Advertisement

Journal of Cancer Research and Clinical Oncology

, Volume 98, Issue 3, pp 287–299 | Cite as

Breast cancer in Greenland-selected epidemiological, clinical, and histological features

  • N. H. Nielsen
  • J. P. H. Hansen
Original Papers Clinical Oncology or Epidemiology

Summary

Fifty-seven breast cancers were diagnosed among indigenous Greenlandic women from 1950 to 1974. An additional 22 cases registered between 1975 and 1979 represent a minimum number and were only used as basis for minimum incidence rates. Changes in age-adjusted rate, age-specific incidence pattern, and relative risk were consistent with an upward shift from a population of low risk between 1950 and 1969 to one of intermediate risk from 1970 onward, a finding that relates well to increased urbanization and westernization. The risk of breast cancer in Greenland may be associated with consumption of saturated fats but is seemingly not correlated to total fat intake which has always been on a par with high-risk Danish levels. An association with diet may in reality have been stronger than suggested but weakened by a counterbalancing effect of high fertility, especially in the youngest age groups. Evaluation of histological features and survival did not suggest differences which could favorably compare with findings in white population groups contrary to reported results from the population of Japan, also one of low risk and of mongoloid origin. Further studies should consider dietary intakes, endocrine variations, and breast fluid secretion with special attention to girls at the age of menarche.

