Early Alcohol Use Initiation, Obesity, Not Breastfeeding, and Residence in a Rural Area as Risk Factors for Breast Cancer: A Case-Control Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Sample Size Calculation
2.2. Lifestyle Assessment
2.3. Statistical Analysis
3. Results
4. Discussion
Limitation
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Bray, F.; Me, J.F.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA A Cancer J. Clin. 2018, 68, 394–424, Erratum in 2020, 70, 313. [Google Scholar] [CrossRef] [Green Version]
- Pantavos, A.; Ruiter, R.; Feskens, E.; De Keyser, C.E.; Hofman, A.; Stricker, B.H.; Franco, O.H.; Jong, J.C.K.-D. Total dietary antioxidant capacity, individual antioxidant intake and breast cancer risk: The Rotterdam study. Int. J. Cancer 2014, 136, 2178–2186. [Google Scholar] [CrossRef]
- Barnard, M.E.; Boeke, C.E.; Tamimi, R.M. Established breast cancer risk factors and risk of intrinsic tumor subtypes. Biochim. Biophys. Acta (BBA) Bioenerg. 2015, 1856, 73–85. [Google Scholar] [CrossRef] [PubMed]
- Pechlivani, F.; Vivilaki, V. Breastfeeding and breast cancer. Health Sci. J. 2012, 6, 610. [Google Scholar]
- Tavani, A.; Gallus, S.; La Vecchia, C.; Negri, E.; Montella, M.; Maso, L.D.; Franceschi, S. Risk factors for breast cancer in women under 40 years. Eur. J. Cancer 1999, 35, 1361–1367. [Google Scholar] [CrossRef]
- Jernstrom, H.; Lubinski, J.; Lynch, H.T.; Ghadirian, P.; Neuhausen, S.; Isaacs, C.; Weber, B.L.; Horsman, D.; Rosen, B.; Foulkes, W.; et al. Breast-feeding and the Risk of Breast Cancer in BRCA1 and BRCA2 Mutation Carriers. J. Natl. Cancer Inst. 2004, 96, 1094–1098. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Brennan, S.F.; Cantwell, M.M.; Cardwell, C.; Velentzis, L.S.; Woodside, J. Dietary patterns and breast cancer risk: A systematic review and meta-analysis. Am. J. Clin. Nutr. 2010, 91, 1294–1302. [Google Scholar] [CrossRef] [Green Version]
- Kellen, E.; Vansant, G.; Christiaens, M.-R.; Neven, P.; Van Limbergen, E. Lifestyle changes and breast cancer prognosis: A review. Breast Cancer Res. Treat. 2008, 114, 13–22. [Google Scholar] [CrossRef]
- Parekh, N.; Jiang, J.; Buchan, M.; Meyers, M.; Gibbs, H.; Krebs, P. Nutrition Literacy among Cancer Survivors: Feasibility Results from the Healthy Eating and Living Against Breast Cancer (HEAL-BCa) Study: A Pilot Randomized Controlled Trial. J. Cancer Educ. 2017, 33, 1239–1249. [Google Scholar] [CrossRef] [PubMed]
- Veer, P.V.; Hermus, R.J.J.; Kok, F.J.; Sturmans, F. Alcohol Dose, Frequency and Age at First Exposure in Relation to the Risk of Breast Cancer. Int. J. Epidemiol. 1989, 18, 511–517. [Google Scholar] [CrossRef]
- Kim, H.J.; Jung, S.; Eliassen, A.H.; Chen, W.Y.; Willett, W.C.; Cho, E. Alcohol Consumption and Breast Cancer Risk in Younger Women According to Family History of Breast Cancer and Folate Intake. Am. J. Epidemiol. 2017, 186, 524–531. [Google Scholar] [CrossRef]
- Sinclair, J.; McCann, M.; Sheldon, E.; Gordon, I.; Brierley-Jones, L.; Copson, E. The acceptability of addressing alcohol consumption as a modifiable risk factor for breast cancer: A mixed method study within breast screening services and symptomatic breast clinics. BMJ Open 2019, 9, e027371. [Google Scholar] [CrossRef] [PubMed]
- Wnuk, M.; Purandare, B.; Marcinkowski, J.T. Structure of alcohol consumption in Poland in a historical perspective. Probl. Hig. Epidemiol. 2013, 94, 446–450. [Google Scholar]
- Ilic, M.; Vlajinac, H.; Marinkovic, J. Breastfeeding and Risk of Breast Cancer: Case-Control Study. Women Health 2015, 55, 778–794. [Google Scholar] [CrossRef] [PubMed]
- Kotsopoulos, J.; Lubinski, J.; Salmena, L.; Lynch, H.T.; Kim-Sing, C.; Foulkes, W.D.; Ghadirian, P.; Neuhausen, S.L.; Demsky, R.; Tung, N.; et al. the Hereditary Breast Cancer Clinical Study Group; Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res. 2012, 14, R42. [Google Scholar] [CrossRef] [Green Version]
- Polki Krótko Karmią Dziecko Piersią. Available online: https://pulsmedycyny.pl/polki-krotko-karmia-dziecko-piersia-936361 (accessed on 1 August 2018).
