Urban-rural differences in breast cancer incidence by hormone receptor status across 6 years in Egypt

Subhojit Dey, Amr S. Soliman, Ahmad Hablas, Ibrahim A. Seifeldin, Kadry Ismail, Mohamed Ramadan, Hesham El-Hamzawy, Mark L. Wilson, Mousumi Banerjee, Paolo Boffetta, Joe Harford, Sofia D. Merajver

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Breast cancer incidence is higher in developed countries with higher rates of estrogen receptor positive (ER+) tumors. ER+ tumors are caused by estrogenic exposures although known exposures explain approximately 50% of breast cancer risk. Unknown risk factors causing high breast cancer incidence exist that are estrogenic and development-related. Xenoestrogens are such risk factors but are difficult to study since developed countries lack unexposed populations. Developing countries have urban-rural populations with differential exposure to xenoestrogens. This study assessed urban-rural breast cancer incidence classified by hormone receptor status using data from Gharbiah population-based cancer registry in Egypt from 2001 to 2006. Urban ER+ incidence rate (per 100,000 women) was 2-4 times (IRR = 3.36, 95% CI = 4.84, 2.34) higher than rural incidence rate. ER-incidence rate was 2-3 times (IRR = 1.86, 95% CI = 2.38, 1.45) higher in urban areas than in rural areas. Our findings indicate that urban women may probably have a higher exposure to xenoestrogens.

Original languageEnglish (US)
Pages (from-to)149-160
Number of pages12
JournalBreast Cancer Research and Treatment
Issue number1
StatePublished - Feb 2010
Externally publishedYes


  • Breast cancer incidence
  • Egypt
  • Hormone receptor status
  • Mammary stem cells
  • Xenoestrogens

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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