CC BY
0THE PROBLEM OF THE INFLUENCE OF ENVIRONMENTAL FACTORS ON THE DEVELOPMENT OF BREAST CANCER IN
WOMEN
1Sattarov Timur Farkhadovich, 2Babarakhimova Sayyora Borievna
1Tashkent Pediatric Medical Institute, Associate Professor 2Tashkent Pediatric Medical Institute, PhD https://doi.org/10.5281/zenodo.11424694
Annotatsiya. Maqolada saraton xavf bo'lgan odamni o'rab turgan atrof-muhit omillarining ta'siri muammosi ko'rib chiqiladi. Chekish, alkogol, kasbiy zararli moddalar, suv, havo, tuproq, oziq-ovqat, oziq-ovqat qo'shimchalari tarkibidagi kanserogenlar kabi toksik omillarning kanserogen ta'siri, ularning turli xil saraton patologiyalariningpaydo bo'lishiga ta'siri darajasi ko'rib chiqiladi.
Kalit so'zlar: ayollar, onkologiya, kanserogenlar, chekish, alkogolizm, ekologiya, oziq-ovqat qo'shimchalari.
Abstract. This article discusses the results of studying the impact of environmental factors surrounding a person at risk of developing breast cancer. The carcinogenic effect of such toxic factors as smoking, alcohol, occupational hazards, carcinogens contained in water, air, soil, food, food additives, the degree of their influence on the occurrence of breast cancer is considered.
Key words: women, oncology, carcinogens, smoking, alcohol, occupational hazards, ecology, food, food additives.
Аннотация. В статье рассматривается проблема влияния факторов внешней среды, окружающих человека с риском возникновением онкологических заболеваний. Рассматривается канцерогенное воздействие таких токсических факторов как курение, алкоголь, профессиональные вредности, канцерогены, содержащиеся в воде, воздухе, почве, продуктах питания, пищевых добавках, степень их влияния на возникновение различных видов онкологической патологии.
Ключевые слова: женщины, онкология, канцерогены, курение, алкоголизм, экология, пищевые добавки.
Relevance. Currently, oncological pathology is one of the most common and socially significant types of diseases. According to WHO statistics (2023), more than 1 million cases of breast cancer (breast cancer) among women are registered in the world per year. The incidence rate of breast cancer among women is 43.3 per 100,000 population. A cumulative risk factor can be defined as a set of threats from exposure to several agents, including biochemical, chemical, physical and psychosocial factors [2]. Exposure to a wide range of chemicals and other agents from various sources in daily life has become a serious problem due to many diseases, including cancer. There is enough information about the causes of cancer, it can be learned from studies of the nature of cancer in human populations and the induction of tumors in experimental animals with carcinogenic agents [3]. Cancer is a multifactorial disease due to the combined effects of both genetic and environmental factors. Environmental risk factors include all non-genetic factors such as diet, alcohol consumption, lifestyle, and infectious agents [4,15]. Tobacco use is one of the main identified environmental causes of cancer deaths worldwide, which affects the lungs and other organs such as the larynx, oral cavity, pharynx, esophagus, pancreas, kidney and mammary
gland [5]. An increased risk of cancer from smoking can also be caused by the interaction of other environmental carcinogens, such as alcohol consumption, exposure to asbestos and ionizing radiation in conjunction with smoking. Epidemiological studies conducted in populations with different levels of alcohol consumption have shown a risk of developing cancers of the oral cavity, esophagus, liver, breast, colon and rectum. Occupational cancer cases are detected mainly in developed countries due to the growth of unhealthy industries and the creation of new industries as part of rapid global industrialization, especially where standards and requirements in the field of health and safety may not be as strict. The assessment of the risk of cancer for humans arose as a result of exposure to chemicals, physical and biological agents such as asbestos, crystalline silica, heavy metals, mustard gas, 2-naphthylamine, dichloromethane, inorganic lead compounds, formaldehyde, 1,3-butadiene, etc. Environmental pollutants mainly belong to a certain group of cancer-causing factors, namely air, water and soil pollutants. Some of the main carcinogenic pollutants include indoor and urban air pollutants, as well as chlorination products and other pollutants of drinking water [11,13]. The assessment of the overall cancer risk due to environmental pollutants in developed countries is 8-9%. One of the main causes of lung cancer may be air pollution. The air can be polluted with a mixture of complex gases and components with different concentrations. Some of the atmospheric pollutants that lead to cancer include benzpyrene, benzene, some metals and, to some extent, ozone. The combustion products of automobile fuels are another major concern for an increased risk of cancer and other health problems. These include volatile organic compounds (benzene, toluene, xylenes and acetylene), nitrogen oxides and microparticles of solids (carbon, adsorbed organic substances, trace amounts of metallic compounds) [9,14]. Air pollution is a serious problem, especially in developing countries, more than in developed ones, due to the poorly regulated use of coal, wood for electricity generation and heating. Anxiety and depressive disorders are the main mental disorders in breast cancer [6, 7]. On the one hand, most women experience psychological distress during and after breast cancer treatment, resulting in high levels of anxiety and depression [12]. On the other hand, the development of pathopsychological symptoms may be due to the personal characteristics of women with breast cancer, which are widely described in the literature [13]. Given the huge risk of developing depression in cancer patients, it can be suggested to conduct early and prompt psychological intervention in order to eliminate the symptoms of depression [14].Based on these data, our study was conducted to identify the personal characteristics and psychoemotional state of breast cancer patients for further development of psychotherapeutic and rehabilitative treatment methods.