- World Cancer Research Found/American Institute for Cancer Research. Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Prospective; AICR: Washington, DA, USA, 2007. [Google Scholar]
- Anderson, J.J.; Darwis, N.D.; Mackay, D.F.; Celis-Morales, C.A.; Lyall, D.M.; Sattar, N.; Gill, J.M.; Pell, J.P. Red and processed meat consumption and breast cancer: UK Biobank cohort study and meta-analysis. Eur. J. Cancer 2018, 90, 73–82. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hanf, V.; Gonder, U. Nutrition and primary prevention of breast cancer: Foods, nutrients and breast cancer risk. Eur. J. Obstet. Gynecol. Reprod. Biol. 2005, 123, 139–149. [Google Scholar] [CrossRef]
- Cárdenas-Cárdenas, E.; Tenorio-Torres, A.; Méndez, J.P.; Orozco-Arguelles, L.; Leal-García, M.; Tejeda, M.E.; Morales, A.; Canto, P. Different body mass indexes and their relation to prognosis of early-stage breast cancer in postmenopausal Mexican-Mestizo women. Women Health 2020, 61, 210–217. [Google Scholar] [CrossRef]
- Cohn, B.A.; Wolff, M.S.; Cirillo, P.M.; Sholtz, R.I. DDT and Breast Cancer in Young Women: New Data on the Significance of Age at Exposure. Environ. Health Perspect. 2007, 115, 1406–1414. [Google Scholar] [CrossRef] [PubMed]
- Kosiński, K. i Instytut Historii Polskiej Akademii Nauk. Alkohol w PRL. Instytut Historii PAN, 2020. Available online: http://rcin.org.pl/Content/152383/WA303_187507_B155-Polska-T-18-2020_Kosinski.pdf (accessed on 12 December 2020).
- NCD Risk Factor Collaboration (NCD-RisC). Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature 2019, 569, 260–264. [Google Scholar] [CrossRef] [Green Version]
- Gacek, M. Selected health habits of the group of women in the rural and urban environment according to their socio-economic and nutritional status. Probl. Hig. Epidemiol. 2011, 92, 260–266. [Google Scholar]
- Ronco, A.L.; De Stefani, E.; Stoll, M. Hormonal and metabolic modulation through nutrition: Towards a primary prevention of breast cancer. Breast 2010, 19, 322–332. [Google Scholar] [CrossRef]
- Schlesselman, J.J. Case-Control Studies: Design, Conduct, Analysis; Oxford University Press: New York, NY, USA, 1982; pp. 1–368. [Google Scholar]
- Alkohol a Młodzież. Available online: http://www.parpa.pl/download/rozdzial05.pdf (accessed on 1 January 2007).
