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Wang H, MacInnis RJ, Li S. Family history and breast cancer risk for Asian women: a systematic review and meta-analysis. BMC Med 2023; 21:239. [PMID: 37400822 DOI: 10.1186/s12916-023-02950-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/19/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Studies of women of European ancestry have shown that the average familial relative risk for first-degree relatives of women with breast cancer is approximately twofold, but little is known for Asian women. We aimed to provide evidence for the association between family history and breast cancer risk for Asian women by systematically reviewing published literature. METHODS Studies reporting the familial relative risk of breast cancer for Asian women were searched in three online databases and complemented by a manual search. Odds ratios (ORs) for the association between family history and breast cancer risk were pooled across all included studies and by subgroups in terms of the type of family history, age, menopausal status and geographical region. RESULTS The pooled OR for women who have a first-degree relative with breast cancer was 2.46 (95% confidence interval [CI]: 2.03, 2.97). There was no evidence that the familial risk differed by the type of affected relative (mother versus sisters), the woman's age (< 50 years versus ≥ 50 years), menopausal status (pre versus post) and geographical region (East and Southeast Asia versus other regions) (all P > 0.3). The pooled ORs for women of Asian ancestry with a family history in any relative were similar for those living in non-Asian countries (2.26, 95% CI: 1.42, 3.59) compared with those living in Asian countries (2.18, 95% CI: 1.85, 2.58). CONCLUSIONS Family history of breast cancer is associated with an approximately twofold relative risk of breast cancer for Asian women, which is of similar magnitude to that observed for women of European ancestry. This implies that similar familial factors are implicated in breast cancer risk between women of European and Asian ancestries. Genetic factors are likely to play a substantial role in explaining the breast cancer familial risk for Asian women, as similar risks were observed across different living environments and cultures.
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Affiliation(s)
- Heran Wang
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- China Astronaut Research and Training Centre, Beijing, 100094, China
| | - Robert J MacInnis
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
| | - Shuai Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia.
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, 3051, Australia.
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Abstract
Objective: To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools. Design: Scoping review. Setting: Systematic search using PubMed and Web of Science. Results: We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations. Conclusions: Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.
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Higher dietary soy intake appears inversely related to breast cancer risk independent of estrogen receptor breast cancer phenotypes. Heliyon 2020; 6:e04228. [PMID: 32642579 PMCID: PMC7334424 DOI: 10.1016/j.heliyon.2020.e04228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 04/05/2020] [Accepted: 06/12/2020] [Indexed: 11/20/2022] Open
Abstract
The relationship between soy intake (SI) and breast cancer (BC) has been widely investigated with limited information on the significance of hormone receptor status of BC on the association. This study assessed the relationship between SI and BC risk in the context of oestrogen receptor (ER) status of BC. We meta-analyzed data from published studies on SI and BC after a methodical search of EMBASE, PubMed and Cochrane Library through December 2019. Summary estimates with 95% confidence intervals (CI) were presented using a random-effects model. Eighteen (5 cohorts and 13 case-control) studies, were included in this meta-analysis and SI was inversely associated with BC risk [OR (95%) for highest vs. lowest soy food intake = 0.88 (0.84-0.92), P < 0.001, I 2 = 76.1%, Egger's p-value = 0.425] among all women. The inverse relationship was stronger among premenopausal women [OR (95%) = 0.79 (0.71-0.87), P < 0.001, I 2 = 77.3%, Egger's p-value = 0.644]. In addition, SI was inversely associated with BC risk among ER-negative (-) BC women [OR (95%) = 0.71 (0.57-0.90), P = 0.013, I 2 = 72.0%, Egger's p-value = 0.355] and among ER-positive (+) BC women [OR (95%) = 0.87 (0.79-0.96), P = 0.008 I 2 = 74.6%, Egger's p-value = 0.061]. SI appears inversely associated with BC risk, with a stronger inverse association among pre-menopausal and ER-negative BC women.
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Hüser S, Guth S, Joost HG, Soukup ST, Köhrle J, Kreienbrock L, Diel P, Lachenmeier DW, Eisenbrand G, Vollmer G, Nöthlings U, Marko D, Mally A, Grune T, Lehmann L, Steinberg P, Kulling SE. Effects of isoflavones on breast tissue and the thyroid hormone system in humans: a comprehensive safety evaluation. Arch Toxicol 2018; 92:2703-2748. [PMID: 30132047 PMCID: PMC6132702 DOI: 10.1007/s00204-018-2279-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 07/31/2018] [Indexed: 02/06/2023]
Abstract
Isoflavones are secondary plant constituents of certain foods and feeds such as soy, linseeds, and red clover. Furthermore, isoflavone-containing preparations are marketed as food supplements and so-called dietary food for special medical purposes to alleviate health complaints of peri- and postmenopausal women. Based on the bioactivity of isoflavones, especially their hormonal properties, there is an ongoing discussion regarding their potential adverse effects on human health. This review evaluates and summarises the evidence from interventional and observational studies addressing potential unintended effects of isoflavones on the female breast in healthy women as well as in breast cancer patients and on the thyroid hormone system. In addition, evidence from animal and in vitro studies considered relevant in this context was taken into account along with their strengths and limitations. Key factors influencing the biological effects of isoflavones, e.g., bioavailability, plasma and tissue concentrations, metabolism, temporality (pre- vs. postmenopausal women), and duration of isoflavone exposure, were also addressed. Final conclusions on the safety of isoflavones are guided by the aim of precautionary consumer protection.
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Affiliation(s)
- S Hüser
- Institute for Food Toxicology, Senate Commission on Food Safety, University of Veterinary Medicine Hannover, Hannover, Germany
| | - S Guth
- Institute for Food Toxicology, Senate Commission on Food Safety, University of Veterinary Medicine Hannover, Hannover, Germany
| | - H G Joost
- Department of Experimental Diabetology, German Institute of Human Nutrition (DIfE), Nuthetal, Germany
| | - S T Soukup
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Str. 9, 76131, Karlsruhe, Germany
| | - J Köhrle
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, CVK, Berlin, Germany
| | - L Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany
| | - P Diel
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - D W Lachenmeier
- Chemisches und Veterinäruntersuchungsamt Karlsruhe, Karlsruhe, Germany
| | - G Eisenbrand
- Division of Food Chemistry and Toxicology, Molecular Nutrition, Department of Chemistry, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - G Vollmer
- Department of Biology, Molecular Cell Physiology and Endocrinology, Technische Universität Dresden, Dresden, Germany
| | - U Nöthlings
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, Rheinische Friedrich-Wilhelms University Bonn, Bonn, Germany
| | - D Marko
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - A Mally
- Department of Toxicology, University of Würzburg, Würzburg, Germany
| | - T Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition (DIfE), Nuthetal, Germany
| | - L Lehmann
- Department of Food Chemistry, Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | - P Steinberg
- Institute for Food Toxicology, University of Veterinary Medicine Hannover, Hannover, Germany
- Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Str. 9, 76131, Karlsruhe, Germany
| | - S E Kulling
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Str. 9, 76131, Karlsruhe, Germany.
