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Breast cancer and exposure to tobacco smoke during potential windows of susceptibility

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Abstract

Purpose

An association between smoking and breast cancer is unresolved, although a higher risk from exposure during windows of susceptibility has been proposed. The objective of this prospective study was to evaluate the association between tobacco smoke and breast cancer with a focus on timing of exposure, especially during early life.

Methods

Sister study participants (n = 50,884) aged 35–74 were enrolled from 2003 to 2009. Women in the United States and Puerto Rico were eligible if they were breast cancer-free but had a sister with breast cancer. Participants completed questionnaires on smoking and environmental tobacco smoke (ETS) exposure. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for breast cancer risk.

Results

During follow-up (mean = 6.4 years), 1,843 invasive breast cancers were diagnosed. Neither active smoking nor adult ETS was associated with breast cancer risk. However, never smoking women exposed to ETS throughout their childhood had a 17% higher risk of breast cancer (95% CI 1.00–1.36) relative to those with no exposure. In utero ETS exposure was also associated with breast cancer (HR = 1.16, 95% CI 1.01–1.32) and the HR was most elevated for women born in earlier birth cohorts (<1940, HR = 1.44, 95% CI 1.02–2.02; 1940–1949, HR = 1.28, 95% CI 1.01–1.62).

Conclusion

In utero ETS and ETS exposure during childhood and adolescence were associated with increased risk of breast cancer and associations varied by birth cohort.

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Acknowledgments

The authors recognize the helpful feedback from Drs. Lauren Wilson and Katie O’Brien.

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Authors and Affiliations

  1. Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709-2233, USA

    Alexandra J. White, Aimee A. D’Aloisio & Dale P. Sandler

  2. Social & Scientific Systems, Inc., Durham, NC, 27703, USA

    Aimee A. D’Aloisio

  3. Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, USA

    Hazel B. Nichols

  4. Department of Global Public Health & Primary Care, University of Bergen, Bergen, Norway

    Lisa A. DeRoo

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  1. Alexandra J. White
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  2. Aimee A. D’Aloisio
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  3. Hazel B. Nichols
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  4. Lisa A. DeRoo
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  5. Dale P. Sandler
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Correspondence to Alexandra J. White.

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The authors have no conflicts of interest to declare.

Sources of financial support

This research was supported in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01-ES044005).

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White, A.J., D’Aloisio, A.A., Nichols, H.B. et al. Breast cancer and exposure to tobacco smoke during potential windows of susceptibility. Cancer Causes Control 28, 667–675 (2017). https://doi.org/10.1007/s10552-017-0903-1

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  • DOI: https://doi.org/10.1007/s10552-017-0903-1

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