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The use of Observational Study Designs to Investigate Breast Cancer

Introduction

            Women are most often diagnosed with cancer in the United States with over 100,000 new diagnoses per year. It is the leading cause of cancer deaths in women with over 40,000 lives attributed to it (Colditz, 2015). Many risk factors have been described for breast cancer such as improper diets and lifestyle and genetic factors, among many others. Low levels of physical activity and a sedentary lifestyle have also been identified as predisposing factors. Work done shows that the disease is more prevalent in women who do not lead an active life (Colditz, 2015). It is necessary that the factors predisposing women to breast cancer are studied so that the appropriate interventions can be put in place.

Observational studies are useful tools for investigating the causes of disease. They provide information on the cause and progression of a disease (von Elm et. al., 2007). In this case, cohort, cross-sectional and case-control studies can be used to investigate the association of race as a risk factor for breast cancer. When conducting such studies, the STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology) is useful as it provides a checklist of items that should be addressed in research.

Cohort studies

A cohort study is an observational study in which the population is selected from among people suspected to have been exposed to the risk factor. In this case, the people of interest will be women who have not had cancer before. The cohort will include women who lead an active life as well as those who do not. The women will be selected from those 30- 45 years old. This is chosen since it is the age at which most women develop breast cancer (Colditz, 2015). They will be observed for up to 10 years while data relevant to the disease is collected. This includes data concerning their lifestyle which can be used to describe the correlation of their lifestyle to the incidence of sickness, and the outcome will be the presence of disease.

The main advantage of this type of study is that it can be used to directly measure the incidence of a disease due to the exposure. The cohort study also makes the relationship between the exposure and the outcome clear and easy to understand. The major disadvantage is that is expensive and time-consuming since subjects are followed for some years.

Case-Control Studies

In this type of study, populations confirmed to have the disease of interest are compared with those who do not. This kind of research is usually retrospective since it compares populations with the outcome of interest against those who do not have the outcome. They look back retrospectively to compare the frequency of exposure to risk factors in each group so as to come up with a relationship between the risk factor and the disease (HHSL, 2011).

            Case-control design can be used to determine the relationship between exercise and breast cancer in women. Two groups of women will be selected, one with breast cancer and the other without. The group with cancer will be the cases while those without will be the control. They should all be in the same age group for a comparison. The research will involve looking back into the history of both groups of women to determine the level of exposure to the risk factor that either led to them having or not having the disease. In this case, the study will be useful in determining whether the level of activity a woman engages in plays a role in role in reducing the risk of breast cancer. The main advantage of the design is that it can be used to study rare diseases such as cancer. It also requires less time to carry out. The biggest problem is that the quality of data is not reliable since it relies on the memory of the participants.

Cross- Sectional Study

In this study, data is collected from the population of interest at a particular point in time to examine the incidence of the disease at a given moment. For instance, the population can be sampled to identify the women with and without breast cancer. Women are selected from the same age group and information about their level of exercise is collected. It will be used to determine the correlation between the frequency of physical activity and the incidence of breast cancer. Such a study is descriptive since it is used to define the prevalence of cancer in women who do not exercise. The main advantage is that it is not as expensive as the cohort and the case study design. The major disadvantage is that it is not useful in studying diseases that have a long term progression such as cancer.

Conclusion

Observational studies are helpful in identifying and investigating the cause of a disease such as breast cancer. These designs include the cohort, case study, and cross-sectional designs. For the study to be valid, it should consider the STROBE statement and the checklist of items to be addressed in observational studies is included. This involves the population of interest, the eligibility criteria and the selection of participants. When examining the influence of exercise on breast cancer, the population of interest is women who either have or have never had cancer.  They are eligible for participation if the fall within 30 – 45 years. As shown, the cross- sectional design is not helpful when studying long-term conditions such as cancer.

References

Colditz, G. (2015). Breast cancer epidemiology and risk factors. Medscape. Retrieved from http://emedicine.medscape.com/article/1697353-overview

The Himmelfarb Health Sciences Library. (2011). Study design- Case Control Study. Retrieved from https://himmelfarb.gwu.edu/tutorials/studydesign101/casecontrols.html

Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C. and Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Annals of Internal Medicine, 147(8), 573–w161.

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