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Stand / Letzte Aktualisierung durch Elisabeth Rieping 2004/07/27 back In general , the countries of Western civilisation and high economic standard show a high incidence rate, except of Japan, where the incidence was low [i], although the country was comparable in standard of living and collecting data. The other less well known exception probably is the North of Sudan, which, in spite of severe underdevelopment, is said to have a very high incidence of breast cancer [ii],[iii]. In the following I show that those differencesin breast cancer incidence may be explainable by the availability of dairy products to infants. The lowest incidence of breast cancer probably was seen in traditionally living Cancadian Eskimos among which the first case of mammary carcinoma was described in 1968 [iv], although almost 100% were regularly medically checked, including X-ray, because of the high prevalence of tuberculosis [v]. In the report of the International Union Against Cancer, the incidence in five continents were compared for site of occurrence and adjusted to different standard populaions, African, European and World [vi]. In that time, Japan, and the Chinese population of Singapore were showing the lowest incidence of developed countries. Both ethnics did not use cows milk as food [vii],[viii], neither for infants nor for adults, until Western influence produced a change [ix]. In the report of the International Union against Cancer only the Chinese of Singapore were included for comparison. But now there are also data conserning the Indian and the Malaysian population [x].
The malaysians were not easy to compare as they still prefered their traditional medicine. But between Chinese and Indian descendants no difference in using health facilities were observed. Both groups showed low incidence rates. But the Indian incidence rate of 30,4 cases per 100.000 was a third higher than the 18.2 found among Chinese population (Diagnosed between 19681970). In comparison to the Chinese kitchen, the Indian one knows many milk dishes which can be verified by every Indian cooking book and it is possible that the Indian infant has more access to cows milk than a Chinese one, even if both are breast-fed. Similar relations were found when looking for antibodies against MMTV. While there were less than 5% positive sera in Chinese breast cancer patient. Antibodies could be demonstrated in 37% of Indian breast cancer patients[xi]. From molecular biology there is aditional evidence that there might be an infectious agent in Western population that did not yet infect women who during infancy lived in an East Asian Country that shielded its population from many foreign influences. Vietnam is a East Asian country whoose inhabitants traditionally did not use bovine milk as food. And it is one of the regions where Western eating habits probably were prohibited from spreading in the past. Its inhabitants and refugees did not yet experience the rise in breast cancer incidence[xii],[xiii], that could be observed in other countries. Using PCR and primers that amplify gene sequences of MMTV tissue from Caucasian-Australian, Vietnamese-Australian, and Vietnamese women was tested and it was found that MMTV-like gene sequences were amplified in 19 of 45 (42.2%) archival breast cancer biopsy tissues from Caucasian-Australian women, but only 1 of 120 (0.8%) and 0 of 41 breast cancer biopsy tissues from Vietnamese and Vietnamese-Australian women from the first immigrant generation, respectively. The same sequences were found in only 2 of 111 and 0 of 60 non cancerous breast tissue samples from Australian and Vietnamese women, respectively. A result that would be in accordance with an exogenous virus which did not yet penetrate all populations[xiv]. The lowest incidence rates were collected from some but not all African regions [xv]. In Lourenco Marques, today called Maputo in Mozambique, Ibadan in the South of Nigeria, among the Bantu population of Johannesburg, and in Kyadondo in Uganda, breast cancer was a rare disease.
Ibadan in Nigeria lies in the region inhabited by the tsetse fly which forbade the rearing of cattle until the invention of insecticides. At that time milk products were not available. In Kyadondo incidence rates were further listed for different subgroups of the population. Kyadondo lies around the the Lake Victoria and at the time of the study was inhabited by immigrants from many parts of Uganda besides the aboriginal Ganda tribe. The incidence rates for people born in the region and those of immigrants were compared for the incidence rates of selected sites. There were no substantial differences for both groups besides breast cancer and leukemias, which were about doubled in the immigrants. That contrasted surprisingly to the highly uniform incidence rates seen in both groups for the other sites. [xvi].
The aboriginal Ganda tribe was not used to rearing cattle, as the region aroud Lake Viktoria was spoiled by trypanosoma rhodiense which is passed on by the tsetse fly. In contrast, the immigrant popuation stemed from a number of different tribes, among those Nilo-Hamitic pastoralists. Trypnosoma rhodiense is not found in all Uganda, and in other parts of the country the rearing of cattle occured and an immigrant in her infancy might have had come into contact with cows milk. There exists some information on the extent of cattle breeding by Bantus in general, suggesting that the habit was acquiered from Nilo Hamitic tribes not to long ago and that the new habit was not so important for the production of food but for demonstrating wealth and importance of the owner [xvii],[xviii]. Women of childbearing age were very restricted in their access to milk and cattle and the production of butter as body lotion being commen among Nil Hamitic tribes was not observed [xix]. In contrast to these four African regions, the Sudan is said to have had a high frequency of breast cancer [xx],[xxi],[xxii]. The Nilo Hamitic tribes living in this region are known for their intensive contact to cattle, and their animals play a major part in the economic life. Milk products are used as food, medicine, and body lotion, whilst the cows urin serves to clean dishes. Some tribes drink the fresh blood often mixed with milk. So there may be many chances for a new born infant to get infected by a bovine virus.
