Environment and Breast Cancer: Science Review

Evidence From Humans
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Body mass index, height, and postmenopausal breast cancer mortality in a prospective cohort of US women
Petrelli, J. M., Calle, E. E., Rodriguez, C., Thun, M. J. Cancer Causes & Control. 2002. 13:4, 325-32.
Topic area
Body size
Study design
Prospective cohort
Study Participants
Number of Cases
2,852 breast cancer deaths
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number in Cohort
Cohort: 424,168
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: participant of the American Cancer Society's Cancer Prevention Study II (CPS-II); resident of any of the 50 US states, District of Columbia or Puerto Rico in 1982; postmenopausal Ex: women with missing values of height or weight; extreme values of height or weight; women with cancer at study entry; women who did not specify their menopausal status; pre or perimenopausal women
Comment about participation selection
Strengths: large prospective cohort; length follow-up (14 years); analyzed a large number of breast cancer mortalities; analyzed breast cancer mortality by BMI and height; controlled for other breast cancer risk factors Limitations: anthropometric data self-reported; low participation rate; lack of data on weight change throughout follow-up period; lacked information on screening behavior and stage at diagnosis
Exposure Investigated
Exposures investigated
BMI and height
How exposure was measured
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data self-reported
Breast cancer outcome investigated
Mortality from breast cancer
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, height, race, family history of breast cancer, breast cysts, number of live births, age at first live birth, age at menarche, age at menopause, menopausal status, oral contraceptive use, estrogen replacement therap
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: 14 years
Strength of associations reported
Association between increased BMI and breast cancer mortality, BMI > 40 vs. 18.5-20.49, RR=3.08(2.09-4.51)
Association between increased height and breast cancer mortality, ht > 69 in vs. < 60 in, RR=1.66(1.19-2.30)
Author address
Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30329, USA.