Serum selenium level and other risk factors for breast cancer among patients in a Malaysian hospital

  • Lokman Rejali
  • Mohd Hasni Jaafar
  • Noor Hassim Ismail
Original Article

Abstract

Objective

The aim of this study is to investigate the association between breast cancer and serum selenium level as well as other risk factors for breast cancer.

Methods

A matched case-control study was conducted in a hospital in Malaysia from July 2000 to January 2001 and from May 2001 to June 2001. Sixty-two newly diagnosed breast cancer patients were selected as the cases. Each control, selected from the same hospital population was matched to each case according to age, ethnic group, and menopausal status.

Results

The mean selenium concentration among the cases was significantly lower than that among the control. There was a significant association (p<0.05) between breast cancer and low selenium serum level, nulliparity (OR=5.5,95% CI=1.22 to 24.81), exposure to cigarette smoke (OR=2.2, 95% CI=1.04 to 4.65) and use of oral contraceptives (OR=3.0, 95% CI=1.09 to 8.25) as determined by the McNemar test. Multivariate analysis showed that nulliparity (OR=10.08, 95% CI=1.48 to 68.52) and use of oral contraceptives (OR=3.66, 95% CI=1.36 to 9.87) were associated with increased breast cancer risk. An increased selenium concentration contributes to a reduced risk of breast cancer (OR=0.89, 95% CI=0.84 to 0.94).

Conclusion

The results suggest that use of oral contraceptive pills, being nulliparous, and a low serum selenium level are associated with breast cancer.

Key words

breast cancer selenium glutathione peroxides enzyme oral contraceptives nulliparity 

