Environment and Breast Cancer: Science Review

Evidence From Humans
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Intake of dairy products, calcium, and vitamin d and risk of breast cancer
Shin, M. H., Holmes, M. D., Hankinson, S. E., Wu, K., Colditz, G. A., Willett, W. C. J Natl Cancer Inst. 2002. 94:17, 1301-11.
Study design
Prospective cohort
Funding agency
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal and premenopausal separate
Number in Cohort
Cohort 88,691
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Registered nurses from 11 states in the US participating in the Nurses' Health Study, who responded to a mailed questionnaire in 1976, who completed the 1980 dietary questionnaire, who did not have implausible values for total energy intake, and who had not left more than 10 food items blank, and had not been diagnosed with cancer by 1980. Ex: Cases of carcinoma in situ and women who developed breast cancer and were of uncertain menopausal status.
Comment about participation selection
Biennial follow-up including FFQ
Exposure Investigated
Exposures investigated
High school milk consumption, total dairy food, skim/low fat milk, whole milk, dietary vitamin D
How exposure was measured
Questionnaire, self-administered, FFQ
Exposure assessment comment
Low amount of milk consumption
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.
Not considered: race
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
Adjusted RR with 95% CI, highest versus lowest categories of intake (tertiles for total dairy, quintiles for milk and vitamin D), stratified by menopausal status. Cumulative average diet model from all dietary questionnaire. Adjustment for outdoor sun ex
Strength of associations reported
Premenopausal: High school milk consumption 0.81 (0.51 - 1.28); total dairy: 0.80 (0.63-1.03); skim/low fat milk: 0.78 (0.60-1.01); whole milk: 0.87 (0.59-1.28); dietary vitamin D: 0.66 (0.43-1.00)
Postmenopausal: High school milk consumption 1.02 (0.82 - 1.26); total dairy: 0.97 (0.85-1.12); skim/low fat milk: 1.05 (0.91-1.22); whole milk: 0.87 (0.69-1.10); dietary vitamin D: 1.06 (0.85-1.34)
Results Comments
Intake of dairy foods or vitamin D are not associated with the risk of breast cancer among postmenopausal women. Among premenopausal women most of the dairy related variables are inversely associated with breast cancer.
Author address
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.