BREAST CANCER RISK FACTORS IN COUNTRIES WITH DIFFERENT SOCIODEMOGRAPHIC INDICES (SDIS) AND CULTURE: A SYSTEMATIC REVIEW

This systematic review was performed to identify breast cancer (BC) risk factors in countries with different sociodemographic indices (SDI) and cultures, with a focus on the USA, Kingdom of Saudi Arabia (KSA), and Pakistan. Inclusion criteria were original articles about BC risk factors from the USA, KSA, and Pakistan, from the last 10 years. A search was done with PubMed and Google Scholar. A total of 43 articles were selected. Different genes were associated with BC in the USA, KSA, and Pakistan. Obesity, low physical activity, cigarette smoking, and hormonal therapy, in both pre- and post-menopausal women were risk factors for BC in studies from USA, KSA, and Pakistan. Red meat intake in the USA, and a high fat intake and chicken in Pakistan were found to be associated with BC. Alcohol was a risk factor for BC in the USA, but no such relationship was found in KSA and Pakistan. Early menarche, late menopause, nulliparity, unmarried status, no breastfeeding, and low Vitamin D levels were also risk factors for BC in Saudi and Pakistani women. Studies from the USA and Pakistan found a relationship between hair dye use and BC risk. The findings of this review provide comprehensive assessment on the prevalence of different risk factors for BC in other cultures and countries of SDI levels. Every country needs to focus on the prevention and control of its respective risk factors.