The aim of the study was to study the effect of environmental pollution on the incidence of breast cancer (breast cancer) in women and the level of anxiety and depression, taking into account the personal characteristics of patients.
Materials and methods of the study: 107 patients with breast cancer in stages I—III were examined on the basis of the Tashkent regional oncological dispensary. The average age is 40.5 ± 10.5 years. 107 sick women with a confirmed diagnosis of breast cancer were analyzed. When determining the factors influencing the development of breast cancer, heredity, hormonal disorders (the number of births, abortions and miscarriages, the use of contraceptives, stress, etc.), injuries, as well as environmental factors were taken into account. To establish the impact of environmental pollution by pesticides on the development of breast cancer, epidemiological studies were conducted taking into account environmental pollution by HOP. Studies of breast tumor tissue for the content of HOP were carried out on a gas-liquid chromatograph. All patients
received voluntary consent to participate in the study. Patients with suspected mental pathology and with pronounced character accentuations were not included in the study. All patients received a combined type of treatment: surgical, remote radiation or drug therapy. The study was conducted during the period of drug therapy. The following psychometric methods were used:
1) Hospital Anxiety and Depression Scale (HADS), developed by A. S. Zigmond and R. P. Snaith in 1983 to identify and assess the severity of anxiety and depression in general medical practice
2) The personal questionnaire of G.Eysenck (EPI)
The data obtained were processed using a statistical method.
Results. According to the clinical and psychological examination, the following results were revealed. Melancholics accounted for 32%, choleric -26%, phlegmatic-24%, sanguine-18%, the level of neuroticism was high in 58%, average -24% and low in 18%.Introverts 56% , extroverts 44% No false answers were found. According to the hospital anxiety and depression Scale (HADS), the presence of an anxiety-depressive state was found in 30.3% of patients. Increased anxiety was noted in all patients without exception. The clinical manifestation of the anxiety state was characterized by a predominance of tension, confusion, emotional lability and irritability were noted. A third of the patients were found to have a depressive statejanie (30.3%). The clinical picture of depressive symptoms was dominated by depression, low mood, melancholy, apathy, and tearfulness. Based on the data obtained, it can be revealed that melancholics were the predominant type of temperament, as well as more introverts than extroverts. According to the analysis of comparative data, it was found that anxiety and depressive personality disorders are more pronounced in introverts than in extroverts. It is also worth noting that there are differences in the type of temperament and the level of anxiety and depression. The level of anxiety and depression was higher in melancholics and choleric people, in phlegmatic and sanguine people these indicators were lower. Overall, the state of the evidence does not support a significant link between the environment and breast cancer risk. Mortality and incidence of breast cancer vary slightly across the country. The results of studies on the effects of organochlorine compounds are inconclusive; the most recent data from prospective analyses do not confirm the link with the development of breast cancer. Ionizing radiation is a known risk factor for breast cancer, but the levels to which the population is exposed are too low to cause an effect. Professional studies of EMF exposure have not yielded results; users of electric blankets may face an increased risk of morbidity compared to those who do not use them, but these results need to be repeated. Women exposed to secondhand smoke may face an increased risk of breast cancer, but there is no evidence of a dose effect, and the results of direct smoking studies are not as convincing. Based on biological hypotheses, the four pollutants discussed here are considered as potential risk factors for breast cancer. There may be other undetected environmental impacts that require assessment. Based on the available data, with the exception of ionizing radiation, no environmental exposure can be confidently called the cause of breast cancer.