No incidence rates have been collected, but ist is interesting that the high incidence of disease is said to stop in the South[xxiii], the region of the tsetse fly, which restricts the rearing of cattle. The age of breast cancer patients in Khartoum is similar to that of patients in developed countries [xxiv] where older, postmenopausal patients are predominant. In countries where the eidemic rise in breast cancer incidence has not been observed the rate does not increase with age. Instead the incidence curve levels off after menopause[xxv], a phenomenon called Clemmensens hook. In Ethopia nearly half of the population is said to belong to tribes who use food similar to those of Nilo-Hamites. The women use butter as body lotion soon after birth [xxvi]. In Addis Abeba the capital of Ethopia among 4640 hospital admission, male and female, there were five breast cancer patients [xxvii]. In the further south lying district Ukambeni in Kenya, a Bantu region, there was no case among 12,475 patients 23% of whom were adult females[xxviii]. In studies on antibodies against MMTV reactivity could be demonstrated in 61% of breast cancer patients and in 26.9% of healthy donors of the region [xxix].
[i] Segi M, Kurihara M, Matsujama T. Cancer Mortality in Japan, 1899-1962. Dep pof Public Health, Tokuho Univers School of Med, Sendai, Japan [ii]Burkitt G. Geographical Distribution of Cancer in East Africa. In: Racial and geographical factors in tumor incidence. Ed.: Shivas AA, Edinburgh, University press: 147-151, 1967. [iii] Hickey BB. Malignant Epithelial Tumours in the Sudanese. Ann R Coll 24: 303-322, 1959. [iv] Schaefer O. Cancer of the Breast and Lactaton. Canad Med Ass J 100: 625-626, 1969. [v] Schaefer O, Hildes JA, Medd LM, cameron DG. The changing pattern of neoplastic disease in Canadian Eskimos. Canad Med Ass J 112: 13991404, 1975. [vi] Doll R, Payne P, Waterhouse J. Cancer Incidence in five Continents. Springer Verlag, Berlin Heidelberg New York, 1966.
[vii] Hahn E. Die Haustiere und ihre Beziehungen zur Wirtschaft des Menschen. Leipzig ,1896. [viii] Sauer CO.Agricultural Origins and Dispersals. Am Geograph Soc, 1952.
[ix] Oiso T. Incidence of stmac cancer and ist ralation to dietary habits and nutrition in Japan between 1900 and 1975. Cancer Res 35: 3254-3258, 1975. [x] Shanmugaratnam K. Cancer in singapore-Ethnic and dialect group variations in cancer incidence. Singapore Med J 14: 69-81, 1973. [xi] Day NK, Witkin SS, Sarkar NH, Kinne D, Jussawalla DJ, Levin A, Hsia CC, Geller N, Good RA. Antibodies reactive with murine mammary tumor virus in sera of patients with breast cancer: geographic and family studies. Proc Natl Acad Sci U S A. 1981 Apr;78(4):2483-7. [xii] Anh PT, Parkin DM, Hanh NT, Duc NB. Cancer in the population of Hanoi, Vietnam, 1988-1990. Br J Cancer. 1993 Dec;68(6):1236-42. [xiii] Nguyen MQ, Nguyen CH, Parkin DM. Cancer incidence in Ho Chi Minh City, Viet Nam, 1995-1996. Int J Cancer. 1998 May 18;76(4):472-9.. [xiv] Ford CE, Tran D, Deng Y, Ta VT, Rawlinson WD, Lawson JS. Mouse mammary tumor virus-like gene sequences in breast tumors of Australian and Vietnamese women. Clin Cancer Res. 2003 Mar;9(3):1118-20. [xv] Doll R, Payne P, Waterhouse J. Cancer Incidence in five Continents. Springer Verlag, Berlin Heidelberg New York, 1966 [xvi] Davies JNP, Knowelden J, Wlson BA. Incidence rates of cancer in Kyadondo county, Uganda, 1954-1960. J Nat Cancer Inst 35: 798-821, 1965. [xvii] Baumann H, Thurnwald R, Westermann D, Völkerkunde von Afrika. Essen 1940. [xviii] Simoons F, The non-milking area of Africa. Anthropos 49: 58-66, 1954. [xix] Kroll H. die Haustiere der Bantu. Zeitschrift für Ethnologie 60: 170-290, 1928.
[xx] Burkitt G. Geographical Distribution of Cancer in East Africa. In: Racial and geographical factors in tumor incidence. Ed.: Shivas AA, Edinburgh, University press: 147-151, 1967. [xxi] Hickey BB. Malignant Epithelial Tumours in the Sudanese. Ann R Coll 24: 303-322, 1959. [xxii] Daoud EH, El hassan AM, Zak F, Zakova N. Aspects of Malignant Disease in the Sudan. In Cancer in Africa. Ed.: Clifford P, Lindell CA, Timm GL, Nairobi, East African Publishing House, 43-50, 1968. [xxiii] Hickey BB. Malignant Epithelial Tumours in the Sudanese. Ann R Coll 24: 303-322, 1959. [xxiv] Hamad HMA. A preliminary Report on the Role of Tamoxifen in Advanced Breast Cancer in the Sudan. Arab Med J: 1-3, 1986. [xxv] Clemmensen j. Statistical Studies in the aetiology of malignent neoplasms. In : The Breast, Acta Pathol Microbiol Scand Suppl 174: 1-543, 1965. [xxvi] Haberland E. Galla Süd-Äthiopiens. Stuttgart, W.Kohlhammer Verlag, 1963 [xxvii] Lester FT, Tsega E. The Pattern of Adult Medical Admissoins in Addis Abeba, Ethiopia. Aest African Med J 53: 620-634, 1976. [xxviii] Oomen L. Disease Pattern in Ukambani, Kenya. East African Med J 53341-349, 1976. [xxix] Day NK, Witkin SS, Sarkar NH, Kinne D, Jussawalla DJ, Levin A, Hsia CC, Geller N, Good RA. Antibodies reactive with murine mammary tumor virus in sera of patients with breast cancer: geographic and family studies. Proc Natl Acad Sci U S A. 1981 Apr;78(4):2483-7.
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