Environment and Breast Cancer: Science Review

Evidence From Humans
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Association of body size and fat distribution with risk of breast cancer among Chinese women
Shu, X. O., Jin, F., Dai, Q., Shi, J. R., Potter, J. D., Brinton, L. A., Hebert, J. R., Ruan, Z., Gao, Y. T., Zheng, W. International Journal of Cancer. 2001. 94:3, 449-55.
Topic area
Body size
Study design
Population based case-control
Study Participants
Number of Cases
1,459 (952 premenopausal) (501 Postmenopausal)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Controls: 1,556 (990 Premenopausal) (562 postmenopausal)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Age 25-64 at baseline, lived in urban Shanghai during study and diagnosed with breast cancer between 8/96 and 3/98 (cases) Ex: Prior history of cancer and death prior to interview
Comment about participation selection
Strengths: High participation rate, anthropometric measurements recorded by a trained interviewer and low obesity rate allowing for an assessment of a population closer to ideal normal weight Limitations: Weight histories may reflect recall bias
Exposure Investigated
Exposures investigated
Weight at diagnosis, Height, BMI, W/H ratio, Weight change in adulthood
How exposure was measured
Questionnaire, in person
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, education, age at menarche, age at first live birth, physical activity, age at menopause, ever fibroadenoma
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
Effect modifiers: menopausal status Interactions: BMI and W/H ratio by menopausal status, BMI at age 20 by weight gain since age 20 by menopausal status
Strength of associations reported
Association between postmenopausal breast cancer and weight gain since age 20, > 5.65 kg vs. <1.15kg, OR=2.7 (1.7-4.2) trend p<0.001
Association between postmenopausal breast cancer and weight, > 64 kg vs. <52 kg, OR= 2.0 (1.4-3.0) trend p<0.0001
Association between postmenopausal breast cancer and BMI, > 28.0 vs. <20.70, OR= 2.0 (1.2-3.2) trend p=0.003
Association between postmenopausal breast cancer and Height, > 162 cm vs. <155 cm, OR= 1.7 (1.2-2.5) trend p=0.001
Association between premenopausal breast cancer risk and W/H ratio, > 0.865 vs. <0.764, OR= 1.8 (1.3-2.6) trend p < 0.001; not modified by BMI
Results Comments
No impact by other premenopausal breast cancer factors
Author address
Vanderbilt Center for Health Service Research and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232-8300, USA. Xiao-Ou.Shu@mcmail.vanderbilt.edu