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Abstract
Several studies have investigated the relation between benign breast diseases (BBD) and food intake. However, dietary patterns of these patients have not been taken into consideration up to now. The aim of this study is to determine the association between dietary patterns and BBD. In this case-control study, ninety-six patients with BBD and seventy controls were selected from women attending the Iranian Center for Breast Cancer affiliated with Academic Center for Education, Culture and Research. Demographic, physical activity and semi-quantitative FFQ were completed. The main dietary patterns were extracted by factor analysis. Two major dietary patterns emerged: Healthy dietary pattern including fish, poultry, eggs, low-fat dairy products, vegetables, legumes, nuts and seeds, whole grains, oil and mayonnaise, olives, fruits; and Unhealthy dietary pattern including red meats, organ and processed meats, high-fat dairy products, refined grains, sweets and desserts, animal and solid fats. After adjustment for age, BMI and energy intake, the participants in the highest tertile of Healthy dietary pattern (OR 0·44; 95 % CI 0·20, 0·99) were less likely to have BBD compared with those in the first tertile. After adjustment for other confounding variables, this relationship still remained close to significant level. However, higher consumption of Unhealthy dietary pattern was not associated with the risk of BBD. In conclusion, Healthy dietary pattern might be inversely associated with the risk of BBD; however, this result should be interpreted with caution. Future studies are needed to confirm our findings.
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Atkinson C, Ray RM, Li W, Lin MG, Gao DL, Shannon J, Stalsberg H, Porter PL, Frankenfeld CL, Wähälä K, Thomas DB, Lampe JW. Plasma equol concentration is not associated with breast cancer and fibrocystic breast conditions among women in Shanghai, China. Nutr Res 2016; 36:863-71. [PMID: 27440541 DOI: 10.1016/j.nutres.2016.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 01/12/2023]
Abstract
Equol (a bacterial metabolite of the soy isoflavone daidzein) is produced by 30% to 50% of humans and may be associated with health outcomes. We hypothesized that plasma equol would be inversely associated with risks of fibrocystic breast conditions (FBC) and breast cancer (BC). Plasma from women in a breast self-examination trial in Shanghai with BC (n=269) or FBC (n=443), and age-matched controls (n=1027) was analyzed for isoflavones. Equol was grouped into categories (<20, 20-<45, and ≥45nmol/L) and, among women with daidzein ≥20nmol/L, the log10 equol:daidzein ratio was grouped into tertiles. Where available, non-cancerous tissue (NCT) adjacent to the carcinomas from women with BC were classified as non-proliferative or proliferative (n=130 and 172, respectively). The lesions from women with FBC were similarly classified (n=99 and 92, respectively). Odds ratios (OR) and 95% confidence intervals (CI) were calculated across equol categories and tertiles of log10 equol:daidzein ratio. Equol categories were not associated with FBC or BC (P>.05). For log10 equol:daidzein, compared to controls there were positive associations in the mid tertile for proliferative FBC (OR 2.06, 95% CI 1.08-3.93), BC with proliferative NCT (OR 2.95, 95% CI 1.37-6.35), and all BC regardless of histology (OR 2.37, 95% CI 1.43-3.95). However, trends in ORs with increasing plasma equol values or equol:daidzein ratios were not observed (P>.05). The results of this study do not provide evidence that equol plays a role in the etiology of these breast conditions. However, further work is needed to confirm or refute this conclusion.
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Affiliation(s)
- Charlotte Atkinson
- Bristol Dental School, University of Bristol, Bristol, UK; NIHR Biomedical Research Unit in Nutrition, Diet, and Lifestyle, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.
| | - Roberta M Ray
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wenjin Li
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ming-Gang Lin
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Dao Li Gao
- Zhong Shan Hospital Cancer Center, Shanghai, China
| | | | | | - Peggy L Porter
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - David B Thomas
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Shift work and breast cancer among women textile workers in Shanghai, China. Cancer Causes Control 2014; 26:143-50. [PMID: 25421377 DOI: 10.1007/s10552-014-0493-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 11/05/2014] [Indexed: 01/12/2023]
Abstract
PURPOSE Although night-shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. METHODS The study included 1,709 incident breast cancer cases and 4,780 non-cases. Data on historical shift work schedules were collected by categorized jobs from the factories, where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night-shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95 % confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20 years. RESULTS We observed no associations with either years of night-shift work or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. CONCLUSIONS The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggests that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women.
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Cronin RM, Field JR, Bradford Y, Shaffer CM, Carroll RJ, Mosley JD, Bastarache L, Edwards TL, Hebbring SJ, Lin S, Hindorff LA, Crane PK, Pendergrass SA, Ritchie MD, Crawford DC, Pathak J, Bielinski SJ, Carrell DS, Crosslin DR, Ledbetter DH, Carey DJ, Tromp G, Williams MS, Larson EB, Jarvik GP, Peissig PL, Brilliant MH, McCarty CA, Chute CG, Kullo IJ, Bottinger E, Chisholm R, Smith ME, Roden DM, Denny JC. Phenome-wide association studies demonstrating pleiotropy of genetic variants within FTO with and without adjustment for body mass index. Front Genet 2014; 5:250. [PMID: 25177340 PMCID: PMC4134007 DOI: 10.3389/fgene.2014.00250] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/10/2014] [Indexed: 01/29/2023] Open
Abstract
Phenome-wide association studies (PheWAS) have demonstrated utility in validating genetic associations derived from traditional genetic studies as well as identifying novel genetic associations. Here we used an electronic health record (EHR)-based PheWAS to explore pleiotropy of genetic variants in the fat mass and obesity associated gene (FTO), some of which have been previously associated with obesity and type 2 diabetes (T2D). We used a population of 10,487 individuals of European ancestry with genome-wide genotyping from the Electronic Medical Records and Genomics (eMERGE) Network and another population of 13,711 individuals of European ancestry from the BioVU DNA biobank at Vanderbilt genotyped using Illumina HumanExome BeadChip. A meta-analysis of the two study populations replicated the well-described associations between FTO variants and obesity (odds ratio [OR] = 1.25, 95% Confidence Interval = 1.11-1.24, p = 2.10 × 10(-9)) and FTO variants and T2D (OR = 1.14, 95% CI = 1.08-1.21, p = 2.34 × 10(-6)). The meta-analysis also demonstrated that FTO variant rs8050136 was significantly associated with sleep apnea (OR = 1.14, 95% CI = 1.07-1.22, p = 3.33 × 10(-5)); however, the association was attenuated after adjustment for body mass index (BMI). Novel phenotype associations with obesity-associated FTO variants included fibrocystic breast disease (rs9941349, OR = 0.81, 95% CI = 0.74-0.91, p = 5.41 × 10(-5)) and trends toward associations with non-alcoholic liver disease and gram-positive bacterial infections. FTO variants not associated with obesity demonstrated other potential disease associations including non-inflammatory disorders of the cervix and chronic periodontitis. These results suggest that genetic variants in FTO may have pleiotropic associations, some of which are not mediated by obesity.
