Environment and Breast Cancer: Science Review

Evidence From Humans
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A cohort study of fat intake and risk of breast cancer
Howe, G. R., Friedenreich, C. M., Jain, M., Miller, A. B. J Natl Cancer Inst. 1991. 83:5, 336-40.
Study design
Nested case-control
Funding agency
Not reported
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Postmenopausal and premenopausal combined
Number in Cohort
Controls 1,182, cohort: 56,837
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Cohort: Women between the ages of 40 and 59 years recruited for the NBSS randomized trial between 1980 and 1985, who completed a dietary questionnaire. Cases: Women with newly incident histologically confirmed breast cancer who completed the dietary questionnaire before the diagnosis. Controls: Women randomly selected from among the remaining members of the cohort.
Comment about participation selection
Women participating to the NBSS: include early diagnosis of breast cancer and less unknown breast cancer
Exposure Investigated
Exposures investigated
Total fat, saturated fat, monounsaturated fat, polyunsaturated fat
How exposure was measured
Questionnaire, self-administered, FFQ
Exposure assessment comment
86 food items questionnaire
Statistical Analysis
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
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, race, parity, menopausal status, alcohol consumption, family history of breast cancer
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Adjusted RR with 95% CI, higher versus lower quartile of intake, subgroup for menopausal status at enrollment, follow-up 5 years
Strength of associations reported
Total fat: 1.30 (0.90 - 1.88); saturated fat: 1.08 (0.73 - 1.59); monounsaturated fat: 1.23 (0.81 - 1.89); polyunsaturated: 1.30 (0.93 - 1.82)
Results Comments
Some evidence for the existence of a positive association between fat intake and increased risk of breast cancer.
Author address
National Cancer Institute of Canada Epidemiology Unit, Faculty of Medicine, University of Toronto, ON.