Conclusions. Thus, the influence of environmental factors on the risk of breast cancer in women has been established. The study of the personal characteristics and psychoemotional state of breast cancer patients is an important component for choosing treatment tactics and achieving adherence to the therapy. Thus, the psychological features identified in this study will be necessary in determining the strategy of psychological care for breast cancer patients.
REFERENCES
1. Goldstein BY, Chang SC, Hashibe M, Vecchia CL, Zhang ZF. Alcohol consumption and cancer of the oral cavity and pharynx from 1988 to 2009: an update. Eur J Cancer Prev. 2010; 19 (6): 431- 65.
2. Ferlay J. Global burden of breast cancer [In Breast cancer epidemiology]. New York: Springer, 2010. Р. 1-19Boffetta P. Human cancer from environmental pollutants: the epidemiological evidence. Mutat Res Genet Toxicol Environ Mutagen. 2006;608(2):157-62.
3. McPherson K. Breast cancer-epidemiology, risk factors, and genetics // BMJ: British Medical Journal. 2000. Vol. 321. № 7261. Pp. 624-628. Weyer PJ, Cerhan JR, Kross BC, Hallberg GR, Kantamneni J, Breuer G, Jones MP, Zheng W, Lynch CF. Municipal drinking water nitrate level and cancer risk in older women: the Iowa women's health study. Epidemiology. 2001;11(3):327-38.
4. Vogt R, Bennett D, Cassady D, Frost J, Ritz B, Picciotto IH. Cancer and non-cancer health effects from food contaminant exposures for children and adults in California: a risk assessment. Environ Health. 2012;11:83-96
5. Zhang J, Huang Y, Wang X, Lin K, Wu K. Environmental polychlorinated biphenyl exposure and breast cancer risk: a meta-analysis of observational studies. PLoS One. 2015;10(11):1-18. 39. Ucar A, Yilmaz S. Saccharin genotoxicity and carcinogenicity: a review. Advances in food. Sciences. 2015;37(3):138-142
6. Depression and anxiety levels in woman under follow-up for breast cancer: relationship to coping with cancer and quality of life / О. Karakoyun-Celik [et al.] // Med. Oncol. — 2010.
— Vol. 27 (1). — P. 108-13.
7. Lim C. C. Anxiety in women with breast cancer undergoing treatment: a systematic review / С. С. Lim, M. K. Devi, E. Ang // Int. J. Evid. Based Healthc. — 2011. — Vol. 9 (3). — P. 215-35.
8. Vahdaninia M. What do predict anxiety and depression in breast cancer patients? A follow-up study / М. Vahdaninia, S. Omidvari, A. Montazeri // Soc. Psychiatry Psychiatr. Epidemiol.
— 2010. — Vol. 45 (3). — P. 355-61.
9. Sattarov T.F. Optimization of the rehabilitation of patients with paranoid schizophrenia/ Sciences of Europe .VOL 1, No 127 (2023) pg. 7-8
10. Sattarov T.F., Babarakhimova S.B. Early detection of teenage depression // Вестник интегративной психологии // Журнал для психологов. Вып. 29. /Под ред. В.В.Козлова, Ш.Р. Баратова, М.Н.Усмановой. - Бухара - Ярославль: МАПН, 2023. - 429 с.; с.328-321
11. Sattarov T.F. Relationship between depressive pathology and the personal characteristics of adolescents // The Norwegian Journal of development of the international science, No 117 (2023) pp. 34-39.
12. Sattarov T.F. et al. The influence of parenting styles on the formation of suicidal tendencies in children and adolescents // Human Factor Social Psychologist, No. 1 (45), 2023; P. 348-353.
13. Sattarov T.F., Babarakhimova S.B. Efficacy of art therapy in adolescents // Вестник интегративной психологии // Журнал для психологов. Вып. 30 /Под ред. В.В. Козлова, Ш.Р. Баратова, М.Н. Усмановой. - Бухара - Ярославль: МАПН, 2023. - 416 с.; с.279-283
14. Sattarov T.F. Integrative methods of psychotherapy in adolescents // Science and innovation international scientific journal volume 2 issue 2 2024, pp. 40-44
15. Yancik R. Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older // Jama. 2001. Vol. 285. № 7. P. 885-892.
