Environment and Breast Cancer: Science Review

Evidence From Humans
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Plasma carotenoids, retinol, and tocopherols and risk of breast cancer
Tamimi, R. M., Hankinson, S. E., Campos, H., Spiegelman, D., Zhang, S., Colditz, G. A., Willett, W. C., Hunter, D. J. Am J Epidemiol. 2005. 161:2, 153-60.
Study design
Nested case-control
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Pre menopausal
Number in Cohort
Controls: 969, cohort: 32,826
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Women who returned the initial questionnaire of the Nurses' Health Study in 1976 (US registered nurses between the ages of 30 and 55 years in 1976) Eligible cases: women with pathologically confirmed, incident invasive and in situ breast cancer from the subcohort of women who returned a blood sample and were diagnosed by June 1, 1998. Cases were excluded if they reported any other prior cancer diagnosis except for nonmelanoma skin cancer. Controls: randomly selected from the subcohort of women who returned a blood sample and never reported a diagnosis of cancer except for non-melanoma skin cancer.
Comment about participation selection
Largest cohort study for biological markers and risk of breast cancer
Exposure Investigated
Exposures investigated
Alpha-carotene, beta-carotene, alpha-tocopherol
Exposure assessment comment
Lack of information about the stability of the biomarkers (i.e. latency between blood being drawn and stored in nitrogen freezers).
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 OR with 95% CI, highest versus lowest quintile of plasma nutrients, stratification by ER, lymphatic node status, and differentiation of tumor cells. Follow-up 9-10 years
Strength of associations reported
Beta-carotene: 0.73 (0.53-1.02); alpha-tocopherol: 0.79 (0.57-1.08)
Results Comments
The inverse association between beta-carotene and risk of breast cancer was attenuated upon adjustment for alpha-carotene.
Author address
Channing Laboratory, Department of Medicine, 181 Longwood Avenue, Boston, MA 02115, USA. rulla.tamimi@channing.harvard.edu