Environment and Breast Cancer: Science Review

Evidence From Humans
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Early life factors in relation to breast cancer risk in postmenopausal women
Titus-Ernstoff, L., Egan, K. M., Newcomb, P. A., Ding, J., Trentham-Dietz, A., Greenberg, E. R., Baron, J. A., Trichopoulos, D., Willett, W. C. Cancer Epidemiol Biomarkers Prev. 2002. 11:2, 207-10.
Topic area
Early life exposures
Study design
Population based case-control
Study Participants
Number of Cases
1716 for birthweight analysis, 1555 for mother's age analysis
Menopausal Status
The menopausal status of women included in this study is listed here.
Number of Controls
Controls: 1886 for birthweight analysis, 1539 for mother's age analysis
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: United States population-based case-control study of breast cancer In: cases: Women of ages 50-79 years with a new diagnosis of invasive breast cancer ascertained from January 1992 to December 1994 by statewide registries in Massachusetts, New Hampshire, and Wisconsin, who had a listed telephone number and a driver's license determined by self-report if less than 65 years of age In: controls: randomly selected women in each state from lists of licensed drivers (age 50-64) and Medicare beneficiaries (ages 65-79) Ex: Unreliable interviews for both cases and controls, premenopausal women or unknown menopausal status
Exposure Investigated
Exposures investigated
Birthweight, maternal age
How exposure was measured
Questionnaire, by telephone
Exposure assessment comment
Misclassification due to self-reported birthweight by at least 50 year-old women (half of the participant were unable to report their birth weight)
Statistical Analysis
Breast cancer outcome investigated
Primary incident 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.
Race, alcohol consumption
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
Logistic regression model. covariates including BMI at reference date, religion, family history, age at first full-term pregnancy, parity, age at menopause, other early life factors and parental smoking were considered, but analyses provided no evidence o
Strength of associations reported
Birthweight: 1.18 (0.92-1.51); mother's age: 1.27 (0.90-1.79)
Results Comments
No clear association between birth weight and breast cancer risk, but the risk appeared to increase with increasing mother's age at the time of the subject's birth
Author address
Norris Cotton Cancer Center and the Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. Linda.Titus-Ernstoff@Dartmouth.edu