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Affiliation(s)
- Robert M. Cronin
- Department of Medicine, Vanderbilt UniversityNashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt UniversityNashville, TN, USA
- *Correspondence: Robert M. Cronin, Department of Biomedical Informatics, Vanderbilt University Medical Center, 220 Garland 440 EBL, Nashville, TN 37232, USA e-mail:
| | - Julie R. Field
- Office of Research, Vanderbilt UniversityNashville, TN, USA
| | - Yuki Bradford
- Department of Molecular Physiology and Biophysics, Center for Human Genetics Research, Vanderbilt UniversityNashville, TN, USA
| | - Christian M. Shaffer
- Department of Molecular Physiology and Biophysics, Center for Human Genetics Research, Vanderbilt UniversityNashville, TN, USA
| | | | - Jonathan D. Mosley
- Department of Medicine, Vanderbilt UniversityNashville, TN, USA
- Department of Pharmacology, Vanderbilt UniversityNashville, TN, USA
| | - Lisa Bastarache
- Department of Biomedical Informatics, Vanderbilt UniversityNashville, TN, USA
| | - Todd L. Edwards
- Vanderbilt Epidemiology Center, Vanderbilt UniversityNashville, TN, USA
| | - Scott J. Hebbring
- Center for Human Genetics, Marshfield Clinic Research FoundationMarshfield, WI, USA
| | - Simon Lin
- Biomedical Informatics Research Center, Marshfield Clinic Research FoundationMarshfield, WI, USA
| | - Lucia A. Hindorff
- Division of Genomic Medicine, National Human Genome Research InstituteBethesda, MD, USA
| | - Paul K. Crane
- Department of Medicine, University of WashingtonSeattle, WA, USA
| | - Sarah A. Pendergrass
- Department of Biochemistry and Molecular Biology, Center for Systems Genomics, The Pennsylvania State UniversityUniversity Park, PA, USA
| | - Marylyn D. Ritchie
- Department of Biochemistry and Molecular Biology, Center for Systems Genomics, The Pennsylvania State UniversityUniversity Park, PA, USA
| | - Dana C. Crawford
- Department of Molecular Physiology and Biophysics, Center for Human Genetics Research, Vanderbilt UniversityNashville, TN, USA
| | - Jyotishman Pathak
- Divisions of Biomedical Informatics and Statistics, Mayo ClinicRochester, MN, USA
| | | | | | - David R. Crosslin
- Department of Genome Sciences, University of WashingtonSeattle, WA, USA
| | | | - David J. Carey
- Weis Center for Research, Geisinger Health SystemDanville, PA, USA
| | - Gerard Tromp
- Weis Center for Research, Geisinger Health SystemDanville, PA, USA
| | - Marc S. Williams
- Genomic Medicine Institute, Geisinger Health SystemDanville, PA, USA
| | | | - Gail P. Jarvik
- Department of Medicine, University of WashingtonSeattle, WA, USA
- Department of Genome Sciences, University of WashingtonSeattle, WA, USA
| | - Peggy L. Peissig
- Biomedical Informatics Research Center, Marshfield Clinic Research FoundationMarshfield, WI, USA
| | - Murray H. Brilliant
- Center for Human Genetics, Marshfield Clinic Research FoundationMarshfield, WI, USA
| | | | - Christopher G. Chute
- Divisions of Biomedical Informatics and Statistics, Mayo ClinicRochester, MN, USA
| | | | - Erwin Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Rex Chisholm
- Department of Cell and Molecular Biology, Feinberg School of Medicine, Northwestern UniversityEvanston, IL, USA
| | - Maureen E. Smith
- Department of Cell and Molecular Biology, Feinberg School of Medicine, Northwestern UniversityEvanston, IL, USA
| | - Dan M. Roden
- Department of Medicine, Vanderbilt UniversityNashville, TN, USA
- Department of Pharmacology, Vanderbilt UniversityNashville, TN, USA
| | - Joshua C. Denny
- Department of Medicine, Vanderbilt UniversityNashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt UniversityNashville, TN, USA
- Joshua C. Denny, Department of Biomedical Informatics and Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37203-8820, USA e-mail:
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Gao Y, Huang YB, Liu XO, Chen C, Dai HJ, Song FJ, Wang J, Chen KX, Wang YG. Tea Consumption, Alcohol Drinking and Physical Activity Associations with Breast Cancer Risk among Chinese Females: a Systematic Review and Meta-analysis. Asian Pac J Cancer Prev 2013; 14:7543-50. [DOI: 10.7314/apjcp.2013.14.12.7543] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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10
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Li W, Ray RM, Thomas DB, Yost M, Davis S, Breslow N, Gao DL, Fitzgibbons ED, Camp JE, Wong E, Wernli KJ, Checkoway H. Occupational exposure to magnetic fields and breast cancer among women textile workers in Shanghai, China. Am J Epidemiol 2013; 178:1038-45. [PMID: 24043439 DOI: 10.1093/aje/kwt161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Exposure to magnetic fields (MFs) is hypothesized to increase the risk of breast cancer by reducing production of melatonin by the pineal gland. A nested case-cohort study was conducted to investigate the association between occupational exposure to MFs and the risk of breast cancer within a cohort of 267,400 female textile workers in Shanghai, China. The study included 1,687 incident breast cancer cases diagnosed from 1989 to 2000 and 4,702 noncases selected from the cohort. Subjects' complete work histories were linked to a job-exposure matrix developed specifically for the present study to estimate cumulative MF exposure. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards modeling that was adapted for the case-cohort design. Hazard ratios were estimated in relation to cumulative exposure during a woman's entire working years. No association was observed between cumulative exposure to MFs and overall risk of breast cancer. The hazard ratio for the highest compared with the lowest quartile of cumulative exposure was 1.03 (95% confidence interval: 0.87, 1.21). Similar null findings were observed when exposures were lagged and stratified by age at breast cancer diagnosis. The findings do not support the hypothesis that MF exposure increases the risk of breast cancer.
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Song JK, Bae JM. Citrus fruit intake and breast cancer risk: a quantitative systematic review. J Breast Cancer 2013; 16:72-6. [PMID: 23593085 PMCID: PMC3625773 DOI: 10.4048/jbc.2013.16.1.72] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 02/13/2013] [Indexed: 12/12/2022] Open
Abstract
PURPOSE We investigated the association between dietary intake of citrus fruits and breast cancer risk. METHODS The PubMed and EMBASE were searched for relevant articles on diet and breast cancer up to January 2012. All of the epidemiological studies that assessed dietary intake of citrus fruits and presented risk estimates of the association between citrus fruits intake and risk of breast cancer were reviewed. Multivariable-adjusted odds ratios (OR) and associated 95% confidence intervals (CI) for highest versus lowest intake of dietary citrus fruits level were extracted. Overall summary OR was calculated by using a fixed-effect meta-analysis. RESULTS Six case-control studies out of five articles were eligible. Overall summary OR showed a 10% reduction in risk of breast cancer associated with high intake of citrus fruits (summary OR, 0.90; 95% CI, 0.85-0.96; p<0.001); results were consistent across the studies (I (2)=0). Visual inspection of the results did not suggest a publication bias. CONCLUSION Pooled results from observational studies showed an inverse association between citrus fruits intake and the risk of breast cancer.
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Affiliation(s)
- Jung-Kook Song
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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12
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Su X, Colditz GA, Collins LC, Baer HJ, Sampson LA, Willett WC, Berkey CS, Schnitt SJ, Connolly JL, Rosner BA, Tamimi RM. Adolescent intakes of vitamin D and calcium and incidence of proliferative benign breast disease. Breast Cancer Res Treat 2012; 134:783-91. [PMID: 22622809 PMCID: PMC3662049 DOI: 10.1007/s10549-012-2091-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 05/03/2012] [Indexed: 11/28/2022]
Abstract
Vitamin D and calcium have been shown to have protective effects against breast cancer development in animal studies. Vitamin D and calcium play important anticarcinogenic roles in animal studies. Exposures between menarche and first birth may be important in breast development and future breast cancer risk. However, the relations between adolescent vitamin D and calcium intake and the risk of proliferative benign breast disease (BBD), a marker of increased breast cancer risk, have not yet been evaluated. We examined these associations in the Nurses' Health Study II. Among the 29,480 women who completed an adolescent diet questionnaire in 1998, 682 proliferative BBD cases were identified and confirmed by centralized pathology review between 1991 and 2001. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated by Cox proportional hazards regression and adjusted for potential confounders. A suggestive inverse association was observed between adolescent total vitamin D intake and proliferative BBD. Women in the highest quintile of vitamin D intake during adolescence had a 21 % lower risk (multivariate HR (95 % CI): 0.79 (0.61, 1.01), p-trend = 0.07) of proliferative BBD than women in the lowest quintile. Results were essentially the same when the analysis was restricted to prospective cases (n = 142) diagnosed after return of the adolescent diet questionnaire and independent of adult vitamin D intake. Adolescent total milk intake was positively associated with proliferative BBD (≥3 servings/day vs. <1 serving/day HR (95 % CI): 1.41 (0.91, 2.17), p-trend = 0.03), after additional adjustment for total vitamin D. Calcium intake during adolescence was not associated with proliferative BBD (p-trend = 0.91). Vitamin D intake during adolescence may be important in the earlier stage of breast carcinogenesis. These findings, if corroborated, may suggest new pathways and strategies for breast cancer prevention.
