Environment and Breast Cancer: Science Review

Evidence From Humans
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Serum insulin and glucose levels and breast cancer incidence: the atherosclerosis risk in communities study.[see comment]
Mink, P. J., Shahar, E., Rosamond, W. D., Alberg, A. J., Folsom, A. R. American Journal of Epidemiology. 2002. 156:4, 349-52.
Topic area
Body size
Study design
Prospective cohort
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number in Cohort
Cohort: 7,894
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: black or white women who participated in the Artherosclerosis Risk in Communities Study (ARIC) cohort; age 45-64 at baseline between 1987 and 1989; lived in one of four US communities (suburban Minneapolis, Minnesota; Forsyth County, North Carolina; Washington County, Maryland; Jackson Mississippi); had blood drawn at baseline Ex: women with diabetes; prior history of breast cancer
Comment about participation selection
Strengths: anthropometric data collected by trained staff; identified women with undiagnosed diabetes; fully adjusted for BMI; examined dose-response for fasting glucose and breast cancer incidence Limitations: does not stratify results by menopausal status or by race; few cases; does not analyze breast cancer risk by BMI and fasting insulin or glucose levels
Exposures investigated
BMI and W/H ratio
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
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, race, study center, BMI, age at menarche, age at first live birth, family history of breast cancer, number of sisters, alcohol intake, smoking habits
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: 7.1 years
Results Comments
Association between breast cancer and BMI among women 51-64 years. No association between breast cancer incidence and W/H ratio. Fasting insulin levels increased across quintiles of BMI and WHR. No association between breast cancer risk and fasting insulin levels.
Author address
Division of Cancer Prevention and Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20852, USA. minkp@mail.nih.gov