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Body size and breast cancer risk: Findings from the European prospective investigation into cancer and nutrition (EPIC)
Author(s) -
Lahmann Petra H.,
Hoffmann Kurt,
Allen Naomi,
van Gils Carla H.,
Khaw KayTee,
Tehard Bertrand,
Berrino Franco,
Tjønneland Anne,
Bigaard Janne,
Olsen Anja,
Overvad Kim,
ClavelChapelon Françoise,
Nagel Gabriele,
Boeing Heiner,
Trichopoulos Dimitrios,
Economou George,
Bellos George,
Palli Domenico,
Tumino Rosario,
Panico Salvatore,
Sacerdote Carlotta,
Krogh Vittorio,
Peeters Petra H.M.,
BuenodeMesquita H. Bas,
Lund Eiliv,
Ardanaz Eva,
Amiano Pilar,
Pera Guillem,
Quirós José R.,
Martínez Carmen,
Tormo María J.,
Wirfält Elisabet,
Berglund Göran,
Hallmans Göran,
Key Timothy J.,
Reeves Gillian,
Bingham Sheila,
Norat Teresa,
Biessy Carine,
Kaaks Rudolf,
Riboli Elio
Publication year - 2004
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.20315
Subject(s) - medicine , breast cancer , waist , european prospective investigation into cancer and nutrition , body mass index , anthropometry , prospective cohort study , waist–hip ratio , cancer , gynecology , obstetrics , obesity , cohort study , oncology
The evidence for anthropometric factors influencing breast cancer risk is accumulating, but uncertainties remain concerning the role of fat distribution and potential effect modifiers. We used data from 73,542 premenopausal and 103,344 postmenopausal women from 9 European countries, taking part in the EPIC study. RRs from Cox regression models were calculated, using measured height, weight, BMI and waist and hip circumferences; categorized by cohort‐wide quintiles; and expressed as continuous variables, adjusted for study center, age and other risk factors. During 4.7 years of follow‐up, 1,879 incident invasive breast cancers were identified. In postmenopausal women, current HRT modified the body size–breast cancer association. Among nonusers, weight, BMI and hip circumference were positively associated with breast cancer risk (all p trend ≤ 0.002); obese women (BMI > 30) had a 31% excess risk compared to women with BMI < 25. Among HRT users, body measures were inversely but nonsignificantly associated with breast cancer. Excess breast cancer risk with HRT was particularly evident among lean women. Pooled RRs per height increment of 5 cm were 1.05 (95% CI 1.00–1.16) in premenopausal and 1.10 (95% CI 1.05–1.16) in postmenopausal women. Among premenopausal women, hip circumference was the only other measure significantly related to breast cancer ( p trend = 0.03), after accounting for BMI. In postmenopausal women not taking exogenous hormones, general obesity is a significant predictor of breast cancer, while abdominal fat assessed as waist–hip ratio or waist circumference was not related to excess risk when adjusted for BMI. Among premenopausal women, weight and BMI showed nonsignificant inverse associations with breast cancer. © 2004 Wiley‐Liss, Inc.