Environment and Breast Cancer: Science Review

Evidence From Humans
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Childhood growth and breast cancer
De Stavola, B. L., dos Santos Silva, I., McCormack, V., Hardy, R. J., Kuh, D. J., Wadsworth, M. E. American Journal of Epidemiology. 2004. 159:7, 671-82.
Topic area
Body size
Study design
Birth cohort
Funding agency
Other: United Kingdom Medical Research Council
Study Participants
Number of Cases
59 breast cancer cases
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 2187
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women who were part of the Medical Research Council National Survey of Health Development (MRCNSHD) socially stratified birth cohort; women born during the week of March 3-9, 1946 in England, Scotland or Wales; alive and resided in the UK in 1971 Ex: died before 1971; emigrated before 1971; women with missing childhood height measurements
Comment about participation selection
Strengths: majority of anthropometric data were obtained by trained staff; high participation rate (85%); analyzed increases in anthropometric measures at different ages and risk of breast cancer and stratified these results by age at menarche; prospective study; obtained anthropometric data at several ages; self-reported cases from 1993 to 1999 Limitations: breast cancer diagnoses were self-reported; adult height at age 26 was self-reported; few cases (59); results not stratified by menopausal status; anthropometric data were not collected between birth and 2 years and between 11 and 14 years of age; only 40% of participants had complete-records
Exposures investigated
Height and BMI through childhood
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
Early life exposures considered
BMI and Height throughout childhood
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: childhood height and BMI, age at first birth, interval between menarche and first birth, parity, social class and adult BMI
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: 1/1/1971 to 12/31/99 Effect modifiers: age at menarche
Strength of associations reported
Association between breast cancer risk among women whose age at menarche was between 12.5 and 13.4 years and women who had a large increase in height between the ages of 11 and 15 years, OR=1.89(1.13-3.15) trend p=0.01
Results Comments
Women who grow fast in childhood and reach an adult height above average for their menarche category are at particularly increased risk of breast cancer
Author address
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom. bianca.destavola@lshtm.ac.uk