Research Article

Environmental Risk factors associated with Breast Cancer in Gaza Strip

Jamal Safi* and Asad Ashour

Published: 14 January, 2019 | Volume 3 - Issue 1 | Pages: 001-009

The study aimed to identify possible environmental risk factors for breast cancer among women in Gaza Strip and conducted in 2010. A case- control study design was used with face to face interviews by structured questionnaire with breast cancer patient women as well as healthy women. Statistical Package of Social Science (SPSS) was used to analyze the collected data. The study population was 288 women, 144 were women with breast cancer (cases) and 144 were healthy women (controls) with response rate 100% for cases as well as controls. The study was carried out in the two main hospitals in Gaza Strip (El-Shifa and European Gaza) and on cases who had a regular follow up in each hospital, while controls have been chosen from women who had no history of breast cancer by mammogram or by self-examination. In this study the main statistically significant risk factors were; marital status, educational status, physical trauma on breast, medication for infertility treatment, eating red meat 500g or more weekly, eating canned food, eating chicken skin, eating raw and cooked vegetables, using oils with saturated fats in cooking, living in or beside a farm, dealing with crops with naked hands, working in a farm during pesticides application or during 24 hours of pesticides application, cleaning pesticides’ equipment, living with people working in a farm or a agricultural field, and application of pesticides personally. In contrary, no statistically significant differences were found between cases and controls in relation to area of residency, exposure to X-ray in the past, having radiation therapy, getting contraceptive pills, using hair dyes, using anti-deodorant underarm, using facial cosmetics, using hair removal ointment, washing vegetables and fruits, buying and transporting pesticides, and wearing protective tools during pesticides mixing and application.

Read Full Article HTML DOI: 10.29328/journal.afns.1001017 Cite this Article Read Full Article PDF