- Janssens, J.; Vandeloo, M. Breast cancer: A life-time disease. Direct and indirect age-related lifestyle risk factors. J. Oncol. 2009, 59, 159–167. [Google Scholar]
- Liu, Y.; Nguyen, N.; Colditz, G.A. Links between Alcohol Consumption and Breast Cancer: A Look at the Evidence. Women’s Health 2015, 11, 65–77. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Charles, D.; Ness, A.R.; Campbell, D.; Smith, G.D.; Hall, M.H. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004, 329, 1375–1376. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chen, W.Y.; Rosner, B.; Hankinson, S.E.; Colditz, G.; Willett, W.C. Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk. JAMA 2011, 306, 1884–1890. [Google Scholar] [CrossRef] [Green Version]
- Smith-Warner, S.A.; Spiegelman, D.; Yaun, S.-S.; Brandt, P.V.D.; Folsom, A.R.; Goldbohm, R.A.; Graham, S.; Holmberg, L.; Howe, G.R.; Marshall, J.R.; et al. Alcohol and Breast Cancer in Women: A pooled analysis of cohort studies. JAMA 1998, 279, 535–540. [Google Scholar] [CrossRef] [Green Version]
- Hamajima, N.; Hirose, K.; Tajima, K.; Rohan, T.; Calle, E.E.; Heath, C.W., Jr.; Coates, R.J.; Liff, J.M.; Talamini, R.; Chantarakul, N.; et al. Collaborative Group on Hormonal Factors in Breast Cancer Alcohol, tobacco and breast cancer—Collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br. J. Cancer 2002, 87, 1234–1245. [Google Scholar] [CrossRef] [PubMed]
- Stolzenberg-Solomon, R.Z.; Chang, S.-C.; Leitzmann, M.F.; Johnson, K.A.; Johnson, C.C.; Buys, S.S.; Hoover, R.N.; Ziegler, R.G. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am. J. Clin. Nutr. 2006, 83, 895–904. [Google Scholar] [CrossRef]
- Iwase, M.; Matsuo, K.; Koyanagi, Y.N.Y.; Ito, H.; Tamakoshi, A.; Wang, C.; Utada, M.; Ozasa, K.; Sugawara, Y.; Tsuji, I.; et al. Alcohol consumption and breast cancer risk in Japan: A pooled analysis of eight population-based cohort studies. Int. J. Cancer 2021, 148, 2736–2747. [Google Scholar] [CrossRef]
- Hong, J.; Holcomb, V.B.; Dang, F.; Porampornpilas, K.; Núñez, N.P. Alcohol consumption, obesity, estrogen treatment and breast cancer. Anticancer Res. 2010, 30, 1–8. [Google Scholar]
- Resler, K.; Cichosz, D. The abuse of alcohol by children and young people in Poland and in the world. Pediatr. Med. Rodz. 2015, 11, 295–301. [Google Scholar] [CrossRef]
- Inchley, J.C.; Currie, D.B.; Vieno, A.; Torsheim, T.; Ferreira-Borges, C.; Weber, M.; Barnekow, V.; Breda, J. Adolescent Alcohol-Related Behaviours: Trends and Inequalities in the WHO European Region, 2002–2014; WHO Regional Office for Europe: København, Danemark, 2018. [Google Scholar]
- Islami, F.; Liu, Y.; Jemal, A.; Zhou, J.; Weiderpass, E.; Colditz, G.; Boffetta, P.; Weiss, M. Breastfeeding and breast cancer risk by receptor status—A systematic review and meta-analysis. Ann. Oncol. 2015, 26, 2398–2407. [Google Scholar] [CrossRef]
- Shema, L.; Ore, L.; Ben-Shachar, M.; Haj, M.; Linn, S. The association between breastfeeding and breast cancer occurrence among Israeli Jewish women: A case control study. J. Cancer Res. Clin. Oncol. 2007, 133, 539–546. [Google Scholar] [CrossRef]
- Ambrosone, C.B.; Zirpoli, G.; Ruszczyk, M.; Shankar, J.; Hong, C.-C.; McIlwain, D.; Roberts, M.; Yao, S.; McCann, S.E.; Ciupak, G.; et al. Parity and breastfeeding among African-American women: Differential effects on breast cancer risk by estrogen receptor status in the Women’s Circle of Health Study. Cancer Causes Control 2013, 25, 259–265. [Google Scholar] [CrossRef] [PubMed]
