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Understanding rural–urban differences in risk factors for breast cancer in an Indian population

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Abstract

Purpose

Although cancer registry data indicate that there are large differences in breast cancer (BC) rates between rural and urban regions of India, the reasons for these differences are not well understood.

Methods

We conducted a hospital based case–control study (1,637 breast cancer cases; 1,515 visitor controls) in Mumbai, India, during the years 2009–2013. Extensive questionnaire data, anthropometry measurement and blood samples were collected on all participants. Using logistic regression models, we estimated risk based on odds ratio (OR) and 95 % confidence intervals (CI) for various reproductive and anthropometric measures, stratified by rural–urban status depending upon residence in first 20 years of life.

Results

Waist-to-hip ratio of ≥0.95 compared to ratio ≤0.84 was strongly associated with risk of BC in both rural and urban populations (ORurban = 4.10, 95 % CI 3.03–5.56; ORrural = 3.01, 95 % CI 1.85–4.90). First full-term pregnancy after the age of 25 compared to first full-term pregnancy below 20 years of age was associated with risk of BC in both urban and rural women (ORurban = 1.78, 95 % CI 1.32–2.41; ORrural = 2.24, 95 % CI 1.13–4.43). The prevalence of age at first full-term pregnancy was significantly lower in rural (mean age at first full-term pregnancy = 19.39 years) versus urban women (mean age at first full-term pregnancy = 22.62 years), whereas mean waist circumference was much higher in urban women (82.13 cm) compared to rural women (79.26 cm). We did not observe any association between breast feeding and risk of BC.

Conclusions

Differences in the prevalence of central adiposity and age at first full-term pregnancy between rural and urban women from India may explain some differences in breast cancer rates between these two populations.

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Acknowledgments

The work was supported by International Agency for Research on Cancer and Department of Biotechnology.

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Authors and Affiliations

  1. Centre for Cancer Epidemiology, Tata Memorial Centre, E. Borges Road, Parel Mumbai, Maharashtra, 400 012, India

    Rajini Nagrani, Sharayu Mhatre & Rajesh Dikshit

  2. Icahn School of Medicine, Mount Sinai Hospital, Institute for Translational Epidemiology, New York, NY, USA

    Paolo Boffetta

  3. Centre for Global Health and Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Rockville, MD, USA

    Preetha Rajaraman

  4. Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India

    Rajendra Badwe & Vani Parmar

  5. Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India

    Sudeep Gupta

  6. Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France

    Isabelle Romieu

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  1. Rajini Nagrani
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Correspondence to Rajesh Dikshit.

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Nagrani, R., Mhatre, S., Boffetta, P. et al. Understanding rural–urban differences in risk factors for breast cancer in an Indian population. Cancer Causes Control 27, 199–208 (2016). https://doi.org/10.1007/s10552-015-0697-y

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  • DOI: https://doi.org/10.1007/s10552-015-0697-y

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