Background: The Middle East and North Africa (MENA) region is witnessing a continuous rise in the incidence of breast cancer (BC). This region is characterized by distinct cultural and lifestyle habits. Despite the importance of diet as a modifiable risk factor for BC, its role in the development of BC within the MENA context has not been extensively studied. This systematic review aims to identify and synthesize existing evidence regarding the effect of different dietary factors on BC risk among women from this region. Methods: We systematically reviewed the scientific literature for observational studies that examined the association between specific dietary factors and the risk of BC in MENA, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Our comprehensive search included databases such as PubMed, Web of Science, ScienceDirect, and Scopus, identified a total of 18,085 records, of which 65 met our inclusion criteria and were assessed for quality using the National Institute of Health Quality Assessment Tool. Results: The findings of the 65 included studies were categorized into food groups, nutrients, and dietary patterns. Studies in the MENA region have consistently shown that the consumption of fruit and vegetables, fish and seafood, and black tea are associated with a reduced BC risk. In contrast, the intake of milk and white bread is linked to an increased risk. Specific dietary patterns such as the Mediterranean diet, a healthy plant-based diet, dietary antioxidant index, and overall healthy dietary patterns have shown a negative association with BC risk. Conversely, the dietary insulin index and load, dietary glycemic index, dietary inflammatory index, and unhealthy dietary patterns are associated with an increased risk of BC. For the remaining dietary factors, research was too limited or inconsistent to draw conclusions. Conclusions: Our findings highlight the significant role of dietary factors in modulating BC risk among women in the MENA region, an area that faces a notable gap in research on this topic. Further studies are essential to deepen our understanding and develop targeted dietary recommendations for BC prevention in this population.

Background: Geographic access to healthcare services can impact cancer outcomes. This paper reviews and updates the current evidence and gaps in the literature on the associations between travel distance and cancer stage. Methods: A search of electronic databases (PubMed, SpringerLink, and Science Direct) was conducted to identify studies published between 2015 and 2025. Studies examining the association between travel distance and cancer stage at diagnosis were included in this article. Results: From 19,197 studies, 11 articles met the inclusion criteria. In summary, four articles reported significant associations between travel distance/time and cancer stage, while six other articles did not report any association. Significant associations were observed in sub-Saharan Africa. In contrast, studies from Scotland, Canada, and the United States did not show significant relationships, while results from Japan varied, with papers showing either no significant impact of travel distance or indicating a correlation with advanced stages. Conclusions: This study suggests that longer travel distance is associated with advanced cancer stage in countries with healthcare access challenges and highlights the importance of healthcare accessibility in improving early cancer detection.

Although evidence suggests adiposity as a modifiable risk factor for postmenopausal breast cancer (BC), its association with premenopausal BC remains uncertain. This potential differential relationship for menopausal status has been insufficiently investigated in the Moroccan population due to limited data. This study aims to assess the relationship between various indicators of adiposity and the risk of BC among Moroccan women by menopausal status. A multicenter case-control study was conducted in Morocco between December 2019 and August 2023, including 1400 incident BC cases and 1400 matched controls. Detailed measures of adiposity and self-reported measures from different life stages were collected. Unconditional logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between body size indicators and the risk of BC, adjusting for a range of known risk factors for BC. Higher waist circumference (WC) and hip circumference (HC) were associated with an increased risk of BC in both pre- (p-trend < 0.001 for both WC and HC) and post-menopausal women (p-trend < 0.001 for WC, 0.002 for HC). Current body mass index (BMI) ≥30 kg/m² increased the risk of postmenopausal BC (p-trend = 0.012). Among postmenopausal women, higher weight at age 20 was positively associated with BC risk (p-trend < 0.001), while, weight at age 30 was significantly associated with increased BC risk in both pre- (p-trend = 0.008) and post-menopausal women (p-trend = 0.028). Interestingly, weight gain since age 20 was inversely associated with BC risk in postmenopausal women in the adjusted model (p-trend = 0.006). Young-adult BMI observed a significant increased trend with BC risk in both pre- (p-trend = 0.008) and post-menopausal women (p-trend < 0.001). In premenopausal women, larger body shape during childhood and early adulthood was positively associated with BC risk (p-trend = 0.01 and = 0.011, respectively). In postmenopausal women, larger childhood and adolescent body silhouettes were also associated with increased BC risk (p-trend = 0.045 and 0.047, respectively). These results suggest that anthropometric factors may have different associations with pre- and post-menopausal BC among Moroccan women. This underscores the importance of conducting large prospective studies to better understand these findings and explore their links to different molecular subtypes of BC.

Purpose: Breast cancer (BC) is a leading cause of morbidity and mortality worldwide, with its incidence varying significantly across different regions. While individual-level studies have explored the link between diet and BC risk, a comprehensive global assessment using an ecological approach is lacking. The aim of this study is to describe and evaluate the relationship between BC incidence and food and nutrient intake on a global scale. Design: An ecological study using publicly available country-level data from global sources. Setting: Country-level data were obtained from the Global Cancer Observatory and the Global Dietary Database. Sample: The present study included data of 175 countries, covering a wide range of geographical areas and different food cultures. Measures: Key measures included country-level data on women’s intake of various food and nutrients, alongside age-standardized BC incidence rates. Additional country-level covariates were also considered to account for potential confounding. Analyses: For initial exploratory assessment, comparisons of median food and nutrient intake were done using the Mann-Whitney U test. Additionally, multiple linear regression was applied to assess the associations between BC incidence and various food and nutrient intake variables, adjusting for potential confounding factors. Results: The multivariate analysis, after rigorous adjustment for confounding factors, initially revealed several food and nutrients that appeared to be significantly associated with BC risk. However, after applying the Bonferroni correction, these associations were no longer statistically significant, with the exception of alcohol consumption, which remained positively associated with BC incidence (β = 0.209, P = 0.048). Conclusion: This study suggests that alcohol consumption may be a potential risk factor for BC and highlight the complexity of the relationship between dietary factors and BC risk. The findings of this study could serve as a baseline for future in-depth individual-level research that aims to assess such a relationship.

Limited evidence exists on the combined effects of lifestyle factors on breast cancer (BC) risk, particularly in developing countries. This study aimed to investigate the association between adherence to the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and BC risk among Moroccan women. We conducted a large case–control study including 1,400 cases and 1,400 matched controls (by age and place of residence) between 2019 and 2023. A structured general questionnaire and a validated Food Frequency Questionnaire were used for data collection. Adherence to cancer prevention recommendations was assessed using a score ranging from 0 to 7, comprising seven components covering dietary patterns, physical activity, healthy weight, and breastfeeding. Multivariable logistic regression models were used to estimate OR and 95 % CI, accounting for potential confounding variables. For each one-point increase in the WCRF/AICR adherence score, the odds of BC decreased by 67 % overall (OR = 0·33; 95 % CI: 0·29–0·37). This inverse association was consistent among both premenopausal women (OR = 0·29; 95 % CI: 0·24–0·35) and postmenopausal women (OR = 0·35; 95 % CI: 0·30–0·41). Analysis of individual recommendations indicated that physical activity, maintaining a healthy weight, breastfeeding, consuming a plant-rich diet, and limiting the intake of fast and other processed foods were the main drivers of the observed inverse association with BC. In conclusion, greater adherence to the WCRF/AICR recommendations is associated with a reduced risk of breast cancer in Morocco. Prevention strategies should incorporate comprehensive interventions targeting multiple lifestyle factors.