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Affiliation(s)
- Xuefen Su
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, PR China
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Graham A. Colditz
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Laura C. Collins
- Department of Pathology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Heather J. Baer
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Division of General Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Laura A. Sampson
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Walter C. Willett
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Catherine S. Berkey
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Stuart J. Schnitt
- Department of Pathology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - James L. Connolly
- Department of Pathology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Bernard A. Rosner
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
| | - Rulla M. Tamimi
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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13
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Demetriou CA, Hadjisavvas A, Loizidou MA, Loucaides G, Neophytou I, Sieri S, Kakouri E, Middleton N, Vineis P, Kyriacou K. The mediterranean dietary pattern and breast cancer risk in Greek-Cypriot women: a case-control study. BMC Cancer 2012; 12:113. [PMID: 22443862 PMCID: PMC3323439 DOI: 10.1186/1471-2407-12-113] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 03/23/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Diet has long been suspected to impact on breast cancer risk. In this study we evaluated whether the degree of adherence to a Mediterranean diet pattern modifies breast cancer risk amongst Greek-Cypriot women. METHODS Subjects included 935 cases and 817 controls, all participating in the MASTOS case-control study in Cyprus. The study was approved by the Cyprus National Bioethics Committee. Information on dietary intakes was collected using an interviewer administered 32-item Food Frequency Questionnaire. Information on demographic, anthropometric, lifestyle, and other confounding factors was also collected. Adherence to the Mediterranean Diet pattern was assessed using two a-priory defined diet scores. In addition, dietary patterns specific to our population were derived using Principal Component Analysis (PCA). Logistic regression models were used to assess the association between the dietary patters and breast cancer risk. RESULTS There was no association with breast cancer risk for either score, however, higher consumptions of vegetables, fish and olive oil, were independently associated with decreased risk. In addition, the PCA derived component which included vegetables, fruit, fish and legumes was shown to significantly reduce risk of breast cancer (ORs across quartiles of increasing levels of consumption: 0.89 95%CI: 0.65-1.22, 0.64 95%CI: 0.47-0.88, 0.67 95%CI: 0.49-0.92, P trend < 0.0001), even after adjustment for relevant confounders. CONCLUSIONS Our results suggest that adherence to a diet pattern rich in vegetables, fish, legumes and olive oil may favorably influence the risk of breast cancer. This study is the first investigation of dietary effects on breast cancer risk in Cyprus, a country whose population has traditionally adhered to the Mediterranean diet.
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Affiliation(s)
- Christiana A Demetriou
- Department of EM/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Andreas Hadjisavvas
- Department of EM/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Maria A Loizidou
- Department of EM/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | | | - Ioanna Neophytou
- Department of EM/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Sabina Sieri
- Nutritional Epidemiology Unit, Istituto Nazionale Tumori, Milan, Italy
| | | | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kyriacos Kyriacou
- Department of EM/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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14
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Fruit and vegetable intakes in relation to plasma nutrient concentrations in women in Shanghai, China. Public Health Nutr 2011; 15:167-75. [PMID: 21729475 DOI: 10.1017/s1368980011001029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the validity of fruit and vegetable intakes as it relates to plasma carotenoid and vitamin C concentrations in Chinese women, using three classification schemes. DESIGN Intakes were calculated using an interviewer-administered FFQ. Fruits and vegetables, botanical groups and high-nutrient groups were evaluated. These three classification schemes were compared with plasma carotenoid and vitamin C concentrations from blood samples collected within 1 week of questionnaire completion. SETTING Shanghai, China. SUBJECTS Participants (n 2031) comprised women who had participated in a case-control study of diet and breast-related diseases nested within a randomized trial of breast self-examination among textile workers (n 266 064) RESULTS Fruit intake was significantly (P < 0·05) and positively associated with plasma concentrations of α-tocopherol, β-cryptoxanthin, lycopene, α-carotene, β-carotene, retinyl palmitate and vitamin C. Fruit intake was inversely associated with γ-tocopherol and lutein + zeaxanthin concentrations. Vegetable consumption was significantly and positively associated with γ-tocopherol and β-cryptoxanthin concentrations. Each botanical and high-nutrient group was also significantly associated with particular plasma nutrient concentrations. Fruit and vegetable intakes and most plasma nutrient concentrations were significantly associated with season of interview. CONCLUSIONS These results suggest that the manner in which fruits and vegetables are grouped leads to different plasma nutrient exposure information, which may be an important consideration when testing and generating hypotheses regarding disease risk in relation to diet. Interview season should be considered when evaluating the associations of reported intake and plasma nutrients with disease outcomes.
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15
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Sakoda LC, Blackston CR, Doherty JA, Ray RM, Lin MG, Gao DL, Stalsberg H, Feng Z, Thomas DB, Chen C. Selected estrogen receptor 1 and androgen receptor gene polymorphisms in relation to risk of breast cancer and fibrocystic breast conditions among Chinese women. Cancer Epidemiol 2010; 35:48-55. [PMID: 20846920 DOI: 10.1016/j.canep.2010.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 08/12/2010] [Accepted: 08/14/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND Polymorphisms in sex hormone receptor-encoding genes may alter the activity of sex hormone receptors and thereby affect susceptibility to breast cancer and related outcomes. METHODS In a case-control study of women from Shanghai, China, we examined the risk of breast cancer and fibrocystic breast conditions associated with the ESR1 PvuII (rs2234693) and XbaI (rs9340799) and AR CAG repeat ((CAG)(n)) and GGC repeat ((GGC)(n)) polymorphisms among 614 women with breast cancer, 467 women with fibrocystic conditions, and 879 women without breast disease. We also evaluated whether risk differed by the presence/absence of proliferative changes (in the extratumoral epithelium or fibrocystic lesion), menopausal status, or body mass index (BMI). Age-adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated using logistic regression. RESULTS Only associations with AR (CAG)(n) and (GGC)(n) genotypes were detected. Allocating AR (CAG)(n) genotypes into six categories, with the (CAG)(22-24)/(CAG)(22-24) genotype category designated as the reference group, the (CAG)(>24)/(CAG)(>24) genotype category was associated with an increased risk of fibrocystic breast conditions (OR, 1.8; 95% CI, 1.1-3.0). Relative to the AR (GGC)(17)/(GGC)(17) genotype, the (GGC)(17)/(GGC)(14) genotype was associated with elevated risks of incident breast cancer (OR, 2.6; 95% CI, 1.3-5.4) and fibrocystic conditions (OR, 2.3; 95% CI, 1.1-4.5). Results did not differ according to proliferation status, menopausal status, or BMI. CONCLUSION Although these data lend support for a link between AR variation and breast disease development, given the low frequency of the putative risk-conferring genotypes and other constraints, further confirmation of our results is needed.
