Evidence From Humans
 
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Body size and breast cancer risk in black women and white women: the Carolina Breast Cancer Study
Hall, I. J., Newman, B., Millikan, R. C., Moorman, P. G. American Journal of Epidemiology. 2000. 151:8, 754-64.
Topic area
Body size
Study design
Population based case-control
Study Participants
Number of Cases
873 cases (invasive only) (350 black women) (523 white women)
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Pre menopausal
Number of Controls
Controls: 824 (353 black women) (471 white women)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: participants of the Carolina Breast Cancer Study: age 20 to 74 years at baseline, lived in a 24 county area of central and eastern North Carolina (DMV and HCFA records for controls), and diagnosed with invasive breast cancer between 1993 and 1996 (cases)
Comment about participation selection
Strengths: Separate analysis by race and anthropometric measurements were taken at the time of the interview Limitations: Low response rate amongst controls, neither physical activity nor dietary considerations were taken into account in the study, misclassification of fat distribution is likely due to race-specific differences in localization of fat not considered, and study does not state that women with previous cancers were excluded
Exposure Investigated
Exposures investigated
BMI, height and W/H ratio
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
Exposure assessment comment
Misclassification of fat distribution due to race-specific differences in localization of fat not considered
Statistical Analysis
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
African Americans Non-hispanic White Americans
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, age at menarche, parity, age at first full term pregnancy, lactation, education, BMI, menopausal status, age at menopause, family history
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: race and menopausal status
Strength of associations reported
Association between breast cancer risk in premenopausal black women and BMI, >30.13 vs. <24.61, OR=0.89(0.38-2.07)
Association between breast cancer risk in premenopausal black women and height, >165.1 cm vs. <160.0 cm, OR=2.93(1.44-5.95)
Association between breast cancer risk in premenopausal black women and WHR, >0.86 vs. <0.77, OR=2.50(1.10-5.67)
Association between breast cancer risk in premenopausal white women and BMI, >30.13 vs. <24.61, OR=0.46(0.26-0.80)
Association between breast cancer risk in premenopausal white women and height, >165.1 cm vs. <160.0 cm, OR=0.77(0.46-1.29)
Association between breast cancer risk in premenopausal white women and WHR, >0.86 vs. <0.77, OR=2.44(1.17-5.09)

Association between breast cancer risk in postmenopausal black women and BMI, >30.13 vs. <24.61, OR=0.68(0.33-1.42)
Association between breast cancer risk in postmenopausal black women and height, >165.1 cm vs. <160.0 cm, OR=1.00(0.55-1.83)
Association between breast cancer risk in postmenopausal black women and WHR, >0.86 vs. <0.77, OR=1.62(0.70-3.79)
Association between breast cancer risk in postmenopausal white women and BMI, >30.13 vs. <24.61, OR=1.08(0.58-2.00)
Association between breast cancer risk in postmenopausal white women and height, >165.1 cm vs. <160.0 cm, OR=1.63(0.96-2.76)
Association between breast cancer risk in postmenopausal white women and WHR, >0.86 vs. <0.77, OR=1.64(0.88-3.07)
Results Comments
Mean BMI higher in black than white women, but height and W/H ratio similar Risk increased with increasing height for postmenopausal whites but not blacks and premenopausal blacks but not whites High W/H ratio >0.86 vs <0.78 associated with >2-fold higher risk for blacks than whites in premenopausal women
Author address
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, USA.
Controls participation rate
Less than 70% (53%)
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