Key words

Breast cancer Eskimo Greenland 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anderson DE (1971) Some characteristics of familial breast cancer. Cancer 28:1500–1504Google Scholar
  2. Armstrong B, Doll R (1975) Environmental factors and cancer incidences and mortality in different countries with special reference to dietary practice. Int J Cancer 15:617–631Google Scholar
  3. Bailar JC, Ederer F (1964) Significance factors for the ratio of a Poisson variable to its expectation. Biometrics 20:639–644Google Scholar
  4. Bang HO, Dyerberg J, Hjørne N (1976) The composition of food consumed by Greenland Eskimos. Acta Med Scand 200:69–73Google Scholar
  5. Bertelsen A (1904) On the occurrence of cancer in Greenland. (In Danish). Hospitalstidende 4′ række 12:209–214Google Scholar
  6. Bertelsen A (1937) Greenlandic medical statistics and nosography. Medd Groenl 117 (2):89–92Google Scholar
  7. Bjarnason O, Day N, Snaedal G, Tulinius H (1974) The effect of year of birth on the breast cancer age-incidence curve in Iceland. Int J Cancer 13:689–696Google Scholar
  8. Brenøe C (1979) Investigation of diet in Greenland 1974 (In Danish with English text in Tables), 1st edn, p 43. Statens Husholdningsråd og Ministeriet for Grønland. CopenhagenGoogle Scholar
  9. Buell P (1973) Changing Incidence of Breast Cancer in Japanese-American Women. J Nat Cancer Inst 51:1479–1483Google Scholar
  10. Carroll KK, Gammal EB, Plunkett ER (1968) Dietary fat and mammary cancer. Can Med Assoc J 98:590–594Google Scholar
  11. Carroll KK, Khor HT (1971) Effects of level and type dietary fat on incidence of mammary tumors induced in Sprague-Dawley rats by 7,12-dimethylbenz(α)anthracene. Lipids 6:415–420Google Scholar
  12. Chabon AB, Takeuchi S, Sommers SC (1974) Histological differences in breast carcinoma of Japanese and American women. Cancer 33:1577–1579Google Scholar
  13. Chan P, Cohen LA (1974) Effect of dietary fat, antiestrogen, and antiprolactin on the development of mammary tumours in rats. J Nat Cancer Inst 52:24–30Google Scholar
  14. Chan PC, Tsuang J, Head J, Cohen LA (1974) Effect of estradiol and prolactin on growth of rat mammary adenocarcinoma cells in monolayer cultures. Proc Soc Exp Biol Med 151:362–365Google Scholar
  15. Choi NW, Howe GR, Miller AB, Matthews V, Morgan RW, Munan L, Burch JD, Feather J, Jain M, Kelly A (1978) An epidemiologic study of breast cancer. Am J Epidemiol 107:510–521Google Scholar
  16. Clemmesen J (1965) Statistical studies in the aetiology of malignant neoplasms II. Acta Pathol Microbiol Scand [Suppl] 174 II:243Google Scholar
  17. Clemmesen J (1969) Statistical studies in the aetiology of malignant neoplasms III. Acta Pathol Microbiol Scand [Suppl] 209:109Google Scholar
  18. Clemmesen J (1974) Statistical studies in the aetiology of malignant neoplasms IV. Acta Pathol Microbiol Scand [A] [Suppl] 247:225Google Scholar
  19. Clemmesen J (1976) Survival of breast-cancer patients in Denmark 1960–1966 (In Danish with English text in Tables) Ugeskr Læg 138:1527–1528Google Scholar
  20. Clemmesen J (1977) Statistical studies in the aetiology of malignant neoplasms V. Acta Pathol Microbiol Scand [A] [Suppl] 261:243Google Scholar
  21. Day NE, Muenz L, Tulinius H (1978) Some aspects of familial breast cancer. In: Grundmann E, Beck L (eds) Early diagnosis of breast cancer. Cancer Campaign vol 1. Gustav Fischer, Stuttgart New York, pp 29–36Google Scholar
  22. De Waard F (1975) Breast cancer incidence and nutritional status with particular reference to body weight and height. Cancer Res 35:3351–3356Google Scholar
  23. De Waard F (1978) Nutritional aspects of breast cancer and their possible bearing on screening programs. In: Grundmann E, Beck L (eds) Early diagnosis of breast cancer. Cancer Campaign vol 1. Gustav Fischer, Stuttgart New York, pp 37–41Google Scholar
  24. Doll R (1976) Comparison between registries. Age-standardized rates. In: Waterhouse J, Muir C, Correa P, Powell J (eds) Cancer incidence in five continents, 1st edn, vol 3. International Agency for Research on Cancer, Lyon, pp 453–459Google Scholar
  25. Dunn JE (1975) Cancer epidemiology in populations of the United States — with emphasis on Hawaii and California- and Japan. Cancer Res 35:3240–3245Google Scholar
  26. Fibiger J (1923) Über das Vorkommen von Krebs und Geschwülsten in Grönland; Ergebnisse der vom dänischen Cancerkomitee bewerkstelligten Untersuchungen. Z Krebsforsch 20:148–187Google Scholar
  27. Frisch RE, McArthur JW (1974) Menstrual cycles: Fatness as a determinant of minimum weight for height necessary for their maintenance or onset. Science 185:949–951Google Scholar
  28. Haenszel W, Loveland DB, Sirken MG (1962) Lung cancer mortality as related to residence and smoking histories. J Nat Cancer Inst 28:947–1001Google Scholar
  29. Hankin JH, Rawlings MS (1978) Diet and breast cancer: a review. Am J Clin Nutr 31:2005–2016Google Scholar
  30. Hems G (1978) The contributions of diet and childbearing to breast-cancer rates. Br J Cancer 37:974–982Google Scholar
  31. Henderson BE, Powell D, Rosario I, Keys C, Hanisch R, Young M, Casagrande J, Gerkins V, Pike MC (1974) An epidemiologic study of breast cancer. J Nat Cancer Inst 53:609–614Google Scholar
  32. Henderson BE, Gerkins V, Rosario I, Casagrande J, Pike MC (1975) Elevated serum levels of estrogen and prolactin in daughters of patients with breast cancer. New Engl J Med 293:790–795Google Scholar
  33. Hill MJ, Goddard P, Williams REO (1971) Gut bacteria and aetiology of cancer of the breast. Lancet 2:472–473Google Scholar
