Healthcare Controversies in Epidemiology

Running head: HEALTHCARE
Controversies in Epidemiology
Name of the Student
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Author Note

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Answer 1
Contemporary exposure-outcome association- The topic of interest is breast cancer that
refers to cancer development in the breast tissue, which is commonly characterised by presence
of a lump in the breast, in addition to swelling of skin, scaly or red patches on the skin, a change
in the shape of the breast, and release of fluid from the nipples (Kyu et al., 2016). The outcome
in this particular literature is disease specific mortality. Disease specific mortality is defined as
the death rate from a particular disease, for a certain population. The numerator refers to the total
number of deaths that can be attributed to the specific disease. In contrast, the denominator refers
to the total size of the population at a particular time period. The outcome is generally expressed
in relation to 100,000 individuals. An estimated 19,535 cases of breast cancer had been
diagnosed Australia in the year 2019, with as many as 19,371 females being diagnosed with the
disease (Cancer Australia, 2020). This accounted for 14% of all the cases of cancer that had been
diagnosed in the same year. Government reports suggested that approximately 3,090 deaths
occurred due to breast cancer in 2019 with 3,058 death among females, in comparison to 32 that
amongst their male counterparts (Cancer Australia, 2020).
While breast cancer contributed to 6.2% of all cancer related deaths in the same year, the
chances of survival of the diagnosed patients for a minimum of 5 years was found to be 91%. In
addition, in the year 2016, breast cancer was identified to be the fourth major reason for cancer
associated deaths in the nation, besides being the second most reason for death due to cancer
amongst women. Though there were approximately 3,004 deaths due to breast cancer in 2016,
Australia has been identified to have one of the best survival rates for breast cancer all across the
globe (Breastcancer.org.au, 2020). The rate of survival for females having been diagnosed with
breast cancer is approximately 90.1%, which can be directly attributed to early cancer detection

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through mammography, self-examination and enhanced treatment outcomes
(Breastcancer.org.au, 2020). Therefore, it can be suggested that the female population is
particularly susceptible to the condition. This can be attributed to the fact that particular risk
factors for the development of breast cancer comprise of obesity, sedentary life, and hormone
replacement therapy at the time of menopause, giving birth to children at older age, family
history of breast cancer, and early age of menarche, all of which have been found prevalent amid
females (Maas et al., 2016). The population is also more susceptible to the condition due to the
inheritance of a genetic predisposition such as, BRCA2 and BRCA1 (Kuchenbaecker et al.,
2017).
Previous research evidences have highlighted the fact that a greater socioeconomic status
is correlated with an increase risk of suffering from breast cancer, predominantly due to hormone
associated risk factors like hormonal contraceptive usage and parity (Silber et al., 2018). The
greater prevalence and incidence of breast cancer among females belonging to high
socioeconomic status can be particularly associated to reproductive factors. The increase is not
merely due to high position in the society but is related to variance in risk factors found amid
females of different income levels and educational attainment (Owusu et al., 2016). In
comparison to those who are from a lower socio economic position, those belonging to a higher
status display an increase in likelihood of consuming more alcohol, having fewer children, using
birth control contraceptives, or postmenopausal hormones, all of which make them more
vulnerable to the condition. Hence, the primary determinants of the outcome are lifestyle factors,
genetics, medical conditions like diabetes mellitus and lupus erythematosus that increase danger
of breast cancer acquisition, and early screening through mammography (Park et al., 2017).