Environment and Breast Cancer: Science Review

Plasma retinol, beta-carotene and vitamin E levels in relation to the future risk of breast cancer
Wald, N. J., Boreham, J., Hayward, J. L., Bulbrook, R. D. Br J Cancer. 1984. 49:3, 321-4.

Topic area
Diet
Diet
Study design
Nested case-control
Nested case-control
Funding agency
Not reported
Not reported

Study Participants
Menopausal Status
Pre menopausal
The menopausal status of women included in this study is listed here.
Post menopausalPre menopausal
Number in Cohort
Controls: 78; cohort 5,004
Controls: 78; cohort 5,004
Cohort participation rate
More than 70%
More than 70%
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women between the ages of 28 and 75 in the ICRF prospective study
Comment about participation selection
Women living on a small island: same basic characteristics and lack of diversity in food choice
Women living on a small island: same basic characteristics and lack of diversity in food choice

Exposure Investigated
Exposures investigated
Beta carotene and vitamin E in plasma
Beta carotene and vitamin E in plasma
How exposure was measured
Biological
Biological
Exposure assessment comment
Only one blood sample, lack of accuracy of plasma level of vitamins, length of time of plasma storage between 7 and 14 years
Only one blood sample, lack of accuracy of plasma level of vitamins, length of time of plasma storage between 7 and 14 years

Statistical Analysis
Breast cancer outcome investigated
Primary breast cancer
Primary breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
No
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Not considered: BMI, alcohol consumption
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
No
Description of major analysis
OR, highest versus lowest quintile of serum level; p- value; follow-up 7-14 years; standardized mean stratified by menopausal status
OR, highest versus lowest quintile of serum level; p- value; follow-up 7-14 years; standardized mean stratified by menopausal status
Strength of associations reported
Beta carotene: OR=0.54, p- value= NS; vitamin E: OR =0.5, p -value<0.01
Beta carotene: OR=0.54, p- value= NS; vitamin E: OR =0.5, p -value<0.01
Results Comments
Plasma vitamin E level showed a clear association (low levels being associated with a significantly higher risk of cancer). Beta-carotene levels showed a similar tendency, but the effect was less strong, less consistent, and not significant.
Plasma vitamin E level showed a clear association (low levels being associated with a significantly higher risk of cancer). Beta-carotene levels showed a similar tendency, but the effect was less strong, less consistent, and not significant.

Reviewers Comments
In a later publication (1988), the author raised concern that results may have been due to differences in handling cases and serum samples.
In a later publication (1988), the author raised concern that results may have been due to differences in handling cases and serum samples.