  34. Hopkins GJ, West CE (1976) Possible roles of dietary fats in carcinogenesis. Life Sci 19:1103–1116Google Scholar
  35. Howell MA (1974) Factor analysis of international cancer mortality data and per capita food consumption. Br J Cancer 29:328–335Google Scholar
  36. Howell MA (1976) The association between colorectal cancer and breast cancer. J Chron Dis 29:243–261Google Scholar
  37. Krogh A, Krogh M (1913) A study of the diet and metabolism of Eskimos undertaken in 1908 on an expedition to Greenland. Medd Groenl 51:1–52Google Scholar
  38. Lewison EF, Neto AS (1971) Bilateral breast cancer at the Johns Hopkins Hospital. Cancer 28:1297–1301Google Scholar
  39. MacMahon B, Cole P, Lin TM, Lowe CR, Mirra AP, Ravnihar B, Salber EJ, Valaoras VG, Yuasa S (1970a) Age at first birth and breast cancer risk. Bull WHO 43:209–221Google Scholar
  40. MacMahon B, Lin TM, Lowe CR, Mirra AP, Ravnihar B, Salber EJ, Trichopoulos D, Valaoras VG, Yuasa S (1970b) Lactation and cancer of the breast. A summary of an international study. Bull WHO 42:185–194Google Scholar
  41. MacMahon B, Cole P, Brown J (1973a) Etiology of human breast cancer: A review. J Nat Cancer Inst 50:21–42Google Scholar
  42. MacMahon B, Morrison AS, Ackerman LV, Lattes R, Taylor HB, Yuasa S (1973b) Histological characteristics of breast cancer in Boston and Tokyo. Int J Cancer 11:338–344Google Scholar
  43. Mertin J (1973) Polyunsaturated fatty acids and cancer. Br Med J 4:357Google Scholar
  44. Miller AB, Kelly A, Choi NW, Matthews V, Morgan RW, Munan L, Burch JD, Feather J, Howe GR, Jain M (1978) A study of diet and breast cancer. Am J Epidemiol 107:499–509Google Scholar
  45. Ministry for Greenland (1971) The population in Greenland at Dec. 31. 1969 and a short review of the population development 1949–1969 (In Danish) Meddedelser fra Økonomiskstatistisk kontor nr 17. Ministry for Greenland, CopenhagenGoogle Scholar
  46. Morrison AS, Black MM, Lowe CR, MacMahon B, Yuasa S (1973) Some international differences in histology and survival in breast cancer. Int J Cancer 11:261–267Google Scholar
  47. Nielsen NH, Mikkelsen F, Hansen JPH (1977) Nasopharyngeal cancer in Greenland. Acta Pathol Microbiol Scand [A] 85:850–858Google Scholar
  48. Nielsen NH, Mikkelsen F, Hansen JPH (1978) Carcinoma of the uterine cervix and dysplasia in Greenland. Acta Pathol Microbiol Scand [A] 86:36–44Google Scholar
  49. Nielsen NH, Hansen JPH (1979) Gastric and colorectal cancer in Greenland. Scand J Gastroenterol 14:697–703Google Scholar
  50. Nomura A, Henderson BE, Lee J (1978) Breast cancer and diet among the Japanese in Hawaii. Am J Clin Nutr 31:2020–2025Google Scholar
  51. Petrakis NL, Mason L, Lee R, Sugimato B, Pawson S, Catchpool F (1975) Association of race, age, menopausal status, and cerumen type with breast fluid secretion in nonlacting women, as determined by nipple aspiration. J Nat Cancer Inst 54:829–833Google Scholar
  52. Petrakis NL (1977) Breast secretory activity in nonlactating women, postpartum breast involution, and the epidemiology of breast cancer. Nat Cancer Inst Monogr 47:161–164Google Scholar
  53. Phillips RL (1975) Role of life-style and dietary habits in risk of cancer among seventh-day adventists. Cancer Res 35:3513–3522Google Scholar
  54. Prior P, Waterhouse JAH (1978) Incidence of bilateral tumours in a population-based series of breast-cancer patients. Two approaches to an epidemiological analysis. Br J Cancer 37:620–634Google Scholar
  55. Rao GA, Abraham S (1976) Brief communication: Enhanced growth rate of transplanted mammary adenocarcinoma induced in C3H mice by dietary linoleate. J Nat Cancer Inst 56:431–432Google Scholar
  56. Staszewski J (1971) Age at menarche and breast cancer. J Nat Cancer Inst 47:935–940Google Scholar
  57. Sørensen EV (1979) Cancer of the breast. A retrospective investigation of 495 cases in a central hospital. (In Danish with English summary). Ugeskr Læg 141:1393–1395Google Scholar
  58. Trichopoulos D, MacMahon B, Cole P (1972) Menopause and breast cancer risk. J Nat Cancer Inst 48:605–613Google Scholar
  59. Tulinius H, Day NE, Johannesson G, Bjarnason O, Gonzales M (1978) Reproductive factors and risk for breast cancer in Iceland. Int J Cancer 21:724–730Google Scholar
  60. Uhl E (1955) Some investigations of Greenlandic foodstuffs and dietary conditions. (In Danish with English Summary). Beretn Groenl 3(2):1–47Google Scholar
  61. Waterhouse J, Muir C, Correa P, Powell J (eds) (1976) Cancer incidence in five continents. Ist edn vol 3, International Agency for Research on Cancer, Lyon, pp 510–511Google Scholar
  62. Wynder EL, Kajitani T, Kuno J, Lucas JC, De Palo A, Farrow J (1963) A comparison of survival rates between American and Japanese patients with breast cancer. Surg Gynec Obstet 117:196–200Google Scholar
  63. Wynder EL, Chan P, Cohen L, MacCornack F, Hill P (1978a) Etiology and Prevention of Breast Cancer. In: Grundmann E, Beck L (eds) Early diagnosis of breast cancer. Cancer Campaign vol 1. Gustav Fischer, Stuttgart New York, pp 1–28Google Scholar
  64. Wynder EL, MacCornack FA, Stellmann SD (1978b) The epidemiology of breast in 785 United States Caucasian women. Cancer 41:2341–2354Google Scholar
  65. Yuasa S, MacMahon B (1970) Lactation and reproductive histories of breast cancer patients in Tokyo, Japan. Bull WHO 42:195–204Google Scholar

Copyright information

© Springer-Verlag 1980

Authors and Affiliations

  • N. H. Nielsen
    • 1
    • 2
  • J. P. H. Hansen
    • 1
    • 2
  1. 1.Department of PathologyRigshospitaletCopenhagenDenmark
  2. 2.Department of PathologyCopenhagen County HospitalGentofteDenmark

Personalised recommendations