Only in 2021 there will be  approximately 281,550 new cases, and 43,600 women are expected to die from the disease (Breastcancer.org, 2020) The chances of women dying from breast cancer is 1 of 39 (2.6%). 

Obesity is a very concerning problem in the US. More than 2 out 3 women are considered overweight or obese (Office of Women’s Health, 2019) Extra fat is related to multiple chronic diseases, diabetes, and especially cancers. 

How?
Obesity contributes risk of developing breast cancer through long-lasting inflammation, higher than normal levels of insulin, insulin like growth hormone and sex hormone. 

Over all the three studies I examined agreed that increased body fat is risk factor for developing breast cancer in post menstrual women.

·         Socio- economic factors: 

-          Lack of healthcare access: many rural areas lack easy access to services or providers. The prevalence of obesity in these areas is also higher than in urban areas (CDC, 2021)

-          Lack of insurance – women who do not have health insurance are less likely to get screened for cancer. In 2018 among women 50-74 only 39% of uninsured women had a mammogram in the past 2 years vs 75% insured (Komen, 2021) 

-          Lack of time off from work – employed women often do not have paid time leave and which could leave to significant economic loss

·         Lack of awareness – not understanding breast cancer, symptoms and factors that can increase the risk. Also not knowing about the existence of preventative measures and programs 

·         Fear – Some women are hesitant to participate in prevention programs and screenings due to the fear of pain, discomfort or possible breast cancer diagnosis 

·         Culture – diet and lifestyle are part of culture and some women, especially elderly, are not willing to change them to reduce their weight.

·         Language – Language barriers may be related to lack of understanding of care and prevention. 

- Healthy body weight and physical activity - women who increase their physical activity after menopause lower the risk for breast cancer by 12 -21%.(National Cancer Institute, 2020)

- Yearly breast cancer screening for women over 50 – United States preventative task force recommends women that are 50 to 74 years old and have an average risk for breast cancer to get a mammogram every two years (CDC, 2021)

- Self -breast awareness- teaching women should familiarize themselves with both the appearance and feel of their breasts and report changes to a health care professional. 

 

·     Behavioral Strategies – Research to develop and test individual and community based behavioral interventions that help to improve overall health as well as prevent cancers. The goal is to develop a strategy where individuals not only will lose weight but sustain the loss over time. (National Cancer Institute, 2020)

 

·    Get involve in advocacy – Support legislation that addresses obesity like, Treat and Reduce obesity act of 2019; legislations that ensued access and coverage to preventative services; funding for research that better understand the correlation between obesity and cancer

- Prevalence of obesity in adults 40-59 is 44.8% and adults older than 60 is 42.8%

-Among women obesity is lower in the highest income groups than in middle- and lowest-income group.

- More than 90% of obesity-related cancers occur in men and women after 50 years old 

(CDC, 2021)

According to the CDC, obesity is a public health problem that is impacting more than 42% of adults. The impact of this crisis does not impact communities equally and there are a variety of factors. The incidence of obesity is affected by low socio-economic status, age groups, ethnicity, and rural areas. Primary prevention is essential for the health of the community. 

Leadership role – This circular concept prepared me to gain a better understanding of public health issues. It makes me better equipped to recognize the needs of a particular population segment and the complex factors that influence them. It helped me to develop critical thinking to solve clinical problems of large diverse groups. It gives me the tools to take the lead in primary prevention to improve the health of my community.

 Patient education – It is imperative for the patient to be educated about their disease and the factors that influence it. 

-Provide one-on-one education to patients about the risk of breast cancer, obesity, and the importance of screening. The education can be face to face or over the phone 

- Education can be performed in multiple settings -clinical, homes, or workplaces

- The education can address the general population or be tailored to the individual needs

- Education can be supplemented by brochures, videos, and demonstration 

(CDC,2021)

 Education is a great nursing responsibility. It helps patients and their families to better understand the importance of prevention, disease process, and treatment. It empowers patients to get an active role in their health and improve their outcomes.

 Leadership role – This circular concept is from the particular importance of taking the leadership role after graduation. It helped me to develop better communication skills and assertiveness. It also made me further research topics I was not familiar with and become more confident in my knowledge so I can pass it to my patients. Education helps to establish rapport with patients and their families. They can take a more active role in their health and improve their outcomes.