life such as breastfeeding duration per session. The data compiled would be collected, and fact checked to ensure that the data given is correct or to clear up any inconsistencies that might arise. Afterward the final data set will be sent to the main research team and be de-identified to reduce the chances of bias as the data is being processed by statisticians and other researchers involved in data analysis. De-identification helps to ensure that the researcher does not know the person whose data they are handling. A statistician will go through the data to try and find linkages that may appear as they pore through the voluminous data that has been provided by researchers. The linkages will help generate common data sets that would help researcher draw conclusions. The common data sets will help to establish whether there are any links between the breastfeeding habits of mothers and their reduction of risk of acquiring cancer. Since the data will be collected periodically as the patients go to the various hospitals for their regular checkups, new information will be gathered to help establish the link. Later, if any of the controls are diagnosed with the disease, the researcher can be able to map their progress over the study period to establish a link. The study, however, is largely based on the similarities between the controls and the cases as a before-and-after type of assessment. Feasibility The study is projected to go for five years with funding. Preparation of the documents, questionnaires and other logistical planning is forecasted to take approximately three months to ensure that the most relevant data is acquired over the period of the study. The necessary approvals by the relevant ethics and research committees are projected to take a year. Bearing in account the copious amount of data that is to be prepared and analyzed it is certain that the statistical process will be slow and may require much time to get quality information from the data. Other considerations for different studies The study does not appear to have any serious probable challenges when being conducted. As the controls are cancer patients undergoing various treatments researchers are urged to be patient with them as they are easy to tire. They should also consider the level of education and understanding of the participants; this means that the researchers would need to handle them in a special manner especially when explaining details of the protocols and consent forms to ensure that they understand the full scope of the study and their involvement. The questions need to be framed in simple and concise ways to make sure that participants understand them. Therefore, this will ensure that researchers acquire the most accurate data. Non-English speakers should also be catered for and the appropriate translators provided to avoid unnecessary misunderstanding. Researchers should set up mechanisms to allow for engagement of participants throughout the process especially when medical tests are concerned; the researchers can ensure that necessary feedback is given to the participants including the results and outcomes of the study Ethical Consideration Researchers today, unlike the past, have to undergo thorough scrutiny to ensure the highest standards of ethics are upheld. For this study measured will be put in place with consultation with the necessary ethical regulators to ensure that the study was above board and there was no room for intentional ethical breaches. Such regulators include the Melbourne chapter of the Human Research Ethics Committee that meant to approve any human research proposals to ensure that they meet acceptable ethical standards according to the Australian standards and regulations. The committee will monitor the project and be responsible for keeping detailed reports and records about ethics including ethical outcomes Informed Consent In consideration of the nature of the study where the participants are recruited on a voluntary basis the consent of the participants is a requirement. The consent is to ensure that the participants are aware of the risks associated and they are willingly taking them on. The consent forms will be prepared to ensure that the rights and freedoms of the participants are guaranteed and not infringed upon in any way. The measures the team will put in place will be by the Nuremberg Code that deals with the treatment of human subjects. No form of coercion will be used to coerce the participants into entering the study in any way using either money or deception by allowing potential participants time to consider consent forms and protocols at their convenience. The contact information of the participants will be made available to ensure authorities can contact them should need to arise. The research outcomes will be analyzed to make sure that they would benefit society and not private interests. Risks and benefits will carefully be analyzed beforehand to ensure that the participants’ safety is assured and that the research team observes the best practices. Qualified personnel is going to be engaged to ensure that the best quality data is collected and to mitigate the risk posed by unqualified personnel. Feedback mechanisms will be put in place to ensure that the participants receive results of any medical tests conducted along with an explanation of the impact of the results of the study. During the planning stage, careful consideration will be given to ensure that the participant’s cultural or religious beliefs and practices were being respected and participants given the option of removing themselves at any time or dictating how they would be handled. Confidentiality and privacy Data handling practices will be scrutinized to ensure that the participants’ medical records are kept secure at all times. The consent forms will clearly state the records that would be used in the study with the participants giving consent first before they are used. No third party will be engaged to handle data to ensure that the records used will remain private at all times. Privacy is