RISK FACTORS FOR BREAST CANCER AMONG MALAYSIAN WOMEN IN KLANG VALLEY

ABSTRACT

            Breast cancer is the most common malignancy cancer affecting woman.  In Malaysia one in 20 women are at risk of breast cancer and 3500 new cases of female breast cancer are diagnosed in our country each year.   The objective of this study is to investigate what are the possible risk factors associated with breast cancer among Malaysian women.  Probable risk factors for breast cancer include race, age, reproductive factor, breastfeeding status, lifestyle factor, hormonal status, and family history.  A survey will be conducted at Pantai Hospital, Kuala Lumpur.  Questionnaire will be distributed to 150 patients who diagnosed with breast cancer.  Data will be analyzed using SPSS program.  Proposed time to finish this project will be 12 month.  Budget for this project will be RM9386.          

           

TITLE

Risk factors for breast cancer among Malaysian women in Klang Valley.

BACKGROUND

            Breast cancer is the most common malignancy cancer affecting woman.  Breast cancer accounts for 22.9 percent of all cancer in women worldwide.  Breast cancer caused 458,503 death in 2008, worldwide.  In the western world, survival rates of breast cancer are high, more than eight out of ten women (84 percent) in England diagnosed with breast cancer survived for at least five years.  However, survival rates are much lesser in developing country rates (Breast cancer, 2012).

            In Malaysia, there is 3525 female breast cancer case reported to the National Cancer Registry (NCR) in 2006 with 29.9 percent of all new cancers.  It is the commonest cancer in all ethnic groups and in all age groups from age 15 years and above (Where it pink, 2011).

            There have been many improvements and advances in the detection and treatment for breast cancer but many patients ignored or misunderstood the need for early detection and treatment.  Because of that, most patients still seek treatment when they are already in advanced stages of breast cancer which may be too late to be cured.

            In Klang Valley, there have been a lot of annual breast cancer awareness campaign period been established to raise awareness and educate women to be more breast cancer aware.  In 2010, Ministry of Health Malaysia and Academy of Medicine Malaysia had suggested the probable risk factor of breast cancer faced by Malaysian women.  This study will be conducted among breast cancer patients in Pantai Hospital Kuala Lumpur to determine the probable risk factors faced by Malaysian women.              

PROBLEM STATEMENT

            Breast cancer is the leading malignancy affecting women in Malaysia.  According to Malaysian’s Health Minister, Dato Sri Liow Tiong Lai, in Malaysia one in 20 women are at risk of breast cancer and 3500 new cases of female breast cancer are diagnosed in our country each year.  Based on statistic from Ministry of Health Malaysia, in 2011 women suffering from breast cancer are 18.1 percent followed by colon cancer and cervix cancer.

            However, the level of breast cancer risk factors and early detection awareness is not known.  It is thus important to assess the risk factor of breast cancer to raise awareness among woman and early detection.          

RESEARCH QUESTIONS

            The research question for this study will be:

1.    What are probable risk factors for breast cancer?

2.    What influence risk factors have on incidence of breast cancer in women?

3.    Which of the risk factors that show the many risks faced by women who suffers from breast cancer?

OBJECTIVE

General Objective

            The purpose of this study is to investigate what are the possible risk factors associated with breast cancer among Malaysian women.

Specific Objectives

1.    To determine the probable risk factors for breast cancer.

2.    To know what influence risk factors on incidence of breast cancer in women.

3.    To determine which risk factors show the many risks faced by breast cancer women.

HYPOTHESIS

            Probable risk factors for breast cancer include race, age, reproductive factor, breastfeeding status, lifestyle factor, hormonal status, and family history.  Reproductive factors are age at menarche, age at menopause, age at first full pregnancy, and age at last full pregnancy.  Lifestyle factors are diet, body weight, alcohol, smoking, working or not working, and married or single.  Hormonal status is taking exogenous hormones like oral contraceptives and hormone replacement therapy (HRT).

            The incidence of breast cancer increases with age.  Women who start menstruating early in life or who have a late menopause have an increased risk of developing breast cancer.  Having first child at late age increase the lifetime incidence of breast cancer.  Women at substantial increased risk of breast cancer are women who have family history of breast cancer especially first degree relative like mother, sister, and daughter.  Obesity is associated with an increase in the risk of breast cancer in postmenopausal women.  Oral contraceptive and hormone replacement therapy does not increase breast cancer mortality.

STUDY DESIGN

            This is a cross-sectional study, which use quantitative method of data collection and will be conducted between June and August 2013.  I choose quantitative method because my aim is to determine the relationship between one thing and another in a population. 

STUDY SETTING

            The study will be conducted in Pantai Hospital Kuala Lumpur.  It is a private hospital located in a residential area of Kuala Lumpur and very close to the city center.  Patient who come to Pantai Hospital Kuala Lumpur mostly from Klang Valley area and composed of all ethnic groups.  It has Breast Care Center that focuses on breast cancer education, screening and treatment which have patient who come for breast screening approximately 480 woman per month and 5760 woman per year.  There also have breast surgeons and breast care nurse counselors that will attract the attention of breast cancer patients.

RESEARCH INSTRUMENT

            For data collection method, the survey will be conducted using questionnaire.  The question from questionnaire is adapted from mammogram questionnaire and patient history questionnaire from Pantai Hospital Kuala Lumpur.  Patients who are diagnosed with breast cancer will be asked to fill in the questionnaires.  The sample of questionnaire is shown in appendix.

SAMPLING DESIGN AND SAMPLE SIZE

            Non-probability sampling technique will be used.  These approaches to sampling results in the target population having an unknown chance of being selected into the sample. 

            Estimated sample size will be 150 patients who are diagnosed with breast cancer with no specific of what type and what stage their cancer are.  The sample will be Malaysian woman only age 40 years old and above to include Malay, Chinese and Indians woman from Klang Valley area.

ETHICAL ISSUES

            The ethical issues will be on human subject only.  For the purpose of this research,  permission to carry out the study will be obtained from human resources of Hospital Pantai Kuala Lumpur.  Informed consent will be sought and respondents will be assured of the confidentiality of the information. 

DATA PROCESSING

            Data from questionnaires will be exported to SPSS statistical program for analysis.  Continuous variables like age will be summarized using descriptive statistics like mean, median, and standard deviation.  Categorical variables will be summarized into frequencies, percentage and bar graft.  The breast cancer risk factors will be determined as percentages.

PROPOSED CHAPTER OF THE REPORT

This are the chapter that I plan to put in my report:

1.    Chapter 1: Introduction, which cover background, problem statement, research question,                study objective, and hypothesis.

2.    Chapter 2: Literature review

3.    Chapter 3: Methodology, which cover study design, study setting, research instrument,                              sampling design, sample size, data analysis, and ethical issues.

4.    Chapter 4: Results

5.    Chapter 5: Discussion, as well as problems of the study.

6.    Chapter 6: Conclusion and recommendation

7.    Chapter 7: References

8.    Chapter 8: Appendices

PROBLEMS AND LIMITATIONS OF THE STUDY

            The limitations for this study include time, budget, and physical constrain.  The time given to do this research is insufficient.  Also, no financial budget was proposed and I may have to spend my own expenses for equipments and consumables.

            The other problem I foresee, if the patient doesn’t want to cooperate or refuses to fill in the questionnaire or if patient forget at what age they start menstruating and menopause.  There will be problem also if the patient doesn’t know their weight and height where this is important to check their BMI accurately.