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Non-dietary factors as risk factors for breast cancer, and as effect modifiers of the association of fat intake and risk of breast cancer

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Abstract

To assess more precisely the relative risks associated with established risk factors for breast cancer, and whether the association between dietary fat and breast cancer risk varies according to levels of these risk factors, we pooled primary data from six prospective studies in North America and Western Europe in which individual estimates of dietary fat intake had been obtained by validated food-frequency questionnaires. Based on information from 322,647 women among whom 4,827 cases occurred during follow-up: the multivariate-adjusted risk of late menarche (age15 years or more compared with under 12) was 0.72 (95 percent confidence interval [CI]=0.62-0.82); of being postmenopausal was 0.82 (CI=0.69-0.97); of high parity (three or more births compared with none) was 0.72 (CI=0.61-0.86); of late age at first birth (over 30 years of age compared with 20 or under) was 1.46 (CI=1.22-1.75); of benign breast disease was 1.53 (CI=1.41-1.65); of maternal history of breast cancer was 1.38 (CI=1.14-1.67); and history of a sister with breast cancer was 1.47 (CI=1.27-1.70). Greater duration of schooling (more than high-school graduation compared with less than high-school graduation) was associated significantly with higher risk in age-adjusted analyses, but was attenuated after controlling for other risk factors. Total fat intake (adjusted for energy consumption) was not associated significantly with breast cancer risk in any strata of these non-dietary risk factors. We observed a marginally significant interaction between total fat intake and risk of breast cancer according to history of benign breast disease, with fat intake being associated nonsignificantly positively with risk among women with a previous history of benign breast disease; no other significant interactions were observed. Risks for reproductive factors were similar to those observed in case-control studies; relative risks for family history of breast cancer were lower. We found no clear evidence in any subgroups of a major relation between total energy-adjusted fat intake and breast cancer.

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Authors and Affiliations

  1. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA

    David J. Hunter, Frank E. Speizer, Walter Willett & Shiaw-Shyuan Yaun

  2. Department of Epidemiology, Harvard School of Public Health, Boston, USA

    Donna Spiegelman

  3. Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden

    Hans-Olov Adami & Alicja Wolk

  4. Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

    Piet A. van den Brandt

  5. Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA

    Aaron R. Folsom & Lawrence H. Kushi

  6. Department of Epidemiology, TNO Nutrition and Food Research Institute, Zeist, The Netherlands

    R. Alexandra Goldbohm

  7. Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, USA

    Saxon Graham & James R. Marshall

  8. NCIC Epidemiology Unit, Department of Preventive Medicine and Biostatistics, Faculty of Medicine, University of Toronto, Toronto, Canada

    Goeffrey R. Howe & Anthony B. Miller

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  1. David J. Hunter
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  2. Donna Spiegelman
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  4. Piet A. van den Brandt
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  7. Saxon Graham
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  8. Goeffrey R. Howe
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  12. Frank E. Speizer
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  13. Walter Willett
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  15. Shiaw-Shyuan Yaun
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Hunter, D.J., Spiegelman, D., Adami, HO. et al. Non-dietary factors as risk factors for breast cancer, and as effect modifiers of the association of fat intake and risk of breast cancer. Cancer Causes Control 8, 49–56 (1997). https://doi.org/10.1023/A:1018431104786

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  • DOI: https://doi.org/10.1023/A:1018431104786

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