Purpose: Comment the Discussion
To Comment:
There are characteristics that can increase the likelihood of receiving a disease diagnosis. Risk factors can be inherited for example an individual can be born with a gene to predispose them to a specific disease and diagnosis. For example, individuals that inherit BRCA1 and BRCA2 are at an increased risk for breast cancer.
Risk factors can be developed through infectious agents and are found in either population's physical environments such as toxins and infectious agents or found in social environments such as stress or life events that can increase risk of emotional or physical illness (Fletcher, 2014).
Individual's behavioral risk factors can be the most devastating, these risks are choices made by an individual that increase risks for disease (Fletcher, 2014). Individual's risk factors to a disease are dependent on whether they are inherited, due to physical environments, social environments or behavior environments and the relationship to the disease (Fletcher, 2014).
These types of risk factors also influence interventions to reduce risks in developing disease. Providing studies, trials, and statistics can change the outcome of risk factors that can overall change the interventions provided for a disease or diagnosis.
I read an article that discussed breast cancer prevention in young women. It discussed and examined how young women, especially college age, were not aware of modifiable lifestyle risk factors for the diagnosis of breast cancer. The article noted that modifiable risk factors for breast cancer for female college students include: oral contraception, hormone replacement therapy, obesity and high fat diets, activity and exercise level, and alcohol consumption (Burak & Boone, 2008).
The method they gathered their evidence was through a survey with 522 college women and asked them questions regarding knowledge, behaviors, beliefs, and demographics. The results showed the lack of knowledge about lifestyle risk factors and knowledge regarding breast cancer (Burak & Boone, 2008).
The article concluded by emphasizing the need for healthcare providers, healthcare educators, and researchers to provide information and skills to engage and change behaviors of these college females to protect them against high risk behavior for breast cancer (Burake& Boone, 2008). These changes in prevention and behavior in female college age population will reduce the risk of breast cancer by following recommendations.
Breast cancer is deadly in the U.S.A. According to the CDC there are nearly 40,000 women who die from breast cancer every year (CDC, 2014). There are scenarios that people cannot change their inherited risk factor genes at birth such as the breast cancer gene. On a personal level, I have a friend who has a familial history of breast cancer.
Last year her doctor discussed with her the breast cancer screening and genetic testing of the BRCA1 and BRCA2 genes because her 32 year old sister was just diagnosed with stage 4 breast cancer. She did the screen and test and did test positive for the gene. She was the first in her family to undergo these screens and tests.
Because of the risk factors of breast cancer with the positive gene apparent, she underwent a double mastectomy and breast reconstruction, she is 31 years old. Looking at her case, the epidemiology risks, screening and possible interventions were implied. It was up to her as the patient to make the decision after getting the results on what evidence based medicine to intervene with.
Her choice of tests, screening, and surgery is an example of how to use evidence based medicine as interventions to reduce the risk of ever receiving the diagnosis of breast cancer. Epidemiology is vital to develop the grade for screening, what to do, when to do it and what interventions are appropriate at that time. Evidence-based practice and medicine are guided through epidemiology.
References
Burak, L. & Boone, B. (2008). College women and breast cancer: Knowledge, behavior, and beliefs regarding risk reduction. American Journal of Health Education, 39(4), 206-212.
Center for Disease Control and Prevention (CDC). (2017).
Fletcher, R. H., Fletcher, S. W., & Fletcher, G. S. (2014). Clinical Epidemiology: The Essentials (5th ed.). Baltimore, MD: Lippincott Williams & Wilkins
Note: When we look at some risks more in depth, we also can analyze what they mean. For example, starting one's menses at an early age, having no pregnancies, and having a late menopause are all increased risk factors for breast cancer. Why?... more estrogen.
More years of estrogen increases a woman's risk. Lower risk of breast cancer is associated with later start to menses, more pregnancies, including breast feeding and an early menopause. Consider many breast cancers are ER/PR +. This is just another example of the complexities of breast cancer risk.