Research On Precise-prevention-oriented And Big-data-based Surveillance Content Risk Factors Of Breast Cancer

Objective Through the qualitative system evaluation and the meta-analysis,the risk factors of breast cancer are summarized,and the monitoring content of the risk factors of the breast cancer is initially constructed in combination with the domestic and international chronic disease monitoring guidelines and contents,and a preliminary reference basis is provided for establishing the monitoring content of the risk factors of the breast cancer,Then,from the two aspects of scientific research and monitoring,the area of monitoring the risk factors of breast cancer can be first carried out in China,and the reference basis for the accurate prevention and control of breast cancer in the future is provided.Methods(1)The risk factors of breast cancer published by authoritative cancer organizations at home and abroad were systematically sorted out.After discussion by the panel,the risk factors of breast cancer were systematically sorted by qualitative and quantitative methods,including the number of authorities,type of epidemiological study and conclusion.In the study of systematic evaluation,the quantitative method includes the principle of screening such as probability value,95%confidence zone and I~2of heterogeneity test.Based on the screening principle,the identified risk factors are retained and summarized.(2)Quantitative systematic evaluation,i.e.Meta analysis of the controversial risk factors,and the forest map test and analysis with RevMan 5.3,obtained the combination ratio(Oddsratio,OR)and 95%Confidence Interval(CI),Stata12.0 was used for publication bias and sensitivity analysis.(3)Collate all the risk factors to be included in the monitoring,combined with WHO monitoring guidelines,chronic diseases and their behavioral risk factors monitoring(Chronic Disease Risk Factor Surveillance System in China,CDRFSS)content,the National Institutes of Health(USA National Institutes of Health,NIH)developed the"Standard Health questionnaire and anthropometric methods"preliminary development of breast cancer risk factors monitoring scale.(4)Directed by precision prevention and control,the scientific research status of breast cancer and its subtypes in various regions of China was analyzed by using crawler and ArcGIS tools.On the basis of spatial distribution,combined with the monitoring points of CDRFSS and(Chinese Cancer Registry System,CCRS)in the national tumor registration system,it provided a reference for the areas suitable for giving priority to the monitoring of breast cancer risk factors in the future.Results(1)The results of qualitative and systematic evaluation of breast cancer risk factors showed that there were 11 primary indicators for breast cancer risk factors,including genetic factors,reproductive factors,disease factors,drug factors,ionizing radiation,lifestyle,body measurement,environmental factors,occupational factors,special behaviors,birth control,and 42 secondary indicators;There are three controversial risk factors,including smoking,miscarriage and wearing bras while sleeping.(2)The controversial risk factors of Meta analysis showed that the risk factors of breast cancer with OR value greater than 1 were smoking,abortion and wearing bra while sleeping,which could be included in the monitoring range.(3)The breast cancer risk factor monitoring scale consists of three parts:questionnaire survey,body measurement and laboratory test,and 16 modules.Among them,the questionnaire includes 14 modules:basic information,diet,drinking,smoking,wearing bra while sleeping,lack of physical activity,menstruation history,fertility history,birth history,incomplete pregnancy history,diabetes history,breast disease history,family history and drug history,among which,the questionnaire includes 14 modules:basic information,diet,drinking,wearing bra while sleeping,insufficient physical activity,menstruation history,birth history,incomplete pregnancy history,diabetes history,breast disease history,family history and drug history.Body measurement includes height,weight and waistline;laboratory tests include genetic testing of BRAC1 and BRAC2(for individuals with a family history of breast cancer).(4)Guided by accurate prevention and control,this paper preliminarily analyzes the areas suitable for breast cancer surveillance in the future,including Shandong,Liaoning,Jiangsu and Henan provinces,followed by Guangdong,Hebei,Xinjiang,Shaanxi and other places.Conclusions On the basis of the existing research on breast cancer risk factors at home and abroad,45 breast cancer risk variables,including genetic factors,reproductive factors,disease factors,drug factors,ionizing radiation,lifestyle,body measurement,environmental factors,occupational factors,special behaviors and contraceptives,were constructed based on the monitoring contents of chronic diseases and behavioral risk factors in China.It provides a preliminary reference for the establishment of breast cancer risk factors monitoring in China.Under the guidance of precision prevention and control,this paper analyzes the areas that can give priority to the monitoring of breast cancer risk factors in the future from the aspects of scientific research basis and monitoring experience,including Shandong,Liaoning,Jiangsu and Henan provinces,followed by Guangdong,Hebei,Xinjiang,Shaanxi and other places,to provide regional reference for the accurate prevention and control of breast cancer.