Environment and Breast Cancer: Science Review

Evidence From Humans
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A prospective study of body size in different periods of life and risk of premenopausal breast cancer
Weiderpass, E., Braaten, T., Magnusson, C., Kumle, M., Vainio, H., Lund, E., Adami, H. O. Cancer Epidemiology, Biomarkers & Prevention. 2004. 13:7, 1121-7.
Topic area
Body size
Study design
Prospective cohort
Funding agency
NCI Other: Norwegian Cancer Society Other: Aakre F
Study Participants
Number of Cases
733 (invasive only)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Number in Cohort
Cohort: 99,717
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: women age 34 to 49 born between 1943 and 1957 from Norway; women age 30 to 49 born between 1942 and 1962 from the Uppsala Health Care Region in Sweden; premenopausal Ex: died or emigrated before the beginning of follow-up; women who reported a previous breast cancer before enrollment; women without any information on weight in questionnaire; postmenopausal women
Comment about participation selection
Strengths: large prospective cohort with a 8 years follow-up; analyzed breast cancer risk by anthropometric variables; analyzed the interaction between height and BMI; analyzed the effect modification of breast cancer on BMI; collected detailed information on anthropometric measures during different periods of life Limitations: anthropometric data were self-reported
Exposure Investigated
Exposures investigated
BMI, height, BMI at 18, perceived body shape at age 7, difference in body size and shape between age 7 and adulthood, adult BMI change
How exposure was measured
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data were self-reported
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, parity, age at first birth, oc use, age at menarche, family history of bc, duration of breast feeding, country of residence, BMI, BMI at 18 years, height, body shape at age 7
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: 1991-1992 to 12/99 Effect modifiers: family history of breast cancer Interaction: adult height and body shape in childhood on BMI
Strength of associations reported
Association between premenopausal breast cancer and BMI, >30 vs. 20-24.9, RR=0.66(0.40-1.07) trend p=0.007
Association between premenopausal breast cancer and height, >175 cm vs. 165-169, RR=0.91(0.67-1.23)
Association between premenopausal breast cancer and height, <160 cm vs. 165-169, RR=0.72(0.54-0.97)
Overall trend for height, p=0.03
Association between premenopausal breast cancer and BMI among women without a history of breast cancer, >30 vs. 20-24.9, RR=0.58(0.36-0.95) trend p=0.0004
Association between premenopausal breast cancer and BMI among women with a history of breast cancer, >30 vs. 20-24.9, RR=0.96(0.30-3.13) trend p=0.37
Interaction between breast cancer and height, <161 cm vs. 162-169, in women with a BMI of 25 or greater, RR=0.59(0.39-0.95) p for interaction=0.29