Environment and Breast Cancer: Science Review
 
	Body-size indicators and risk of breast cancer according to menopause and estrogen-receptor status
	Mannisto, S., Pietinen, P., Pyy, M., Palmgren, J., Eskelinen, M., Uusitupa, M. International Journal of Cancer. 1996. 68:1, 8-13.
 
	 Topic area
Body size
Body size
	 Study design
Population based case-control
Population based case-control
	 Funding agency
Other: Academy of Finland, Yrjo Jahnsson Foundatio
Other: Academy of Finland, Yrjo Jahnsson Foundatio
 
Study Participants
	 Number of Cases
328 (132 pre) (196 post)
328 (132 pre) (196 post)
	 Menopausal Status
	
Post menopausal
 The menopausal status of women included in this study is listed here.
	Pre menopausalPost menopausal
	Number  of Controls  
Control: 417 (184 pre) (233 post)
Control: 417 (184 pre) (233 post)
	 Participant selection: Inclusion and exclusion criteria
	
 Criteria used to select participants in the study.
	In: participants in the Kuopio Breast Cancer Study who were diagnosed with a breast lump between 1990 and 1994 (cases); women in the population based register that covers the same area as the catchment area used to locate cases (controls)
Ex: women who refused to participate; women who were missed by the study's enrollment system in the hospital; women who lived outside the catchment area; women with dementia; women with problems cooperating
	 Comment about participation selection
Stengths: population based study; anthropometric data were measured by trained staff; analyzed breast cancer risk by anthropometric indicators stratified by menopausal status; high participation rate Limitations: few premenopausal case; possible selection bias since more controls used estrogen replacement therapy than cases
Stengths: population based study; anthropometric data were measured by trained staff; analyzed breast cancer risk by anthropometric indicators stratified by menopausal status; high participation rate Limitations: few premenopausal case; possible selection bias since more controls used estrogen replacement therapy than cases
	 Exposures investigated
Height, weight, BMI, WHR, body fat %, fat weight, lean body weight, weight gain, weight loss at age 22-44, weight loss at age 45 and older
Height, weight, BMI, WHR, body fat %, fat weight, lean body weight, weight gain, weight loss at age 22-44, weight loss at age 45 and older
	 How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
Questionnaire, in person Anthropometric measurement, researcher-administered
	 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.
	Adequately controlled, Confounders: age, area, age at menarche, age at first childbirth, oc use, estrogen use, family history, history of benign breast disease, education, alcohol consumption, smoking habits, leisure activity
	 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
Effect modifiers: menopausal status ER+, ER- measurements
Effect modifiers: menopausal status ER+, ER- measurements
	 Strength of associations reported
Association between post breast cancer risk and height, >169 cm vs <159cm, OR=2.3(1.1-4.6) trend p=0.12
Association between pre breast cancer risk and WHR, >0.89 vs <0.79, OR=4.6(2.0-10.7) trend p=0.01
Association between post breast cancer risk and WHR, >0.89 vs <0.79, OR=2.6(1.3-5.1) trend p=0.03
Association between post breast cancer risk and weight, >80 kg vs. <60 kg, OR=1.2(0.7-2.4) trend p=0.60
Association between post breast cancer risk and BMI, >31.3 vs. <23.4, OR=0.8(0.4-1.5) trend p=0.41
Association between post breast cancer risk and height, >169 cm vs <159cm, OR=2.3(1.1-4.6) trend p=0.12
Association between pre breast cancer risk and WHR, >0.89 vs <0.79, OR=4.6(2.0-10.7) trend p=0.01
Association between post breast cancer risk and WHR, >0.89 vs <0.79, OR=2.6(1.3-5.1) trend p=0.03
Association between post breast cancer risk and weight, >80 kg vs. <60 kg, OR=1.2(0.7-2.4) trend p=0.60
Association between post breast cancer risk and BMI, >31.3 vs. <23.4, OR=0.8(0.4-1.5) trend p=0.41
 
	 Controls participation rate
Greater than 70%
Greater than 70%

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