Environment and Breast Cancer: Science Review
About
Early age at menopause and breast cancer: are leaner women more protected? A prospective analysis of the Dutch DOM cohort
Monninkhof, E. M., van der Schouw, Y. T., Peeters, P. H. Breast Cancer Research & Treatment. 1999. 55:3, 285-91.
Topic area
Body size
Body size
Study design
Prospective cohort
Prospective cohort
Funding agency
Not reported
Not reported
Study Participants
Number of Cases
485
485
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number in Cohort
Cohort: 10,591
Cohort: 10,591
Country where study was conducted
Netherlands
Netherlands
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: women in the DOM Cohort who participated in a population based breast cancer screening project in Utrecht, Netherlands: born between 1911 and 1925; resident of Utrecht, Netherlands; age 44-66 years at baseline (1974)
Ex:did not reach menopause at baseline or during study; developed premenopausal breast cancer; had breast cancer at baseline; did not have data on smoking habits
Comment about participation selection
Strengths: analyzed Dutch women who have the highest incidence of breast cancer in Europe; population based study; histologically confirmed all breast cancers as primary cancers; analyzed the relationship between breast cancer incidence by age at menopause and BMI; analyzed the relationship between breast cancer incidence by age at menopause and BMI stratified by smoking status; anthropometric measurements were obtained by a trained staff Limitations: possible recall bias which could cause women to be misclassified
Strengths: analyzed Dutch women who have the highest incidence of breast cancer in Europe; population based study; histologically confirmed all breast cancers as primary cancers; analyzed the relationship between breast cancer incidence by age at menopause and BMI; analyzed the relationship between breast cancer incidence by age at menopause and BMI stratified by smoking status; anthropometric measurements were obtained by a trained staff Limitations: possible recall bias which could cause women to be misclassified
How exposure was measured
Questionnaire, self-administered Anthropometric measurement, researcher-administered
Questionnaire, self-administered Anthropometric measurement, researcher-administered
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, parity, health insurance, smoking status, oc use, age at first birth, BMI, fat distribution and type of menopause
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: age at menopause and smoking status Follow-up: 19 years (median)
Effect modifiers: age at menopause and smoking status Follow-up: 19 years (median)
Results Comments
Association between breast cancer risk and women with a BMI <27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.56(0.34-0.91) trend p=0.0129 Association between breast cancer risk and women with a BMI >27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.76(0.41-1.40) trend p=0.2808 Association between breast cancer risk and women who never smoked with a BMI <27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.70(0.39-1.24) Association between breast cancer risk and women who smoked with a BMI <27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.33(0.13-0.83)
Association between breast cancer risk and women with a BMI <27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.56(0.34-0.91) trend p=0.0129 Association between breast cancer risk and women with a BMI >27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.76(0.41-1.40) trend p=0.2808 Association between breast cancer risk and women who never smoked with a BMI <27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.70(0.39-1.24) Association between breast cancer risk and women who smoked with a BMI <27, who reached menopause at or before age 44, < 44 yrs vs. 55 yrs, HR=0.33(0.13-0.83)
Author address
Julius Center for Patient Oriented Research, Utrecht University Hospital, The Netherlands.
Julius Center for Patient Oriented Research, Utrecht University Hospital, The Netherlands.
Reviewers Comments
Smoking appears to have a protective affect in postmenopausal women.
Smoking appears to have a protective affect in postmenopausal women.