Environment and Breast Cancer: Science Review

Evidence From Humans
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Adolescence and breast carcinoma risk
Berkey, C. S., Frazier, A. L., Gardner, J. D., Colditz, G. A. Cancer. 1999. 85:11, 2400-9.
Topic area
Body size
Study design
Prospective cohort
Study Participants
Number of Cases
2,291 (806 pre) (1,485 post)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 65,140
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: female registered nurses age 30-55 in 1976 who were participants of the Nurses' Health Study; women who completed mailed questionnaires Ex: women with prior breast cancers; women who did not report their ancestry; women who did not provide information on their body size at ages 5, 10, and 20 years; non-white women
Comment about participation selection
Strengths: large prospective cohort; many cases; lengthy follow-up of 16 years; 1,042,240 person years of follow up; obtained pathology reports for 96% of the cases; analyzed breast cancer risk by height, body fat at different ages and by peak height velocity all stratified by menopausal status; one of the only studies of adolescent growth velocity and breast cancer risk; most of the variables were reported before breast cancer diagnoses Limitations: low participation rate of 53% due to many exclusion factors; anthropometric variables were self-reported; adolescent peak height growth velocities were estimated using a model from another study; did not include confidence intervals in analysis
Exposure Investigated
Exposures investigated
Height; body fat at age 5,10 & 20 years; peak adolescent height velocity
How exposure was measured
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data self-reported
Early life exposures considered
Body fat at age 5 and 10
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 in 1976; age at menarche; adult height; body fatness at age 5,10, 20; family history; alcohol consumption; maternal smoking status; family SES; adolescent benign breast disease diagnosis
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: menopausal status Follow-up: 16 years
Strength of associations reported
Risk of premenopausal breast cancer was lower for women with more body fat at age10 years, fattest vs. leanest, RR=0.60
Risk of postmenopausal breast cancer was lower for women with more body fat at age10 years, fattest vs. leanest, RR=0.72
Association between postmenopausal breast cancer and adult height, >67 inches vs. <62 inches, RR=1.29
Association between premenopausal breast cancer and peak height growth velocity, >8.9 cm/yr vs. < 7.6 cm/yr, RR=1.31
Association between postmenopausal breast cancer and peak height growth velocity, >8.9 cm/yr vs. < 7.6 cm/yr, RR=1.40