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Affiliation(s)
- Lori C Sakoda
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
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16
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Dijkstra SC, Lampe JW, Ray RM, Brown R, Wu C, Li W, Chen C, King IB, Gao D, Hu Y, Shannon J, Wähälä K, Thomas DB. Biomarkers of dietary exposure are associated with lower risk of breast fibroadenomas in Chinese women. J Nutr 2010; 140:1302-10. [PMID: 20484550 PMCID: PMC2884331 DOI: 10.3945/jn.109.119727] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Fibroadenomas are the most common benign breast condition among women and account for up to 50% of all breast biopsies being performed. Although considered a benign condition, fibroadenomas utilize substantial resources for management and treatment to rule out potential malignancies. Dietary factors may influence benign fibrocystic breast conditions, but little is known of their association with fibroadenomas. We examined possible associations between a broad spectrum of circulating biomarkers of dietary intake and risk of fibroadenomas. Participants were women in a breast self-examination trial in Shanghai, China who were diagnosed with fibroadenomas (n = 258) and 1035 controls. Conditional logistic regression was used to estimate adjusted odds ratios (OR) and 95% CI. Isoflavone concentrations were inversely associated with risk of fibroadenomas. Adjusted OR (95% CI) for the highest versus the lowest quartile of plasma concentration were 0.36 (0.16-0.79; P-trend < 0.001) for daidzein and 0.39 (0.19-0.84; P-trend = 0.010) for genistein. We also observed inverse associations between higher percentages of the RBC (n-3) fatty acids, eicosapentaenoic acid (EPA) ([0.38 (0.19-0.77); P-trend = 0.007] and docosapentaenoic acid (DPA) [0.32 (0.15-0.70); P-trend = 0.024], and fibroadenoma risk. Circulating concentrations of carotenoids, vitamin C, retinol, and ferritin were not associated with fibroadenoma risk. The inverse associations between plasma isoflavone concentrations and RBC EPA and DPA and fibroadenoma risk suggest that higher intakes of soy foods and fatty fish may lower the risk of fibroadenomas.
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Affiliation(s)
- S. Coosje Dijkstra
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Johanna W. Lampe
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland,To whom correspondence should be addressed. E-mail:
| | - Roberta M. Ray
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Rose Brown
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Chunyuan Wu
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Wenjin Li
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Chu Chen
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Irena B. King
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Daoli Gao
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Yongwei Hu
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Jackilen Shannon
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - Kristiina Wähälä
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
| | - David B. Thomas
- Public Health Sciences Division, Fred Hutchinson Research Center, Seattle, WA 98109; Division of Human Nutrition, Wageningen University, Wageningen 6700 EV, The Netherlands; Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Shi Dong Hospital, Shanghai 200438, China; Oregon Health and Science University, Portland, OR 97239; and University of Helsinki, Helsinki 00014, Finland
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17
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Nelson ZC, Ray RM, Wu C, Stalsberg H, Porter P, Lampe JW, Shannon J, Horner N, Li W, Wang W, Hu Y, Gao D, Thomas DB. Fruit and vegetable intakes are associated with lower risk of breast fibroadenomas in Chinese women. J Nutr 2010; 140:1294-301. [PMID: 20484549 PMCID: PMC2884330 DOI: 10.3945/jn.109.119719] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Fibroadenomas are common benign breast conditions among women and account for approximately 50% of breast biopsies performed. Dietary factors are known to influence benign breast conditions in the aggregate, but little is known of their association specifically with fibroadenoma. Our objective in this study was to evaluate the association between dietary and other factors and fibroadenoma risk. A case-control study, nested in a randomized trial of breast self-examination (BSE) in Chinese textile workers in Shanghai, China, was conducted between 1989 and 2000. The study sample included 327 affected women and 1070 controls. Women were administered a FFQ and a questionnaire that elicited reproductive and gynecological history and other information. Odds ratios, as estimates of relative risks, were calculated using multivariate conditional logistic regression. Significant decreasing trends in risk of fibroadenoma were observed with intake of fruits and vegetables and with number of live births, and a reduced risk was also associated with natural menopause, oral contraceptive use, and moderate exercise (walking and gardening). Increased risk of fibroadenoma was associated with heavy physical activity in one's 20s, breast cancer in a first-degree relative, and a history of prior benign breast lumps; and significant increasing trends in risk were observed with numbers of BSE per year and years of education. In conclusion, a diet rich in fruits and vegetables and the use of oral contraceptives may reduce risk of fibroadenoma.
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Affiliation(s)
- Zakia Coriaty Nelson
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Roberta M. Ray
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Chunyuan Wu
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Helge Stalsberg
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Peggy Porter
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Johanna W. Lampe
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Jackilen Shannon
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Neilann Horner
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Wenjin Li
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Wenwan Wang
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Yongwei Hu
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - Daoli Gao
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China
| | - David B. Thomas
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782; Fred Hutchinson Cancer Research Center, Seattle, WA 98109; Institute of Medical Biology, University of Tromsø, N-9035, Tromsø, Norway; Oregon Health and Science University, Portland, OR 97239; Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai 200052, China; Department of Pathology, Shi Dong Hospital, Shanghai 200438, China,To whom correspondence should be addressed. E-mail:
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18
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Wong EY, Ray R, Gao DL, Wernli KJ, Li W, Fitzgibbons ED, Camp JE, Heagerty PJ, De Roos AJ, Holt VL, Thomas DB, Checkoway H. Physical activity, physical exertion, and miscarriage risk in women textile workers in Shanghai, China. Am J Ind Med 2010; 53:497-505. [PMID: 20340112 DOI: 10.1002/ajim.20812] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Strenuous occupational physical activity and physical demands may be risk factors for adverse reproductive outcomes. METHODS A retrospective study in the Shanghai, China textile industry study collected women's self-reported reproductive history. Occupational physical activity assessment linked complete work history data to an industry-specific job-exposure matrix. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by multivariate logistic regression for the first pregnancy outcome and utilized generalized estimating equations to consider all pregnancies per woman. RESULTS Compared with women employed in sedentary jobs, a reduced risk of miscarriage was found for women working in jobs with either light (OR 0.18, 95% CI: 0.07, 0.50) or medium (OR 0.24, 95% CI: 0.08, 0.66) physical activity during the first pregnancy and over all pregnancies (light OR 0.32, 95% CI: 0.17, 0.61; medium OR 0.43, 95% CI: 0.23, 0.80). Frequent crouching was associated with elevated risk (OR 1.82, 95% CI: 1.14, 2.93; all pregnancies per woman). CONCLUSIONS Light/medium occupational physical activity may have reduced miscarriage risk, while specific occupational characteristics such as crouching may have increased risk in this cohort.
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Affiliation(s)
- Eva Y Wong
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA.
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19
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Intake of fiber and nuts during adolescence and incidence of proliferative benign breast disease. Cancer Causes Control 2010; 21:1033-46. [PMID: 20229245 DOI: 10.1007/s10552-010-9532-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 02/25/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We examined the association between adolescent fiber intake and proliferative BBD, a marker of increased breast cancer risk, in the Nurses' Health Study II. METHODS Among 29,480 women who completed a high school diet questionnaire in 1998, 682 proliferative BBD cases were identified and confirmed by centralized pathology review between 1991 and 2001. Multivariate-adjusted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Women in the highest quintile of adolescent fiber intake had a 25% lower risk of proliferative BBD (multivariate HR (95% CI): 0.75 (0.59, 0.96), p-trend = 0.01) than women in the lowest quintile. High school intake of nuts was also related to significantly reduced BBD risk. Women consuming >or=2 servings of nuts/week had a 36% lower risk (multivariate HR (95% CI): 0.64 (0.48, 0.85), p-trend < 0.01) than women consuming <1 serving/month. Results were essentially the same when the analysis was restricted to prospective cases (n = 142) diagnosed after return of the high school diet questionnaire. CONCLUSIONS These findings support the hypothesis that dietary intake of fiber and nuts during adolescence influences subsequent risk of breast disease and may suggest a viable means for breast cancer prevention.
