Environment and Breast Cancer: Science Review

Evidence From Humans
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Serum steroid hormone levels, sex hormone-binding globulin, and body mass index in the etiology of postmenopausal breast cancer
Lipworth, L., Adami, H. O., Trichopoulos, D., Carlstrom, K., Mantzoros, C. Epidemiology. 1996. 7:1, 96-100.
Topic area
Body size
Study design
Population based case-control
Funding agency
NCI Other: Swedish Cancer Society
Study Participants
Number of Cases
122 (post only)
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number of Controls
Control: 122
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: women diagnosed with breast cancer in one of four counties in central Sweden between 10/1975 and 03/1976 (cases); postmenopausal women; women in the population register matched to cases by age (within 3 days) and county of residence (controls) Ex: women using HRT; matched pairs who did not have serum samples from both participants
Comment about participation selection
Strengths: population based case-control study; high participation rate; analyzed breast cancer risk by serum levels of different hormones and by BMI Limitations: small study with few cases; anthropometric data were self-reported
Exposure Investigated
How exposure was measured
Questionnaire, in person
Exposure assessment comment
Anthropometric data were self-reported
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.
Adequately controlled, confounders: age, residence and hormonal factors
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
Interaction: BMI and Sex Hormone-Binding Globulin levels
Strength of associations reported
Inverse association between postmenopausal breast cancer and BMI, 30.8 vs 21.3 OR=0.19(0.06-0.61)
Inverse association between postmenopausal breast cancer and women with a high BMI and a high level of Sex Hormone-Binding Globulin in an interaction, OR=0.14(0.04-0.53)