Environment and Breast Cancer: Science Review

Evidence From Humans
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Breast cancer incidence in ex-smokers in relation to body mass index, weight gain and blood lipid levels
Manjer, J., Malina, J., Berglund, G., Bondeson, L., Garne, J. P., Janzon, L. European Journal of Cancer Prevention. 2001. 10:3, 281-7.
Topic area
Body size
Study design
Prospective cohort
Funding agency
Not reported
Study Participants
Number of Cases
93 (invasive and in situ)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 2,082
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: registered Malmo, Sweden citizens in the Malmo Preventive Cohort; attended health examination for early detection and treatment of risk factors associated with the occurrence of cardiovascular disease; ex-smoker
Comment about participation selection
Strengths: anthropometric data was assessed by trained nurses at baseline examination; lengthy follow-up of 13.3 years; agreement between self-reported smoking habits and high plasma levels of carboxyhaemoglobin was high, meaning that it is likely that the vast majority of the women in the study were indeed ex-smokers Limitations: weight gained after cessation of smoking was not known, therefore the number of women who were obese while smoking was unknown; limited number of cases; did not compare results to non-smokers
Exposures investigated
Height, BMI and weight gain
How exposure was measured
Questionnaire, self-administered Anthropometric measurement, researcher-administered by trained nurses at baseline examination
Statistical Analysis
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 at baseline, oral contraceptive use and HRT use
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
Follow up: 13.3 years
Strength of associations reported
Association between breast cancer risk and BMI, >26.44 vs. <21.47, OR=1.91(1.00-3.69) trend p=0.16
Association between breast cancer risk and height, >167.5 vs. <159.8, OR=1.53(0.82-2.86) trend p=0.44
Results Comments
None of the exposures reached statistical significance.
Author address
Department of Community Medicine, Lund University, Malmo University Hospital, Malmo, Sweden. jonas.manjer@smi.mas.lu.se