Environment and Breast Cancer: Science Review

Evidence From Humans
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Comparative case-referent study of risk factors among hormone-related female cancers in Japan
Hirose, K., Tajima, K., Hamajima, N., Kuroishi, T., Kuzuya, K., Miura, S., Tokudome, S. Japanese Journal of Cancer Research. 1999. 90:3, 255-61.
Topic area
Body size
Study design
Other: Comparative case-referent study
Funding agency
Other: Japanese Ministry of Health and Welfare
Study Participants
Number of Cases
Cases: 1,465 breast cancer
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Pre menopausal
Number of Controls
Controls: 25,488 (referents)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Participants of the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC), older than 30 years at baseline, visited Aichi Cancer Center Hospital between 1/89 and 12/95, and diagnosed with breast cancer between 1/89 and 12/95 (cases) Ex: Women previously diagnosed with any type of cancer
Comment about participation selection
Strengths: Very large hospital-based case-referent study, recall bias was minimized because all data was collected prior to diagnosis, and study analyzed and compared the risk for endocrine related cancers (breast cancer, endometrial and ovarian cancer) Limitations: Possible bias caused by using hospital-based non-cancer patients as referent, results not stratified by menopausal status, and anthropometric data self-reported
Exposure Investigated
Exposures investigated
Height, weight, weight at 20 years, BMI, BMI at 20 years, and change of BMI after 20 years of age
How exposure was measured
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data self-reported
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, marital status, age at menarche, menstrual regularity, age at first full-term pregnancy and parity
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Strength of associations reported
Association between breast cancer risk and height, >158 cm vs. <151 cm, OR=1.17(1.00-1.36) trend p<0.05
Association between breast cancer risk and weight, >55 kg vs. <49 kg, OR=1.40(1.23-1.59) trend p<0.01
Association between breast cancer risk and BMI, >25 vs. <20, OR=1.49(1.24-1.78) trend p<0.01
Association between breast cancer risk and BMI around 20 years of age, >23 vs. <20, OR=0.75(0.62-0.90) trend p<0.01
Author address
Division of Epidemiology, Aichi Cancer Center Research Institute, Nagoya. khirose@aichi-cc.pref.aichi.jp