- Millikan, R.C.; Newman, B.M.; Tse, C.-K.; Moorman, P.G.; Conway, K.; Smith, L.V.; Labbok, M.; Geradts, J.; Bensen, J.T.; Jackson, S.; et al. Epidemiology of basal-like breast cancer. Breast Cancer Res. Treat. 2007, 109, 123–139, Erratum in 2008, 109, 141. [Google Scholar] [CrossRef] [PubMed]
- Romieu, I.I.; Amadou, A.; Chajes, V. The Role of Diet, Physical Activity, Body Fatness, and Breastfeeding in Breast Cancer in Young Women: Epidemiological Evidence. Rev. Investig. Clínica. 2017, 69, 193–203. [Google Scholar] [CrossRef]
- Kwan, M.L.; Bernard, P.S.; Kroenke, C.H.; Factor, R.E.; Habel, L.; Weltzien, E.K.; Castillo, A.; Gunderson, E.P.; Maxfield, K.S.; Stijleman, I.J.; et al. Breastfeeding, PAM50 Tumor Subtype, and Breast Cancer Prognosis and Survival. J. Natl. Cancer Inst. 2015, 107, djv087. [Google Scholar] [CrossRef] [Green Version]
- Russo, J.O.S.E.; Russo, I.H. Differentiation and breast cancer. Medicina (B Aires) 1997, 57, 81–91. [Google Scholar] [PubMed]
- Lipworth, L.; Bailey, L.R.; Trichopoulos, D. History of breast-feeding in relation to breast cancer risk: A review of the epidemiologic literature. J. Natl. Cancer Inst. 2000, 92, 302–312. [Google Scholar] [CrossRef] [Green Version]
- Chajès, V.; Romieu, I. Nutrition and breast cancer. Maturias 2014, 77, 7–11. [Google Scholar] [CrossRef] [PubMed]
- Neuhouser, M.L.; Aragaki, A.K.; Prentice, R.L.; Manson, J.E.; Chlebowski, R.T.; Carty, C.L.; Ochs-Balcom, H.M.; Thomson, C.A.; Caan, B.; Tinker, L.F.; et al. Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials. JAMA Oncol. 2015, 1, 611–621. [Google Scholar] [CrossRef] [PubMed]
- Renehan, A.G.; Tyson, M.; Egger, M.; Heller, R.; Zwahlen, M. Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies. Lancet 2008, 371, 569–578. [Google Scholar] [CrossRef]
- Harvie, M.; Howell, A.; Vierkant, R.; Kumar, N.; Cerhan, J.; Kelemen, L.E.; Folsom, A.R.; Sellers, T.A. Association of Gain and Loss of Weight before and after Menopause with Risk of Postmenopausal Breast Cancer in the Iowa Women’s Health Study. Cancer Epidemiol. Biomark. Prev. 2005, 14, 656–661. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Eliassen, A.H.; Colditz, G.; Rosner, B.; Willett, W.C.; Hankinson, S.E. Adult Weight Change and Risk of Postmenopausal Breast Cancer. JAMA 2006, 296, 193–201. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Key, T.; Appleby, P.; Barnes, I.; Reeves, G. The Endogenous Hormones and Breast Cancer Collaborative Group Endogenous Sex Hormones and Breast Cancer in Postmenopausal Women: Reanalysis of Nine Prospective Studies. J. Natl. Cancer Inst. 2002, 94, 606–616. [Google Scholar] [CrossRef] [PubMed]
- Key, T.J.; Appleby, P.N.; Reeves, G.K.; Roddam, A.; Dorgan, J.F.; Longcope, C.; Stanczyk, F.Z.; Stephenson, H.E., Jr.; Falk, R.T.; Miller, R.; et al. Endogenous Hormones Breast Cancer Collaborative Group Body Mass Index, Serum Sex Hormones, and Breast Cancer Risk in Postmenopausal Women. J. Natl. Cancer Inst. 2003, 95, 1218–1226. [Google Scholar] [CrossRef]
- Moradi, T.; Nyrén, O.; Zack, M.; Magnusson, C.; Persson, I.; Adami, H.-O. Breast cancer risk and lifetime leisure-time and occupational physical activity (Sweden). Cancer Causes Control 2000, 11, 523–531. [Google Scholar] [CrossRef]
- The Effect of Rurality on Cancer Incidence and Mortality. Available online: http://www.ncin.org.uk/publications/data_briefings/rurality (accessed on 5 April 2011).