References

  1. (1).
    Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000: The global picture. Eur J Cancer. 2001;37:4–66.CrossRefGoogle Scholar
  2. (2).
    McPherson K, Steel CM, Dixon JM. Breast cancer epidemiology, risk factors and genetics: clinical review. Br Med J. 2000;321:624–628.CrossRefGoogle Scholar
  3. (3).
    Ministry of Health. National Health and Morbidity Survey Report. Ministry of Health: Kuala Lumpur, Malaysia; 1997.Google Scholar
  4. (4).
    Clark LC, Cantor KP, Allaway W. Selenium in forage crops and cancer mortality in US counties. Arch Env Health. 1991; 46:37–42.Google Scholar
  5. (5).
    Harr JR. Effect of dietary selenium onN-2-fluorenylacetamide (FAA): Induced cancer in vitamin E-supplemented selenium depleted rat. Clin Toxicol. 1972;5:187–194.PubMedCrossRefGoogle Scholar
  6. (6).
    Shamberger RJ, Frost DV. Possible protective effect of selenium against human cancer. Can Med Assoc J. 1969; 104:82–84.Google Scholar
  7. (7).
    Shamberger RJ, Willis CE. Selenium distribution and human cancer mortality. Crit Rev Clin Lab Sci. 1971;2:211–221.CrossRefGoogle Scholar
  8. (8).
    Xiu YQ, An YZ, Guang LW, Wen ZP. The association between breast cancer and other factors. Asia Pacific J Pub Health. 1994;7:98–104.Google Scholar
  9. (9).
    Ge K, Yang G. The epidemiology of selenium deficiency in the etiological study of endemic diseases in China. Am J Clin Nutr. 1993;57:259–263.Google Scholar
  10. (10).
    Hunter DJ, Morris JS, Stampher MJ, Colditz GA, Speizer FE, Willett WC. A prospective study of selenium status and breast cancer risk. J Am Med Assoc. 1990;264:1128–1131.CrossRefGoogle Scholar
  11. (11).
    Madigan MP, Ziegler RG, Benichou J, Byrne C, Hoover RN. Proportion of breast cancer cases in the United States explained by well-established risk factors. J Natl Cancer Inst. 1995;87:1681–1685.PubMedCrossRefGoogle Scholar
  12. (12).
    Slattery ML, Kerber RA. A comprehensive evaluation of family history and breast cancer risk. The Utah Population Database. J Am Med Assoc. 1993;270:1563–1568.CrossRefGoogle Scholar
  13. (13).
    Claus EB, Risch NJ, Thompson WD. Age at onset as an indicator of familial risk of breast cancer. Am J Epidemiol. 1990;131:961–972.PubMedGoogle Scholar
  14. (14).
    Collaborative Group on Hormonal Factors in Breast Cancer. Collaborative group on hormonal factors in breast cancer: Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet. 1996;347: 1713–1727.CrossRefGoogle Scholar
  15. (15).
    Steinberg KK, Thacker SB, Smith SJ. A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. J Am Med Assoc. 1991;265:1985–1990.CrossRefGoogle Scholar
  16. (16).
    Tee ES. Changing dietary intake and food consumption in Malaysia. National implications. Institute for Medical Research: Kuala Lumpur, Malaysia; 1995.Google Scholar
  17. (17).
    Thomas CT. Methods for biological monitoring: a manual for assessing human exposure to hazardous substances. In: Kneip TJ, Crable JV editors. Washington: American Public Health Association; 1988. p. 237–240.Google Scholar
  18. (18).
    Amstrong K, Eisen A, Weber B. Primary care: Assessing the risk of breast cancer. N Engl J Med. 2000;342:564–571.CrossRefGoogle Scholar
  19. (19).
    Cui Y, Miller AB, Rohan TE. Cigarette smoking and breast cancer risk: update of a prospective cohort study. Breast Cancer Res Treat. 2006;100:293–298.PubMedCrossRefGoogle Scholar
  20. (20).
    Combs GF, Clark LC. Can dietary selenium modify cancer risk? Nutr Rev. 1985;43:325–331.PubMedGoogle Scholar
  21. (21).
    Vernie LN. Selenium in carcinogenesis. Biochim Biophys Acta. 1984;738:203–217.PubMedGoogle Scholar
  22. (22).
    Schrauzer GN, Molenaar T, Mead S, Kuehn K, Yamamoto H, Araki E. Selenium in the blood of Japanese and American women with and without breast cancer and fibrocystic disease. Jpn J Cancer Res. 1985;76:374–377.PubMedGoogle Scholar
  23. (23).
    Dupont WD, Page DL. Breast cancer risk associated with proliferative disease, age at first birth and a family history of breast cancer. Am J Epidemiol. 1987;125:769–779.PubMedGoogle Scholar
  24. (24).
    Helmrich SP, Shapiro S, Rosenberg L, Kaufman DW, Slone D, Bain C, et al. Risk factors for breast cancer. Am J Epidemiol. 1983;117:35–45.PubMedGoogle Scholar
  25. (25).
    Lipnick R, Speizer FE, Bain C, Willett W, Rosner B, Stampfer MJ, et al. A case-control study of risk indicators among women with premenopausal and early postmenopausal breast cancer. Cancer. 1984;53:1020–1024.PubMedCrossRefGoogle Scholar
  26. (26).
    Soini I. Risk factors of breast cancer in Finland. Int J Epidemiol. 1977;6:365–373.PubMedCrossRefGoogle Scholar
  27. (27).
    Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw KT, Tehard B, et al. Body size and breast cancer risk: Findings from the European Prospective Investigation into Cancer And Nutrition. Int J Cancer. 2004;111:762–771.PubMedCrossRefGoogle Scholar
  28. (28).
    Zhu K, Caulfield J, Hunter S, Roland CL, Payne-Wilks K, Texter L. Body mass index and breast cancer risk in African American women. Ann Epidemiol. 2005;15:123–128.PubMedCrossRefGoogle Scholar
  29. (29).
    Tao MH, Shu XO, Ruan ZX, Gao YT, Zheng W. Association of overweight with breast cancer survival. Am J Epidemiol. 2006;163:101–107.PubMedCrossRefGoogle Scholar
  30. (30).
    Hunter DJ, Spiegelman D, Adami H, Beeson L, van den Brandt P, Folsom AR, et al. Cohort studies of fat intake and the risk of breast cancer: A pooled analysis. N Engl J Med. 1995;334:356–361.CrossRefGoogle Scholar
  31. (31).
    Collaborative group on hormonal factors in breast cancer. Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet. 1996;347:1713–1727.CrossRefGoogle Scholar
  32. (32).
    World Health Organization. International Program on Chemical Safety. World Health Organization: Geneva, Switzerland; 1987.Google Scholar

Copyright information

© Japanese Society of Hygiene 2007

Authors and Affiliations

  • Lokman Rejali
    • 1
  • Mohd Hasni Jaafar
    • 1
  • Noor Hassim Ismail
    • 1
  1. 1.Department of Community Health, Faculty of MedicineUniversity Kebangsaan MalaysiaKuala LumpurMalaysia

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