Environment and Breast Cancer: Science Review

Evidence From Humans
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Is the association of birth weight with premenopausal breast cancer risk mediated through childhood growth?
dos Santos Silva, I., De Stavola, B. L., Hardy, R. J., Kuh, D. J., McCormack, V. A., Wadsworth, M. E. Br J Cancer. 2004. 91:3, 519-24.
Topic area
Early life exposures
Study design
Prospective cohort
Funding agency
Other: UK Medical Research Council
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Number in Cohort
Cohort: 2176
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
National Survey of Health and Development In: Women born from a single legitimate live-birth that occurred in Britain during the week 3-9 March 1946 and who have since been followed, are known to be still alive on January 1971 and for whom birth weight information and at least one height measurement in childhood is available. Ex: Women who had no height measurements between ages 2 and 15 years and who had no birthweight data
Comment about participation selection
Long and thorough follow-up but limited to a subgroup of women born in the same week
Exposure Investigated
Exposure assessment comment
Few premenopausal cases in each category of birthweight
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, family history of breast cancer
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
Cox proportional hazard model adjusted for age. Additional adjustment for age-specific attained height, BMI, height and BMI velocity throughout childhood and adolescence, adult leg length, age at menarche, maternal age, birth order, father's social class,
Strength of associations reported
All women:1.57 (0.60 - 4.13); premenopausal women 5.03 (1.13 - 22.47)
Results Comments
A positive association between birthweight and risk of breast cancer, which was particularly strong at premenopausal age.
Author address
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. isabel.silva@lshtm.ac.uk