Environment and Breast Cancer: Science Review

Evidence From Humans
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Adult height and risk of breast cancer among white women in a case-control study
Zhang, Y., Rosenberg, L., Colton, T., Cupples, L. A., Palmer, J. R., Strom, B. L., Zauber, A. G., Warshauer, M. E., Harlap, S., Shapiro, S. American Journal of Epidemiology. 1996. 143:11, 1123-8.
Topic area
Body size
Study design
Hospital based case-control
Funding agency
Not reported
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Control: 4555
Country where study was conducted
USA, Canada and Israel
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: White residents of Boston, New York, Philadelphia, Baltimore, San Francisco, Tucson, state of Kansas, country of Israel or Canada; age 20-69 years; diagnosed with breast cancer between 1976 and 1992 (cases); women admitted into a hospital with nonmalignant conditions with no history of cancer (controls) Ex: women admitted for diseases related to height or weight, pregnancy, childbirth or puerperium; women diagnosed with hypertension, ischemic heart disease, back pain, disc disorder or other diseases that may be associated with stature
Comment about participation selection
Strengths: large number of cases; analyzed height and breast cancer association; analyzed height and breast cancer risk by numerous effect modifiers; height distributions were similar across different geographic areas within the US Limitations: Hospital based case-control study, controls not matched by age or population; anthropometric data were self-reported; many exclusions which lowered the participation rate of controls; did not include confidence intervals in some of the findings; possible selection bias
Exposure Investigated
How exposure was measured
Questionnaire, in person
Exposure assessment comment
Anthropometric data were self-reported
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.
Adequately controlled, confounders: age, geographic area, religion, year of interview, education, BMI, smoking status, history of benign breast disease, family history of breast cancer, age at menarche, menopausal status, age at first pregnancy, parity, O
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
Effect modifiers: geographic area, BMI, age at menarche, menopausal status, age at first pregnancy, parity, benign breast disease, family history of breast cancer, OC use, estrogen use
Strength of associations reported
Association between breast cancer and height, >68 in vs. <62 in, OR=1.0(0.8-1.2)
Association between breast cancer and height, >68 in vs. <62 in, in women with a BMI of 29 or greater, OR=0.6 trend p=0.030
Results Comments
No significant association between breast cancer and height