| Abstrakt: |
Modern demographic and nutritional transitions have been implicated in global epidemiological transitions intensifying over the last 60 years. These transitions include steadily declining fertility rates, improving nutritional indicators, and increasing incidence rates of chronic diseases such as breast cancer. This research draws on the well established pathways linking individual reproductive and nutritional profiles to breast cancer risk, in order to test the links among demographic, nutritional, and epidemiological transitions on a global scale. We propose two hypotheses that test the reproductive and nutritional pathways that are suggested to increase breast cancer risk at the population level. We use total fertility rate (TFR) to test the reproductive behaviour hypothesis, and we use average height and the percentage of the population that is overweight for the nutritional hypothesis; these indicators are compared to breast cancer incidence rates for 2008. Accounting for national wealth and expenditures on healthcare, we found that both hypotheses were significantly associated with breast cancer incidence, although TFR appears to have a more consistent association with incidence. Drawing on our regression model, we explain trends in breast cancer incidence in selected countries, as well as making predictions about shifting breast cancer incidence rates over the next several decades. These data suggest that greater attention should be paid to the unintended health consequences of transitions that are largely considered to bring improvements in quality of life. Our findings suggest that greater investments in screening and treatment are particularly needed in regions undergoing transitions in fertility rates, particularly those areas experiencing super-low fertility. [ABSTRACT FROM AUTHOR] |
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