Environment and Breast Cancer: Science Review

Evidence From Humans
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Body weight and cancer screening among women
Fontaine, K. R., Heo, M., Allison, D. B. Journal of Womens Health & Gender-Based Medicine. 2001. 10:5, 463-70.
Topic area
Body size
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 80,000
Cohort participation rate
Retention/participation exceeded 70% for exposed a
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: women who participated in the 1998 Behavioral Risk Factor Surveillance Survey (BRFSS), a telephone survey Ex: women with missing data on height or weight
Comment about participation selection
Strengths: large dataset used for study; analyzed women who delayed mammograms and clinical breast exams by BMI; stratified findings by race Limitations: anthropometric data self-reported; conducted telephone interviews; women with lower BMIs could be more health conscious and be more likely to obtain cancer screenings; associations observed between BMI and screening cold result from residual confounding or confounding from unmeasured variables; survey did not investigate why obese women delay screening; relationship between underweight BMI category and delays in screenings could be due to an underlying illness
Exposure Investigated
How exposure was measured
Questionnaire, by telephone
Exposure assessment comment
Anthropometric data self-reported
Breast cancer outcome investigated
Other: mammogram use and clinical breast examinations
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Non-hispanic White Americans Non-whites
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, race, smoking status, and health insurance status
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Results Comments
Underweight and obese women are more likely to delay mammography (underweight BMI is <18.5) (obese BMI is >30). Overweight and obese women are more likely to delay clinical breast examinations (overweight is 25-29.9).
Author address
University of Maryland, Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland, USA.