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Prenatal and childhood origin of an adult disease; The case of breast cancer

Prenatal and childhood origin of an adult disease; The case of breast cancer. Gabriel Gulis SDU Esbjerg, Denmark Anna Pakosova Trnava University, Trnava, Slovakia. Breast cancer mortality. Breast cancer morbidity. Major risk factors. Hormonal risks (menarche, parity, menopause)

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Prenatal and childhood origin of an adult disease; The case of breast cancer

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  1. Prenatal and childhood origin of an adult disease; The case of breast cancer Gabriel Gulis SDU Esbjerg, Denmark Anna Pakosova Trnava University, Trnava, Slovakia

  2. Breast cancer mortality

  3. Breast cancer morbidity

  4. Major risk factors • Hormonal risks (menarche, parity, menopause) • Lifestyle (diet, alcohol, smoking, physical exercise) • Medications (oral contraceptives, HRT) • Genetic predisposition • Early life risk factors

  5. Early life risk factors • birthweight • birth length • gestational age at birth • twin, zygosity • age of mother at delivery • weight and height of mother in/out of pregnancy • birth order

  6. What data are available in Slovakia • Presentation of data and data soruces available in Slovakia on early life risk factors Data sources:birthbook birthregistry medical record

  7. Data from Birthbook • Birthweight/birthlength • twin, zygosity • gestational age at birth • age of mother at delivery • birth order

  8. Data of birth registry • Birthweight/birth length • twin, zygosity • gestational age at birth • age of mother at delivery • birth order *data from birth registry are available since 1959

  9. Data from Medical record • Birthweight/birth length • twin, zygosity • age of mother at delivery • birth order • weight/height of mother at different ages • age at menarche • age at menopause

  10. Data from Medical record • Use of oral contraceptives • use of hormone contraceptives • alcohol • smoking

  11. Changes of data sources over time

  12. Description of Slovak study - methodology • Prospective, hospital based case-control study • Trnava region, Trnava and Skalica district hospitals • 3 years, 250 cases and controls • Newly diagnosed histologically confirmed cases, if possible at the beginning of treatment • Age and region matched controls by frequency matching

  13. Description of Slovak study – practical performance • Key collaborators in hospitals are head nurses, good collaboration with heads of oncology departments as well

  14. Possibilities forintervention • Based on study we expect to bring new field for breast cancer prevention among adolescents: • Increaseinformation campaigns in schools • Breast cancer awareness programs, risk factors, determinants • Involvment of pediatricians

  15. Summary • Work in progress, first experiences • Interest of clinicians from hospitals is crucial • High willingness of cases to participate • Implications for intervention

  16. Acknowledgement: The authors acknowledge a grant number R03 TW 06137 of Fogarty Center of NIH, USA which made the study possible

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