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Moore AB, Shannon J, Chen C, Lampe JW, Ray RM, Lewis SK, Lin M, Stalsberg H, Thomas DB. Dietary and stored iron as predictors of breast cancer risk: A nested case-control study in Shanghai. Int J Cancer 2009; 125:1110-7. [PMID: 19444907 DOI: 10.1002/ijc.24404] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Increases in risk of breast cancer in successive generations of migrants to the United States from China and rapid temporal changes in incidence rates in China following social and economic changes clearly implicate environmental factors in the etiology of this disease. Case-control and cohort studies have provided evidence that at least some of these factors may be dietary. Iron, an essential element necessary for cell function, has also been demonstrated to have potential carcinogenic and co-carcinogenic activities. Iron overload, which was previously uncommon, has become more common in the United States than iron deficiency and may be increasing in China concurrently with dramatic increases in meat consumption. A case-control study nested in a cohort of women in Shanghai, China, was conducted to evaluate possible associations between risk of proliferative and nonproliferative fibrocystic changes as well as breast cancer and dietary iron intake and plasma ferritin levels. Plasma ferritin levels and reported dietary iron intake were compared in 346 women with fibrocystic changes, 248 breast cancer cases and 1,040 controls. Increasing ferritin levels were significantly associated with increasing risk of nonproliferative fibrocystic changes (OR: 2.51, 95% CI: 1.16-5.45, p trend = 0.04). Similar, but weaker, trends were observed for proliferative changes and for breast cancer. Risk of breast cancer relative to the risk of fibrocystic changes was associated with dietary iron intake in women with nonproliferative fibrocystic changes (OR: 2.63, 95% CI: 1.04-6.68, p = 0.02). In conclusion, this study finds significant associations between iron (stored and dietary) and fibrocystic disease and breast cancer.
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Affiliation(s)
- Amber B Moore
- Department of Public Health and Preventive Medicine, Oregon Health and Sciences University, Portland, 97239, USA.
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21
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Djuric Z, Edwards A, Madan S, Darga L, Ren J, Blake C, Koletsky M, Heilbrun LK. Obesity is associated with atypia in breast ductal lavage of women with proliferative breast disease. Cancer Epidemiol 2009; 33:242-8. [PMID: 19683484 DOI: 10.1016/j.canep.2009.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 06/15/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Benign proliferative breast disease without atypia slightly increases breast cancer risk but there are currently few clinical options for breast cancer prevention in this group of women. METHODS We conducted a pilot study of women with a past diagnosis of proliferative breast disease with a goal to determine if the characteristics of cells obtained by breast ductal lavage were related to nutritional factors. RESULTS There were 57 women who enrolled. A total of 39 women yielded nipple aspirate fluid (NAF) samples and 36 underwent breast ductal lavage. Five of the lavage samples were acellular and 28 had at least 200 cells. Surprisingly, atypia was present in 11 women. Presence of atypia was associated with slight changes in morphometric features of the epithelial cells such as measures of circularity as obtained by image analysis, but the only variable significantly different in women with atypia (versus no atypia) was a higher mean body mass index. Body mass index was also significantly correlated with C-reactive protein (CRP) levels in the nipple aspirate fluid, indicating that obesity might have a pro-inflammatory effect on the breast that can contribute to increased rates of atypia. CONCLUSIONS Although the clinical significance of atypia in breast ductal lavage is uncertain, these results support further work on prevention of obesity as a strategy for reducing breast cancer risk.
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Affiliation(s)
- Zora Djuric
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109, United States.
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22
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Shannon J, King IB, Lampe JW, Gao DL, Ray RM, Lin MG, Stalsberg H, Thomas DB. Erythrocyte fatty acids and risk of proliferative and nonproliferative fibrocystic disease in women in Shanghai, China. Am J Clin Nutr 2009; 89:265-76. [PMID: 19056601 PMCID: PMC2647713 DOI: 10.3945/ajcn.2008.26077] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although benign breast changes are more common than breast cancer, little evidence regarding risk factors for benign breast conditions is available. Omega-3 (n-3) fatty acids have antiinflammatory and antiproliferative actions and may be important in reducing the risk of benign conditions. There is a lack of research on the association of n-3 fatty acids with risk of benign fibrocystic breast changes. OBJECTIVES The objectives of the study were to evaluate the role of n-3 and other fatty acids in the development of benign proliferative fibrocystic conditions (PFCs) and nonproliferative fibrocystic conditions (NPFCs) in the breast and to evaluate the progression of fibrocystic changes in breast cancer. DESIGN We conducted a case-control study to determine erythrocyte fatty acid concentrations in 155 women with NPFCs, 185 women with PFCs, 241 women with breast cancer (127 with nonproliferative and 114 with proliferative changes in the noncancerous extratumoral mammary epithelium), and 1,030 control subjects. We estimated the relative risk of NPFCs, PFCs, and breast cancer with proliferative and nonproliferative changes in extratumoral tissue compared with the risk of these changes alone. RESULTS Women in the highest quartile of eicosapentaenoic acid concentrations were 67% less likely to have an NPFC alone or with breast cancer and 49% less likely to have breast cancer than were women with PFCs. gamma-Linolenic acid (18:3n-6) was positively associated with all fibrocystic and cancerous conditions. Palmitic:palmitoleic acid (n-7 saturation index) was inversely associated with risk in all comparisons. CONCLUSION Our results support a protective effects of n-3 fatty acid intake and the n-7 saturation index against benign fibrocystic breast changes and the progression of proliferative changes to breast cancer.
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Affiliation(s)
- Jackilen Shannon
- Center for Research on Occupational and Environmental Toxicology, Oregon Health and Science University, Portland, OR 97239, USA.
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23
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Sakoda LC, Blackston C, Doherty JA, Ray RM, Lin MG, Stalsberg H, Gao DL, Feng Z, Thomas DB, Chen C. Polymorphisms in steroid hormone biosynthesis genes and risk of breast cancer and fibrocystic breast conditions in Chinese women. Cancer Epidemiol Biomarkers Prev 2008; 17:1066-73. [PMID: 18483327 DOI: 10.1158/1055-9965.epi-07-2680] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Common variants in genes encoding for key enzymes involved in steroidogenesis may alter sex steroid hormone levels, thereby influencing susceptibility to breast carcinoma and related conditions. In a case-control study of Chinese women, we examined genotypes of the CYP11A1 pentanucleotide [(TAAAA)n] repeat (D15S520), CYP17A1 rs743572, and HSD17B1 rs605059 polymorphisms in relation to the risk of breast cancer and fibrocystic breast conditions, comparing 615 women with breast cancer and 467 women with fibrocystic breast conditions separately with 879 women without clinical breast disease. We also evaluated whether these relationships differed by the presence of proliferation in the extratumoral epithelium or fibrocystic lesions, menopausal status, or body mass index. Only CYP11A1 genotype was related to breast cancer risk, with women homozygous for the 4-repeat allele, relative to those homozygous for the 6-repeat allele, at reduced risk (age-adjusted odds ratio, 0.58; 95% confidence interval, 0.37-0.91). There was some suggestion of a stronger inverse association for breast cancer with evidence of proliferation in the extratumoral epithelium than for breast cancer without extratumoral proliferation. Breast cancer risk associated with CYP11A1 genotype did not differ by menopausal status or body mass index level. No associations between CYP11A1, CYP17A1, and HSD17B1 genotypes and risk of fibrocystic breast conditions were observed. Our findings support the possibility that common allelic variation at the CYP11A1 D15S520 locus alters breast cancer risk in Chinese women.
