Early-Age Breast Cancer during Active Conflict in Syria: A Cross-Sectional Study

Abstract

OBJECTIVE: To examine the risk factors associated with breast cancer within a war-affected region enduring over a decade of conflict in Northwest Syria. METHODOLOGY: A cross-sectional study was conducted from January to December 2022. Inclusion criteria required patients to have a palpable breast mass confirmed by biopsy. Patients residing in the region for less than 5 years were excluded from the study. The study included 164 female patients, averaging 47.14±11.31 years. Data were collected through surveys during visits to the regional cancer center. Ten risk factors were analyzed: Age, family history, Age at menarche, age at menopause, body mass index, breastfeeding, age at first birth, smoking, hormonal contraceptive use, and psychological stress. Statistical analysis was performed using IBM SPSS Statistics 25. RESULTS: Among the breast cancer patients, 32.9% were ≤40 years old (mean = 34.7, SD = 4.35), 32.9% were 41-50 years old (mean = 46.3, SD = 2.75), and 34.1% were >50 years old (mean = 59.89, SD = 6.15). Significant correlations (p < 0.05) were found between all fixed and variable risk factors except smoking, age at menarche, and hormonal contraceptive use. CONCLUSION: Our study revealed a nearly ten-year decrease in the average age of breast cancer onset among our patients compared to global standards. Prolonged conflict is likely a key factor driving earlier and increased breast cancer cases in Syria's younger women. These findings highlight the need for targeted public health interventions and further research into the impact of chronic conflict on cancer epidemiology.

Keywords

• breast cancer
• early age
• risk factors
• stress
• protracted conflict