Cancer Causes & Control

, Volume 8, Issue 1, pp 49–56

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

  • David J. Hunter
  • Donna Spiegelman
  • Hans-Olov Adami
  • Piet A. van den Brandt
  • Aaron R. Folsom
  • R. Alexandra Goldbohm
  • Saxon Graham
  • Goeffrey R. Howe
  • Lawrence H. Kushi
  • James R. Marshall
  • Anthony B. Miller
  • Frank E. Speizer
  • Walter Willett
  • Alicja Wolk
  • Shiaw-Shyuan Yaun
Article

DOI: 10.1023/A:1018431104786

Cite this article as:
Hunter, D.J., Spiegelman, D., Adami, HO. et al. Cancer Causes Control (1997) 8: 49. doi:10.1023/A:1018431104786

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.

Breast cancer diet reproductive factors women 

Copyright information

© Chapman and Hall 1997

Authors and Affiliations

  • David J. Hunter
    • 1
  • Donna Spiegelman
    • 2
  • Hans-Olov Adami
    • 3
  • Piet A. van den Brandt
    • 4
  • Aaron R. Folsom
    • 5
  • R. Alexandra Goldbohm
    • 6
  • Saxon Graham
    • 7
  • Goeffrey R. Howe
    • 8
  • Lawrence H. Kushi
    • 5
  • James R. Marshall
    • 7
  • Anthony B. Miller
    • 8
  • Frank E. Speizer
    • 1
  • Walter Willett
    • 1
  • Alicja Wolk
    • 3
  • Shiaw-Shyuan Yaun
    • 1
  1. 1.Channing Laboratory, Department of MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  3. 3.Department of Cancer EpidemiologyUniversity HospitalUppsalaSweden
  4. 4.Department of EpidemiologyMaastricht UniversityMaastrichtThe Netherlands
  5. 5.Division of Epidemiology, School of Public HealthUniversity of MinnesotaMinneapolisUSA
  6. 6.Department of EpidemiologyTNO Nutrition and Food Research InstituteZeistThe Netherlands
  7. 7.Department of Social and Preventive MedicineState University of New York at BuffaloBuffaloUSA
  8. 8.NCIC Epidemiology Unit, Department of Preventive Medicine and Biostatistics, Faculty of MedicineUniversity of TorontoTorontoCanada