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Affiliation(s)
- Lori C Sakoda
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
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24
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Wong EY, Ray RM, Gao DL, Wernli KJ, Li W, Fitzgibbons ED, Camp JE, Astrakianakis G, Heagerty PJ, De Roos AJ, Holt VL, Thomas DB, Checkoway H. Dust and chemical exposures, and miscarriage risk among women textile workers in Shanghai, China. Occup Environ Med 2008; 66:161-8. [PMID: 18805889 DOI: 10.1136/oem.2008.039065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION To investigate possible associations between miscarriage and occupational exposures in the Shanghai textile industry. METHODS A retrospective cohort study of miscarriages among 1752 women in the Shanghai textile industry was conducted. Reproductive history was self-reported by women and occupational work histories were collected from factory personnel records. Occupational exposures were assigned by linking work history information to an industry-specific job-exposure matrix informed by factory-specific textile process information and industrial hygiene assessments. Estimates of cotton dust and endotoxin exposure were also assigned. Odds ratios (OR) and 95% CI were estimated by multivariate logistic regression, with adjustment for age at pregnancy, educational level, smoking status of the woman and her spouse, use of alcohol, and woman's year of birth. RESULTS An elevation in risk of a spontaneously aborted first pregnancy was associated with exposure to synthetic fibres (OR 1.89, 95% CI 1.20 to 3.00) and mixed synthetic and natural fibres (OR 3.31, 95% CI 1.30 to 8.42). No increased risks were observed for women working with solvents, nor were significant associations observed with quantitative cotton dust or endotoxin exposures. Associations were robust and similar when all pregnancies in a woman's reproductive history were considered. CONCLUSIONS Occupational exposure to synthetic fibres may cause miscarriages, and this possibility should be the subject of further investigation.
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Affiliation(s)
- E Y Wong
- Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195-7234, USA
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Oral contraceptives and the risk of all cancers combined and site-specific cancers in Shanghai. Cancer Causes Control 2008; 20:27-34. [PMID: 18704712 DOI: 10.1007/s10552-008-9213-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 07/12/2008] [Indexed: 12/23/2022]
Abstract
From 1998 to 1991, an in-person baseline interview was administered to approximately 267,400 female textile workers in Shanghai, China. The cohort was followed until July 2000 for incident cancer cases. Incidence rate ratios (RR) for 12 types of cancers in users of oral contraceptives (OCs) were calculated using Cox Proportional Hazards analysis. There was a reduced risk of uterine corpus cancer for women who had ever used OCs (RR = 0.68, 95% CI = 0.45-1.04) and a trend of decreasing risk with increasing duration of use (p = 0.015). There was an increased risk of colon cancer in women who had used OCs for 10 years or more (RR = 1.56, 95% CI = 1.01-2.40) and an increased risk of rectal cancer in women who had ever used OCs (RR = 1.31, 95% CI = 0.98-1.75), with a trend of increasing risk with increasing duration of use (p = 0.017), but these associations may have been due to uncontrolled confounding by physical activity or other non-causal factors. No associations were observed between OCs and the risk of all cancers combined or for any of the nine other cancers. It is unlikely that the use of OCs has contributed to the temporal trends in cancer incidence in China in recent decades.
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26
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Lampe JW, Nishino Y, Ray RM, Wu C, Li W, Lin MG, Gao DL, Hu Y, Shannon J, Stalsberg H, Porter PL, Frankenfeld CL, Wähälä K, Thomas DB. Plasma isoflavones and fibrocystic breast conditions and breast cancer among women in Shanghai, China. Cancer Epidemiol Biomarkers Prev 2008; 16:2579-86. [PMID: 18086761 DOI: 10.1158/1055-9965.epi-07-0368] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Proliferative benign breast conditions are associated with elevated risk of breast cancer, whereas nonproliferative conditions are not strongly associated with risk. Factors acting before onset of hyperplasia might be associated with both benign conditions and breast cancer, whereas those on the proliferative disease-to-cancer pathway would be associated only with cancer. Soy isoflavone exposure may influence breast cancer risk, but little is known of its association with benign conditions. MATERIALS AND METHODS We examined possible relationships between plasma genistein and daidzein concentrations and risk of breast disease in women, in a breast self-examination trial in Shanghai, China, diagnosed with breast cancer (n = 196) or a benign breast condition (n = 304), and 1,002 age-matched controls with no known breast disease. Benign conditions were classified as nonproliferative (n = 131) or proliferative with or without atypia (n = 173). RESULTS Isoflavone concentrations were inversely associated with risk of nonproliferative and proliferative benign fibrocystic conditions, as well as with breast cancer, both with and without concomitant proliferative changes in ipsilateral noncancerous mammary epithelium (P(trend) < 0.01 for all comparisons with controls). Women in the highest quartile of plasma genistein (>76.95 ng/mL) were less likely to have breast cancer (odds ratio, 0.26; 95% confidence interval, 0.13-0.50) or benign conditions (odds ratio, 0.40; 95% confidence interval, 0.23-0.70) compared with women in the lowest quartile (<9.42 ng/mL). Observed risks for breast cancer with and without surrounding proliferative changes were not different, respectively, from observed risks for benign proliferative and nonproliferative conditions alone. CONCLUSION Isoflavone exposure was inversely associated with fibrocystic breast conditions and breast cancer, and the results suggest that effects on cancer risk occur early in carcinogenesis.
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Affiliation(s)
- Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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27
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Salehi F, Turner MC, Phillips KP, Wigle DT, Krewski D, Aronson KJ. Review of the etiology of breast cancer with special attention to organochlorines as potential endocrine disruptors. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2008; 11:276-300. [PMID: 18368557 DOI: 10.1080/10937400701875923] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Breast cancer is the most frequently diagnosed cancer among Canadian women, accounting for about 30% of all new cancer cases each year. Although the incidence of breast cancer has increased over the past 50 years, the cause of this rise is unknown. Risk factors for breast cancer may be classified into four broad categories: (1) genetic/familial, (2) reproductive/hormonal, (3) lifestyle, and (4) environmental. Established risk factors for breast cancer include older age, later age at first full-term pregnancy, no full-term pregnancies, postmenopausal obesity, and genetic factors. However, these known risk factors cannot account for the majority of cases. In the early 1990s, it was suggested that exposure to some environmental chemicals such as organochlorine compounds may play a causal role in the etiology of breast cancer through estrogen-related pathways. The relationship between organochlorines and breast cancer risk has been studied extensively in the past decade and more, and at this point there is no clear evidence to support a causal role of most organochlorine pesticides in the etiology of human breast cancer, but more evidence is needed to assess risk associated with polychlorinated biphenyls (PCBs). Future studies need to consider the combined effects of exposures, concentrate on vulnerable groups such as those with higher levels of exposure, only consider exposures occurring during the most etiologically relevant time periods, and more thoroughly consider gene-environment interactions.