- Howe, G.R.; McLaughlin, J. Breast Cancer Mortality between 1950 and 1987 after Exposure to Fractionated Moderate-Dose-Rate Ionizing Radiation in the Canadian Fluoroscopy Cohort Study and a Comparison with Breast Cancer Mortality in the Atomic Bomb Survivors Study. Radiat. Res. 1996, 145, 694–707. [Google Scholar] [CrossRef]
- Tokunaga, M.; Land, C.; Tokuoka, S.; Nishimori, I.; Soda, M.; Akiba, S. Incidence of Female Breast Cancer among Atomic Bomb Survivors, 1950–1985. Radiat. Res. 1994, 138, 209–223. [Google Scholar] [CrossRef]
- Ociepa-Zawal, M.; Rubis, B.; Wawrzynczak, D.; Wachowiak, R.; Trzeciak, W.H. Accumulation of environmental estrogens in adipose tissue of breast cancer patients. J. Environ. Sci. Health Part A Tox Hazard Subst. Env. Eng. 2010, 45, 305–312. [Google Scholar] [CrossRef] [PubMed]
Cases | Controls | ||
---|---|---|---|
Age (years) mean ± SD | 59 ± 6 | 58 ± 6 | p |
Characteristics | n (%) | n (%) | |
Educational level | n (% of level) | ||
Primary | 22 (66.67) | 11 (33.33) | |
Vocational | 40 (68.97) | 18 (31.03) | 0.006 |
High school | 71 (41.28) | 101 (58.72) | |
University degree | 68 (48.92) | 71 (51.08) | |
Physical activity | n (% of all) | ||
No | 102 (51) | 110 (55) | |
Moderate | 63 (31) | 50 (25) | 0.7 |
High | 36 (18) | 41 (20) | |
Smoking | |||
Never | 85 (43) | 90 (45) | |
Former | 86 (43) | 69 (34) | 0.3 |
Current | 30 (14) | 42 (21) | |
Age of alcohol initiation (year) | |||
≤15 | 35 (17) | 19 (9) | 0.05 |
16–18 | 74 (37) | 79 (39) | |
>18 | 92 (46) | 103 (52) | |
Age at menarche (year) | |||
≤12 | 39 (19) | 40 (20) | 0.9 |
>12 | 162 (81) | 161 (80) | |
Mononucleosis in childhood | |||
Yes | 3 (1.5) | 3 (1.5) | |
No | 171 (85) | 178 (88.5) | 0.5 |
I do not know | 27 (13.5) | 20 (10) | |
Number of live births | |||
0 | 34 (17) | 25 (12) | |
1 | 44 (22) | 53 (26) | |
2 | 73 (36) | 77 (38) | 0,9 |
3 | 29 (14) | 28 (14) | |
≥4 | 21 (11) | 18 (10) | |
Breastfeeding (>3 months) | |||
Yes | 104 (52) | 123 (61) | <0.001 |
No | 97 (48) | 78 (39) | |
Hormone replacement therapy * | |||
Yes | 54 (27) | 38 (19) | 0.06 |
No | 147 (73) | 163 (81) | |
Age of menopause: | |||
Premenopausal | 41 (20) | 52 (26) | 0.9 |
≤55 | 98 (49) | 98 (49) | |
>55 | 62 (31) | 51 (25) | |
Family history of breast cancer: | |||
Yes | 52 (26) | 45 (22) | |
No | 149 (74) | 156 (78) | 0.4 |
Family history of breast cancer < 55-year-old | |||
Present | |||
Absent | 30 (15) | 21 (10) | 0.2 |
