Environment and Breast Cancer: Science Review
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Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses' Health Study
Huang, Z., Willett, W. C., Colditz, G. A., Hunter, D. J., Manson, J. E., Rosner, B., Speizer, F. E., Hankinson, S. E. American Journal of Epidemiology. 1999. 150:12, 1316-24.
Topic area
Body size
Body size
Study design
Prospective cohort
Prospective cohort
Funding agency
NCI
NCI
Study Participants
Number of Cases
1,037 (invasive) (197 pre) (840 post)
1,037 (invasive) (197 pre) (840 post)
Menopausal Status
Post menopausal
The menopausal status of women included in this study is listed here.
Pre menopausalPost menopausal
Number in Cohort
Cohort: 47,382
Cohort: 47,382
Cohort participation rate
Retention/participation exceeded 70% for exposed a
Retention/participation exceeded 70% for exposed a
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: participants of the Nurses' Health Study; reported waist and hip circumferences in 1986
Ex: women who reported any cancers other than nonmelanoma skin cancer prior to 1986
Comment about participation selection
Strengths: large prospective study with 333,097 person years of follow-up and over 1,000 cases; lengthy follow-up of 8 years; information on most variables were updated biennially; hospital records were obtained for 96% of the women who reported breast cancer; 99.4% of the self-reported breast cancers were confirmed; analyzed breast cancer risk by WHR stratified by menopausal status and HRT use Limitations: anthropometric data were self-reported: few premenopausal breast cancer cases; did not analyze BMI
Strengths: large prospective study with 333,097 person years of follow-up and over 1,000 cases; lengthy follow-up of 8 years; information on most variables were updated biennially; hospital records were obtained for 96% of the women who reported breast cancer; 99.4% of the self-reported breast cancers were confirmed; analyzed breast cancer risk by WHR stratified by menopausal status and HRT use Limitations: anthropometric data were self-reported: few premenopausal breast cancer cases; did not analyze BMI
Exposure Investigated
How exposure was measured
Questionnaire, self-administered
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data were self-reported
Anthropometric data were self-reported
Breast cancer outcome investigated
Primary breast cancer
Primary breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
No
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, height, history of benign breast disease, family history of breast cancer, age at menarche, physical activity, age at first birth, age at menopause, HRT use, 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.
No
Description of major analysis
Effect modifiers: menopausal status, HRT use
Effect modifiers: menopausal status, HRT use
Strength of associations reported
Association between premenopausal breast cancer risk and waist circumference, >36.0 in vs. <28.0 in, RR=0.90(0.52-1.55) trend p=0.78
Association between premenopausal breast cancer risk and hip circumference, >42.9 in. vs. <37.0 in., RR=0.60(0.37-0.98) trend p=0.02
Association between premenopausal breast cancer risk and WHR, >0.84 vs <0.73, RR=1.18(0.74-1.88) trend p=0.43
Association between postmenopausal breast cancer risk and WHR, >0.84 vs <0.73, RR=1.28(1.02-1.61) trend p= 0.005
Association between postmenopausal breast cancer risk and waist circumference, >36.0 in vs. <28.0 in, RR=1.34(1.05-1.72) trend p=0.007
Association between postmenopausal breast cancer risk and hip circumference, >42.9 in. vs. <37.0 in., RR=1.29(1.02-1.64) trend p=0.06
Association between postmenopausal breast cancer risk and WHR in women who had never used HRT, >0.84 vs <0.73, RR=1.85(1.25-2.74)
Association between premenopausal breast cancer risk and waist circumference, >36.0 in vs. <28.0 in, RR=0.90(0.52-1.55) trend p=0.78
Association between premenopausal breast cancer risk and hip circumference, >42.9 in. vs. <37.0 in., RR=0.60(0.37-0.98) trend p=0.02
Association between premenopausal breast cancer risk and WHR, >0.84 vs <0.73, RR=1.18(0.74-1.88) trend p=0.43
Association between postmenopausal breast cancer risk and WHR, >0.84 vs <0.73, RR=1.28(1.02-1.61) trend p= 0.005
Association between postmenopausal breast cancer risk and waist circumference, >36.0 in vs. <28.0 in, RR=1.34(1.05-1.72) trend p=0.007
Association between postmenopausal breast cancer risk and hip circumference, >42.9 in. vs. <37.0 in., RR=1.29(1.02-1.64) trend p=0.06
Association between postmenopausal breast cancer risk and WHR in women who had never used HRT, >0.84 vs <0.73, RR=1.85(1.25-2.74)