one of the most sensitive ethical issues faced by researchers; strict measures have to be applied to ensure that it is upheld. One such method that this research is going to utilize is the use of de-identifying techniques. These techniques would ensure that the researchers are kept from being able to identify with a patient to reduce chances of bias personally. The study is to be structured to ensure that there is an equitable distribution of benefits and burdens among all the participants, more so among the research teams. It will be done in the spirit of justice. In this spirit, the planners will take extra care to make sure that the study does not in any way discriminate against any person or group especially in the recruitment phase. During the planning stage, the sample size will be carefully chosen to ensure that the results yielded are statistically significant and give room for dropouts and other unintended or unforeseen circumstances. Transparency measures such as fully engaging participants in the study will also be put in place. The study will also meticulously scrutinize, and a detailed account of the methodology is given to ensure that readers would clearly understand the procedures that were undertaken. This strict measure will ensure that future researchers can repeat the experiment independently without issue. Checks and balances will be embedded to avoid fabrication or concealment of results; these will include having one member fact check every piece of information that is provided or produced during the research. Significance and Implications The study is aimed at creating awareness on cancer and breastfeeding as an effective breast cancer prevention technique. Like all the studies that have been conducted on this and other forms of cancer the knowledge acquired is hoped to help find a cure or appropriate treatment and prevention techniques for mothers. The disease itself has taken a significant toll on the city’s society, and more needs to be done to reduce the mortality rates associated with the disease. It is important the studies being conducted ensure that the public is made aware of the seriousness of the matter especially about the riskiness of changing their breastfeeding habits on the baby and the health of the woman. Although many factors are at play when it concerns cancer of all forms, people should be educated on how they can manage the risk factors that are known to cause the disease. The study results should also make aware the population of the measures they can take to ensure that they detect cancer as early as possible to increase their chances of a quick recovery. Findings of the research should help improve already existing breastfeeding awareness programs to ensure that the public is given the as much information as possible to ensure they make an informed decision about the subject. Timeline and justification of funding for 5 years Months of study 6 12 18 24 30 36 42 48 52 60 Finalization of protocols Enrolment baseline Testing Data collection Data analysis Funding will be sourced from the City’s metropolitan council from funds earmarked for research together with funds raised by the researchers and well-wishers. Most of these funds will go towards paying salaries of research members and equipment to be used. The study type is not labor or resource intensive and as such saving on monetary costs. References Awatef, M., Olfa, G., Imed, H., Kacem, M., Imen, C., Rim, C., Mohamed, B. & Slim, B. (2010). Breastfeeding reduces breast cancer risk: A case-control study in Tunisia. Cancer Causes and Control, 21(3), 393-397. Bernie, M., Plu-Bureau, G., Bossard, N., Ayzac, L. & Thalabard, J. (2000). Breastfeeding and risk of breast cancer: A meta-analysis of published studies. Human Reproduction Update, 6(4), 374-386. De Silva, M., Senarath, U., Gunatilake, M. & Lokuhetty, D. (2010). Prolonged breastfeeding reduces the risk of breast cancer in Sri Lankan women: A case-control study. Cancer Epidemiology, 34(3), 267-273. Dieterich, C., Felice, J., O’Sullivan, E. & Rasmussen, K. (2014). Breastfeeding and health outcomes for the mother-infant dyad. Pediatric Clinics of North America, 60(1), 31-48. Freund, C., Mirabel, L., Annane, K. & Mathelin, C. (2005). Breastfeeding and breast cancer. Gynecologie, Obstetrique, and Fertility, 33(10), 739-744. Giudici, F., Scaggiante, B., Scomersi, S., Bortul, M., Tonutti, M. & Zanconati, F. (2016). Breastfeeding: A reproductive factor able to reduce the risk of luminal B breast cancer in premenopausal white women. European Journal of Cancer Prevention. Institute of Medicine. (2012). Breast cancer and the environment: A life course approach. Washington, DC: The National Academies Press. Inumaru, L., Gomes, M., Erika, A. & Naves, M. (2012). Risk and protective factors for breast cancer in Midwest of Brazil. Journal of Environmental and Public Health, 2(3), 1-10. Kumar, B., Singh, M., Malik, J. & Kalhan, M. (2014). Breastfeeding reduces breast cancer risk: A case-control study in North India. International Journal of Preventive Medicine, 5(6), 791-795. Nagata, C., Mizoue, T., Tanaka, K., Tsuji, I., Tamakoshi, A. & Tsugane, S. (2012). Breastfeeding and breast cancer risk: An evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Japanese Journal of Clinical Oncology, 42(2), 124-130. Sakai, T. (2001). Does breastfeeding reduce the risk for breastcancer? A short lesson in evidence-based practice. The American Journal of Maternal Child Nursing, 26(1), 42-45. Stuebe, A. (2009). The risks of not breastfeeding for mother and infants. Reviews in Obstetrics and Gynecology, 2(4), 222-231. Unar-Munguia, M., Torres-Mejia, G., Colchero, M. & De Cosio, G. (2017). Breastfeeding mode and risk of breast cancer. Journal of Human Lactation. doi:10.1177/0890334416683676. Woodman, I. (2002). Breastfeeding reduces the risk of breast cancer, says study. British Medical Journal, 325(7357), 184. Yang, L. & Jacobsen, K. (2008). A systematic review of the association between breastfeeding and breast cancer. Journal of Women’s Health, 17(10), 1635-1645. Read More