171 (85) | 180 (80) | ||
Residence area: | |||
Urban | 151 (75) | 171 (85) | 0.01 |
Rural | 50 (25) | 30 (15) | |
BMI ** | |||
≤29.99 | 133 (66) | 161 (80) | 0.002 |
≥30 | 68 (34) | 40 (20) | |
Alcohol > 12g/day | |||
Yes | 15 (3.76) | 10 (2.49) | 0.37 |
No | 186 (46.27) | 191 (47.51) |
OR * | 95% CI ** | p | |
---|---|---|---|
Rural residence area | 1.9 | 1.15–3.14 | 0.01 |
Lower educational level | 2.73 | 1.66–4.47 | 0.0001 |
Lack of physical activity | 1.17 | 0.71–1.93 | 0.5 |
Smoking | 1.1 | 0.75–1.64 | 0.6 |
Exposure to radiation | 1.4 | 0.77–2.57 | 0.3 |
History of mononucleosis | 1.33 | 0.76–2.35 | 0.3 |
Age at menarche > 12 y | 1.03 | 0.63–1.69 | 0.9 |
History of miscarriage or abortion | 1.12 | 0.7–1.8 | 0.63 |
Menopause | 0.92 | 0.66–1.45 | 0.98 |
HRT *** | 1.58 | 0.98–2.52 | 0.06 |
Family history of breast cancer | 1.2 | 0.76–1.9 | 0.4 |
Diseases predisposing one to breast cancer | 1.45 | 0.54–3.9 | 0.45 |
BMI **** ≥ 30 | 2.06 | 1.3–3.24 | 0.018 |
Alcohol initiation > 15 | 0.51 | 0.27–0.94 | 0.03 |
Alcohol > 12 g/day | 1.54 | 0.67–3.52 | 0.3 |
Breastfeeding < 3 months | 2.44 | 1.63–3.63 | <0.001 |
Educational level—secondary | 1 | ||
Educational level—primary | 3.16 | 1.68–5.96 | 0.0004 |
Educational level—vocational | 2.84 | 1.3–6.23 | 0.009 |
Educational level—high | 1.3 | 0.85–2.1 | 0.2 |
OR * | 95% CI ** | p | |
---|---|---|---|
BMI *** ≥ 30 | 1.9 | 1.16–3.04 | 0.009 |
Alcohol initiation ≤ 15 y | 1.98 | 1.06–3.69 | 0.03 |
Breastfeeding below 3 months | 2.31 | 1.52–3.50 | <0.001 |
Rural residence | 1.7 | 1.05–2.9 | 0.05 |
Primary and vocational education | 2.5 | 1.49–4.20 | <0.001 |
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Dydjow-Bendek, D.A.; Zagożdżon, P. Early Alcohol Use Initiation, Obesity, Not Breastfeeding, and Residence in a Rural Area as Risk Factors for Breast Cancer: A Case-Control Study. Cancers 2021, 13, 3925. https://doi.org/10.3390/cancers13163925
Dydjow-Bendek DA, Zagożdżon P. Early Alcohol Use Initiation, Obesity, Not Breastfeeding, and Residence in a Rural Area as Risk Factors for Breast Cancer: A Case-Control Study. Cancers. 2021; 13(16):3925. https://doi.org/10.3390/cancers13163925
Chicago/Turabian StyleDydjow-Bendek, Dorota Anna, and Paweł Zagożdżon. 2021. "Early Alcohol Use Initiation, Obesity, Not Breastfeeding, and Residence in a Rural Area as Risk Factors for Breast Cancer: A Case-Control Study" Cancers 13, no. 16: 3925. https://doi.org/10.3390/cancers13163925