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Affiliation(s)
- Fariba Salehi
- McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ottawa, Canada
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28
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Sakoda LC, Blackston CR, Xue K, Doherty JA, Ray RM, Lin MG, Stalsberg H, Gao DL, Feng Z, Thomas DB, Chen C. Glutathione S-transferase M1 and P1 polymorphisms and risk of breast cancer and fibrocystic breast conditions in Chinese women. Breast Cancer Res Treat 2007; 109:143-55. [PMID: 17624589 PMCID: PMC2741390 DOI: 10.1007/s10549-007-9633-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Accepted: 05/24/2007] [Indexed: 12/20/2022]
Abstract
Enzymes encoded by the glutathione S-tranferase mu 1 (GSTM1) and pi 1 (GSTP1) genes, which are expressed in breast tissue, catalyze the detoxification of endogenous and exogenous electrophiles. Reduced enzyme activity, due to carriage of the GSTM1 deletion or the GSTP1 Ile105Val Val allele, may therefore affect susceptibility to breast cancer and related conditions. In a case-control study of Chinese women, we examined whether these polymorphisms were associated with risk of breast cancer and fibrocystic breast conditions. Women diagnosed with breast cancer (n=615) or fibrocystic breast conditions (n=467) were compared to women without clinical breast disease (n=878). We also examined whether these associations differed by menopausal status or by presence of proliferation in the extra-tumoral epithelium among women with breast cancer and in lesions among women with fibrocystic conditions. No overall association of either GST polymorphism with risk of breast cancer or fibrocystic breast conditions was observed. There was some evidence of slightly elevated cancer risk associated with carriage of the GSTM1 null genotype and at least one GSTP1 105-Val allele (OR=1.33, 95% CI, 0.99-1.80), compared to carriage of the GSTM1 non-null and GSTP1 Ile/Ile genotypes. This relationship was stronger in women who had breast cancer with extra-tumoral tissue proliferation (OR=1.77, 95% CI, 1.03-3.04). Our results suggest that GSTM1 and GSTP1 genotypes do not individually influence susceptibility to breast cancer or fibrocystic breast conditions. The observed increased risk of breast cancer associated with joint carriage of the GSTM1 null genotype and GSTP1 105-Val allele needs confirmation in other studies.
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Affiliation(s)
- Lori C. Sakoda
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Christie R. Blackston
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kan Xue
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jennifer A. Doherty
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Roberta M. Ray
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ming Gang Lin
- Program in Cancer Biology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Helge Stalsberg
- Institute of Medical Biology, University of Tromsø, Tromsø, Norway
| | - Dao Li Gao
- Department of Epidemiology, Zhongshan Hospital Cancer Center, Fudan University, Shanghai, China
| | - Ziding Feng
- Program in Biostatistics and Bioinformatics, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David B. Thomas
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Correspondence to: Chu Chen, Ph.D., Program in Epidemiology, Fred Hutchinson Cancer Research Center, Mailstop M5-C800, P.O. Box 19024, Seattle, WA 98109-1024, USA. Phone: 206-667-6644, Fax: 206-667-2537. E-mail:
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Wernli KJ, Ray RM, Gao DL, De Roos AJ, Checkoway H, Thomas DB. Menstrual and reproductive factors in relation to risk of endometrial cancer in Chinese women. Cancer Causes Control 2006; 17:949-55. [PMID: 16841262 DOI: 10.1007/s10552-006-0034-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Accepted: 04/05/2006] [Indexed: 11/28/2022]
Abstract
Menstrual, reproductive and contraceptive factors have been associated with risk of endometrial cancer in populations where the incidence of this tumor is high. To investigate associations between these factors in a low-risk population with a low prevalence of hormone replacement therapy, we conducted a cohort study among 267,400 women employed in the textile industry in Shanghai, China. Menstrual, reproductive and other factors were ascertained at baseline in 1989-1991, and women were followed for incident endometrial cancer through 31 December 1998 (n = 206). Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Risk of endometrial cancer decreased with increasing age at menarche (p-trend = 0.004). Among menopausal women, risk increased with age at menopause and increasing years of menstruation. Compared to women with one live birth, risk was increased in relation to nulliparity (Hazard ratio = 3.95, 95% CI 1.43-10.86). Risk was decreased with increasing age at first live birth (p-trend = 0.03). There was a decreased risk associated with ever use of an intrauterine device (HR = 0.56, 95% CI 0.35-0.88) and use of oral contraceptives for > or =2 years (HR = 0.50, 95% CI 0.23-1.07). This prospective study confirms findings from previous case-control studies relating menstrual, reproductive, and contraceptive factors and endometrial carcinoma.
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Affiliation(s)
- Karen J Wernli
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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30
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Chen C, Doherty JA, Lewis SK, Ray RM, Gao DL, Stalsberg H, Feng Z, Thomas DB. Insulin-like growth factor-I, insulin-like growth factor binding protein-3 and the risk of fibrocystic breast conditions among Chinese women. Int J Cancer 2006; 118:2303-9. [PMID: 16331609 DOI: 10.1002/ijc.21624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We investigated whether circulating insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels are associated with the risk of fibrocystic breast conditions (FBC), in a case-control study nested within a randomized trial of breast self-examination conducted in Shanghai, China. Participants were enrolled during 1989-1991 and were followed over 10 years for the development of breast diseases. Controls (n = 897) were frequency-matched by age to cases (n = 451), who were diagnosed with FBC between 1995 and 2000. Circulating IGF-I and IGFBP-3 levels and their molar ratio were positively associated with risk of FBC. The odds ratios (ORs) and 95% confidence intervals (CI) for the upper fourth of the distribution compared to the lowest fourth for IGF-I, IGFBP3 and their molar ratio were 3.02 (2.02-4.52), 1.92 (1.37-2.71) and 2.26 (1.52-3.36), respectively. The strength of the association between IGF-I levels and FBC was attenuated after adjustment for IGFBP-3 and that for IGFBP-3 was largely eliminated after adjustment for IGF-I. Increasing levels of IGF-I were particularly associated with increasing risk of FBC with proliferative elements (ORs and 95% CIs for the 2nd, 3rd and upper fourth of the distribution of IGF-I: 3.13 (1.50-6.53), 4.57 (2.22-9.39) and 6.30 (3.08-12.89), compared with the lowest fourth. Our results suggest that elevated levels of IGF-I may contribute to the development of FBC.
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Affiliation(s)
- Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
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31
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Qin LQ, Xu JY, Wang PY, Hoshi K. Soyfood Intake in the Prevention of Breast Cancer Risk in Women: A Meta-Analysis of Observational Epidemiological Studies. J Nutr Sci Vitaminol (Tokyo) 2006; 52:428-36. [PMID: 17330506 DOI: 10.3177/jnsv.52.428] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Many studies have suggested that the intake of soy products may protect against the occurrence of breast cancer because of the considerable amount of isoflavones they contain. To review the results of the observational studies, we performed this meta-analysis of the relevant literature. We searched Medline for reports that examined the association between soyfood consumption (or isoflavone intake) and breast cancer risk from January 1966 to April 2006. The random-effects model was used to estimate the pooled relative risk (RR). Twenty-one independent studies (14 case-control studies and 7 cohort studies) were included in the final analysis. The pooled RR of breast cancer for soyfood intake was 0.75 with a 95% CI of 0.59-0.95. As the main types of soyfood in Japan and China, tofu and miso showed clear protective effects. Isoflavone intake resulted in a 20% decrease in risk (RR = 0.81, 95% CI 0.67-0.99). The pooled RR varied little according to study stratification. When the studies published in Japanese and Chinese were added, the inverse associations between soyfood, tofu and breast cancer risk became slightly stronger. The weak association of miso was possibly due to the high concentration of salt in miso soup. In the present analysis, we did not find strong evidence for publication bias in the combination of the studies. This meta-analysis supported the hypotheses that soyfood intake may be associated with a decreased risk of breast cancer due to the isoflavones. Further epidemiological studies need to be conducted with more comprehensive information about the soyfood, and more accurate assessment of the isoflavones.
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Affiliation(s)
- Li-Qiang Qin
- School of Radiology and Public Health, Soochow University, Suzhou, 215123, China.
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