Environment and Breast Cancer: Science Review

Evidence From Humans
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Risk of breast cancer in young women in relation to body size and weight gain in adolescence and early adulthood
Coates, R. J., Uhler, R. J., Hall, H. I., Potischman, N., Brinton, L. A., Ballard-Barbash, R., Gammon, M. D., Brogan, D. R., Daling, J. R., Malone, K. E., Schoenberg, J. B., Swanson, C. A. British Journal of Cancer. 1999. 81:1, 167-74.
Topic area
Body size
Study design
Population based case-control
Funding agency
NCI Other: USA to Emory University, Fred Hutchinso
Study Participants
Number of Cases
1,590 (invasive and in situ)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Number of Controls
Control: 1390
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: diagnosed with in situ or invasive breast cancer between ages 20-44 years (cases); diagnosed between 5/90 and 12/92 (cases); resident of the metropolitan area of Atlanta, Georgia or Seattle, Washington or one of five counties in central New Jersey Ex: women who refused to participate; women who died before interview; women whose physician's refused their patient's participation (cases); women who did not have a telephone; women with missing weight or height measurements; pregnant women; women less than 7 months postpartum
Comment about participation selection
Strengths: large population based study; high participation rate amongst cases; anthropometric data were obtained by trained staff; conducted in-person interviews; analyzed breast cancer risk by BMI, perceived body size at age 15-16 and weight change; analyzed breast cancer risk by weight change stratified by stage and tumor grade; interviews were conducted a few months after reference dates; considered a number of possible confounders Limitations: differences in study designs may contribute to error in assessment; differences in populations may be associated with different findings; possible recall error or bias of early age anthropometric data
Exposures investigated
BMI, weight change, perceived body size from age 15-16
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
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: race, education, family history of breast cancer; age at menarche; history of breast biopsy; number of births and age at first birth; years of oral contraceptive use; alcohol consumption; mammogram history; adolescent d
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: age, stage and tumor grade
Strength of associations reported
Association between premenopausal breast cancer and BMI, trend across quintiles, RR=0.93(0.88-0.98)
Association between premenopausal breast cancer and total weight change from age 20 to interview, trend across quintiles in kg, RR=0.93(0.87-0.98)
Reduced risk of premenopausal breast cancer in women who perceived themselves to be shorter and thinner than other girls at ages 15-16, RR=0.73(0.58-0.93)
Reduced risk of premenopausal breast cancer in women who perceived themselves to be taller and heavier than other girls at ages 15-16, RR=0.53(0.32-0.88)
Author address
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
Controls participation rate
Greater than 70% (70%)