Dietary fiber intake and risk of breast cancer defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study
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Epidemiological studies have suggested a protective effect of dietary fiber intake on breast cancer risk while the results have been inconsistent. Our study aimed to investigate the association between dietary fiber intake and breast cancer risk and to explore whether this association is modified by reproductive factors and hormone receptor status of the tumor.
A total of 44,444 women aged 45 to 74 years from the Japan Public Health Center-based Prospective Study were included in analyses. Dietary intake assessment was performed using a validated 138-item food frequency questionnaire (FFQ). Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer incidence were calculated by multivariate Cox proportional hazards regression models.
During 624,423 person-years of follow-up period, 681 breast cancer cases were identified. After adjusting for major confounders for breast cancer risk, inverse trends were observed but statistically non-significant. Extremely high intake of fiber was associated with decreased risk of breast cancer but this should be interpreted with caution due to limited statistical power. In stratified analyses by menopausal and hormone receptor status, null associations were observed except for ER-PR- status.
Our findings suggest that extreme high fiber intake may be associated with decreased risk of breast cancer but the level of dietary fiber intake among Japanese population might not be sufficient to examine the association between dietary fiber intake and breast cancer risk.
KeywordsBreast cancer Dietary fiber intake Estrogen receptor (ER) Progesterone receptor (PR)
We would like to thank the Iwate, Ibaraki, Niigata, Kochi, Nagasaki, and Okinawa Cancer Registries for providing their incidence data.
This work was funded by the National Cancer Center Research and Development Fund [23-A-31(toku), 26-A-2] and Kiban A: Burden of Disease Fund .
Compliance with Ethical Standards
Conflict of interest
M. Inoue is the beneficiary of a financial contribution from the AXA Research Fund as a chair holder of the AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo. The AXA Research Fund had no role in the design, data collection, analysis, interpretation or manuscript drafting, or in the decision to submit the manuscript for publication. All authors declare that they have no conflict of interest.
- 2.National Cancer Center (2016) Cancer Registry and Statistics. http://ganjoho.jp/reg_stat/statistics/stat/summary.html.
- 5.Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al (2013) Cancer incidence and mortality worldwide: IARC cancerbase no. 11. International Agency for Research on Cancer, LyonGoogle Scholar
- 10.Kaaks R, Berrino F, Key T, Rinaldi S, Dossus L, Biessy C et al (2005) Serum sex steroids in premenopausal women and breast cancer risk within the European prospective investigation into cancer and nutrition (EPIC). J Natl Cancer Inst 97(10):755–765. doi: 10.1093/jnci/dji132 CrossRefPubMedGoogle Scholar
- 13.Ferrari P, Rinaldi S, Jenab M, Lukanova A, Olsen A, Tjonneland A et al (2013) Dietary fiber intake and risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition study. Am J Clin Nutr 97(2):344–353. doi: 10.3945/ajcn.112.034025 CrossRefPubMedGoogle Scholar
- 14.Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S, for the Japan Public Health Center-Based Prospective Study on Cancer Cardiovascular Diseases Group (2003) Soy, isoflavones, and breast cancer risk in Japan. J Natl Cancer Inst 95(12):906–913. doi: 10.1093/jnci/95.12.906 CrossRefPubMedGoogle Scholar
- 15.Suzuki R, Iwasaki M, Hara A, Inoue M, Sasazuki S, Sawada N et al (2013) Fruit and vegetable intake and breast cancer risk defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective study. Cancer Causes Control 24(12):2117–2128. doi: 10.1007/s10552-013-0289-7 CrossRefPubMedGoogle Scholar
- 20.The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology (2005) Standard tables of food composition in Japan. 5th revised and enlarged edn. National Printing Bureau, TokyoGoogle Scholar
- 22.Sasaki S, Matsumura Y, Ishihara J, Tsugane S (2003) Validity of a self-administered food frequency questionnaire used in the 5-year follow-up survey of the JPHC study Cohort I to assess dietary fiber intake: comparison with dietary records. J Epidemiol 13 (1 Sup):S106–S114. doi: 10.2188/jea.13.1sup_106 CrossRefPubMedGoogle Scholar
- 25.Ministry of Education, Culture, Sports, Science and Technology (2000) International classification of diseases for oncology. 3rd edn. WHO, GenevaGoogle Scholar
- 29.Suzuki R, Rylander-Rudqvist T, Ye W, Saji S, Adlercreutz H, Wolk A (2008) Dietary fiber intake and risk of postmenopausal breast cancer defined by estrogen and progesterone receptor status–a prospective cohort study among Swedish women. Int J Cancer 122(2):403–412. doi: 10.1002/ijc.23060 CrossRefPubMedGoogle Scholar
- 31.World Health Organization (2014) Systematic review on diet, nutrition, physical activity and survival and second cancers in breast cancer survivors. Imperial College London, LondonGoogle Scholar
- 32.World Cancer Research Fund International Continuous Update Project Report (2010) Breast cancer 2010 report: Food, nutrition, physical activity, and the prevention of breast cancer. Imperial College London, LondonGoogle Scholar
- 34.World Cancer Research Fund/American Institute for Cancer Research (2014) Guideline for breast cancer screening based on effectiveness evaluation 2013. National Cancer Center, TokyoGoogle Scholar
- 36.National Cancer Center (2012) Cancer fact sheets: breast cancer. https://gco.iarc.fr/today/fact-sheets-cancers?cancer=15&type=0&sex=2
- 37.International Agency for Research on Cancer (2015) Cancer incidence 3 prefectures (1985–2010). http://ganjoho.jp/reg_stat/statistics/dl/index.html