Environment and Breast Cancer: Science Review

Evidence From Humans
Print this page
Breast-cancer incidence in relation to height, weight and body-fat distribution in the Dutch "DOM" cohort
Kaaks, R., Van Noord, P. A., Den Tonkelaar, I., Peeters, P. H., Riboli, E., Grobbee, D. E. International Journal of Cancer. 1998. 76:5, 647-51.
Topic area
Body size
Study design
Prospective cohort
Funding agency
Not reported
Study Participants
Number of Cases
Cases: 275 (147 premenopausal) (76 natural menopause) (52 hysterectomized and/or ovariectomized)
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Pre menopausal
Number in Cohort
Cohort participation rate
Retention/participation exceeded 70% for exposed a
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women who participated in the Dutch DOM Project in Utrecht, Netherlands from 1984 to 1986 Ex: Unclear menopausal status, and missing data
Comment about participation selection
Strengths: Study analyzed a large cohort, analyzed 3 sub-cohorts that differed by menopausal status, examined six exposures, anthropometric data was taken at screening and study had a very high participation rate Limitations: Few cases in each of the 3 sub-cohorts
Exposure Investigated
Exposures investigated
Height, weight, BMI, waist circumference, hip circumference, W/H ratio
How exposure was measured
Questionnaire, self-administered Anthropometric measurement, researcher-administered taken at screening
Exposure assessment comment
Few cases overall
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, age at menarche, age at first full term pregnancy, age at menopause, number of live children, and menopausal status
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
Follow up: 10.6 years (median) Effect modification: Menopausal status
Strength of associations reported
Association between premenopausal breast cancer risk and height, >169.00 cm vs. <160.80 cm, RR=1.28(0.78-2.11) trend p=0.25
Association between postmenopausal breast cancer risk and height, >169.00 cm vs. <160.80 cm, RR=0.96(0.46-1.98) trend p=0.53
Association between premenopausal breast cancer risk and BMI, >27.15 vs <22.50, RR=1.04(0.65-1.68) trend p=0.73
Association between postmenopausal breast cancer risk and BMI, >27.15 vs <22.50, RR=0.81(0.43-1.51) trend p=0.59
Association between postmenopausal breast cancer risk and WHR, >0.80 vs. <0.73, RR=2.63(1.09-6.36) trend p=0.007
Author address
Unit of Nutrition and Cancer, International Agency for Research on Cancer, Lyon, France. Kaaks@iarc.fr