  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers CD, Parkin D. GLOBOCAN 2008, Cancer incidence and mortality Worldwide: IARC Cancer base No. 10. International Agency for Research on Cancer. Ref.: https://goo.gl/yXoN1k
  2. Breast cancer in Eastern Mediterranean Region. Paper presented at the international symposium on breast cancer in developing world: meeting the unforeseen challenge to women, health, and equity. 2009;
  3. Salim JM, Moore MA, Al-lawati JA, Al-sayad J, Bawazir A, et al. Cancer epidemiology and control in Arab World-past, present and future. Asian Pac J Cancer Prev. 10: 3-16. Ref.: https://goo.gl/6EcCof
  4. Ministry of Health. The status of health in Palestine. Annual report. Palestine.
  5. Richter ED, Safi J. Pesticide use, exposure, and risk. A joint Israeli-Palestinian perspective. Environ Res. 37: 211-218. Ref.: https://goo.gl/en8VTt
  6. Safi JM. Association between chronic exposure to pesticides and recorded cases of human malignancy in Gaza Governorates (1990-1999). Sci Total Environ 284: 75-84. Ref.: https://goo.gl/6ZqWuV
  7. Cancer Registry Center, 2010. Cancer Status in Palestine, Gaza Strip, Palestine.
  8. Key TJ, Verkasalo PK, Banks E. Epidemiology of breast cancer. The Lancet Oncology. 2001; 2: 133-140. Ref.: https://goo.gl/NpYMbD
  9. Saeed E, Isa S. Risk factors of breast cancer among women (A sample from Baghdad). Iraqi J Comm Med. 2013; 1: 1-6. Ref.: https://goo.gl/rvwmkQ
  10. Cauchi JP, Camilleri L, Scerri C. Environmental and lifestyle risk factors of breast cancer in Malta-a retrospective case-control study. EPMA J. 2016; 7: 20. Ref.: https://goo.gl/V7jqFo
  11. Gray J. State of the evidence; the connection between breast cancer and the environment. 5th edition, Breast Cancer Fund. 2010; 14.
  12. Charlier CJ, Dejardin MTC. Increased risk of relapse after breast cancer with exposure to organochlorine pollutants. Bull Environ Contam Toxicol. 2007; 78: 1-4. Ref.: https://goo.gl/n745Yk
  13. Watts M. Pesticides and Breast Cancer: A wake up call. PNA, Asia and the Pacific: Malaysia 2007; 61-101. Ref.: https://goo.gl/B51nsz
  14. Rodgers KM, Udesky JO, Rudel RA, Brody JG. Environmental chemicals and breast cancer: An updated review of epidemiological literature informed by biological mechanisms. Environ Res. 2018; 160: 152-182. Ref.: https://goo.gl/79Fks3
  15. Safi JM. The state of the environment in Gaza Strip. Alex Sci. 1998; 19: 137-150. Ref.: https://goo.gl/d6eRh2
  16. Safi JM, El-Nahhal YZ, Soliman SA, El-Sebae AH. Mutagenic and carcinogenic pesticides used in Gaza Strip agricultural environment. The Science of the Total Environment. 1993; 123:371-380. Ref.: https://goo.gl/7GtZZm
  17. Shomar BH, Muller G, Yahya A. Occurrence of pesticides in ground water and topsoil of The Gaza Strip. Water, Air, and Soil Pollution Journal. 2006; 171: 237-251. Ref.: https://goo.gl/W6Fhkn
  18. Statistical Package for Social Science, 2007. Inc. Chicago, USA.
  19. Pakseresh S, Ingle GA, Bahadur AK, Rameteke VK, Sighn MM, et al. Risk factors with breast cancer among women in Delhi. Indian J Cancer. 2009; 46: 132-138. Ref.: https://goo.gl/q2wHeu
  20. Hinyard L, Wirth LS, Clancy JM, Schwartz T. The effect of marital status on breast cancer-related outcomes in women under 65: A SEER database analysis. Breast. 2017; 32: 13-17. Ref.: https://goo.gl/qiM6XW
  21. Darweesh A. Risk factors of breast cancer among Palestinian women in North West Bank. MSc Thesis, An-Najah National University, Nablus, Palestine. 2009; Ref.: https://goo.gl/CjsEzF
  22. Rigby JE, Morris JA, Lavelle J, Stewart M, Gatell AC. Can physical trauma cause breast cancer? European J of Cancer Prevention. 2002; 11: 307-311. Ref.: https://goo.gl/qeKW1S
  23. Memon Z, Ain Q, Khan R, Raza N, Noor T. Clinical presentation and frequency of risk factors in patients with breast carcinoma in Pakistan. Asian Pac J Cancer Prev. 2015; 16: 7467-7472. Ref.: https://goo.gl/jp4X4j
  24. Brinton LA, Scoccia B, Moghissi KS, Westhoff CL, Althuis MD, et al. Breast cancer risk associated with ovulation-stimulating drugs. Hum Reprod. 2005; 19: 2005-2013. Ref.: https://goo.gl/wyvm3j
  25. Reigstad MM, Storeng R, Myklebust TÅ, Oldereid NB, Omland AK, et al. Cancer risk in women treated with fertility drugs according to parity status- A registry-based cohort study. Cancer Epidemiol Biomarkers Prev. 2007; 26: 953-962. Ref.: https://goo.gl/AWJr99
  26. Linos E, Willett WC, Cho E, Golditz, Frazier LA. Red meat consumption during adolescence among premenopausal women and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 2008; 17: 2146-2151. Ref.: https://goo.gl/cqYxTt
  27. Sierris S, Krogh V, Ferrari P, Berrino F, Pala V, et al. Dietary fat and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition. Am J Clan Nut. 2008; 88: 1304-1312. Ref.: https://goo.gl/mxaJ5R
  28. National Cancer Institute. Chemicals in meat cooked at high temperature and cancer risk. 2011; Ref.: https://goo.gl/pifPMb
  29. Norat T, Riboli E. Meat consumption and colorectal cancer: a review of epidemiologic evidence. Nut Rev. 2001; 59: 37-47. Ref.: https://goo.gl/mC7aDY
  30. Dioxins and their effects on human health. Fact sheet 225. 2007;
  31. Safi JM, Abou-Foul NS, El-Nahal Y, El-Sebae AH. Monitoring of pesticide residues on green pepper, potatoes, vice faba, green bean and green peas in Gaza Governorates, Palestine. J Pest cont Environ Sci. 2001; 9: 55-72 Ref.: https://goo.gl/9GHgjL
  32. Thiebaut AC, Kipnis V, Chang SC, Subar AF, Thompson FE, et al. Dietary fat and postmenopausal invasive breast cancer in the National Institute of Health- AARP Diet and Health Study Cohort. J Nati Cancer Inst. 2007; 99: 451-462. Ref.: https://goo.gl/KgJZ1V
  33. Balasubramaniam SM, Rotti SB, Vivekanandam S. Risk factors of female breast carcinoma: a case control study at Puducherry. Indian J Cancer. 2013; 50: 65-70. Ref.: https://goo.gl/9kmRJU
  34. Brotons JA, Olea-Serrano MF, Villalobos M, Pedraza V, Olea N. Xenoestrogen released from lacquer coating in food cans. Environ Health Perspect. 1995; 103: 608-612. Ref.: https://goo.gl/AujTwf
  35. Duell EJ, Millikan RC, Savitz DA, Newman B, Smith JC, et al. A population- based case- control study of farming and breast cancer in North Carolina. Epidemiol. 2000; 11: 523-531. Ref.: https://goo.gl/Hx6NJk
  36. Ferro R, Parvathaneni A, Patel S, Cheriyath P. Pesticides and Breast Cancer. Advances in Breast Cancer Research. 2012; 1: 30-35. Ref.: https://goo.gl/gSbSNh
  37. Brophy JT, Keith MM, Gorcy KM, Laukkanen E, Hellyer D, et al. Occupational histories of cancer patients in a Canadian cancer treatment center and general hypothesis regarding breast cancer and farming. Int J Occup Environ Health0 2002; 8: 346-353. Ref.: https://goo.gl/Z3GmmT
  38. Engel LS, Hill DA, Hoppin JA, Lubin JH, Alavanja MC. Pesticides and breast cancer risk among farmers' wives in the agricultural health study. Am J Epidemiol. 2005; 161: 121-135. Ref.: https://goo.gl/HK5ydm
  39. Band PR, Le ND, Fang R, Deschamps M, Gallagher RP, et al. Identification of occupational cancer risk in British Columbia: a population-based case-control study of 995 incident breast cancer cases by menopausal status, controlling for confounding factors. J Occup Environ Med. 2002; 42: 284-310. Ref.: https://goo.gl/4itZ3E

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?