Risk factors for breast cancer in the breast cancer risk model study of Guam and Saipan. (October 2017)

• Record Type: Journal Article
• Authors: Leon Guerrero, Rachael T.; Novotny, Rachel; Wilkens, Lynne R.; Chong, Marie; White, Kami K.; Shvetsov, Yurii B.; Buyum, Arielle; Badowski, Grazyna; Blas-Laguaña, Michelle
• Is Part Of: Cancer epidemiology. Volume 50: Part B(2017:Oct.)
• Page Start: 221
• Page End: 233
• Publication Date: 2017-10
• Subjects: Breast cancer -- BRISK -- Guam -- Risk factors -- Saipan; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2017.04.008
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: A retrospective case-control study was conducted looking female breast cancer among women in the Mariana Islands. OR and 95% CI were calculated for lifestyle-related factors from logistic regression of breast cancer in all women. Age at first live birth was significantly associated with an increase in breast cancer risk. Waist circumference was significantly associated with breast cancer risk in Filipino women. The results provide a basis for cancer prevention guidance for women in the Mariana Islands. Abstract: Background: Chamorro Pacific Islanders in the Mariana Islands have breast cancer incidence rates similar to, but mortality rates higher than, those of U.S. women. As breast cancer risk factors of women of the Mariana Islands may be unique because of ethnic and cultural differences, we studied established and suspected risk factors for breast cancer in this unstudied population. Methods: From 2010–2013, we conducted retrospective case-control study of female breast cancer (104 cases and 185 controls) among women in the Mariana Islands. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each of various lifestyle-related factors from logistic regression of breast cancer, in all women and in pre- and postmenopausal women separately. Tests for interaction of risk factors with ethnicity were based on the Wald statistics for cross-product terms. Results: Of the medical and reproductive factors considered — age at menarche, breastfeeding, number of live births, age at first live birth, hormone use, and menopause — only age at first live birth was confirmed. Age at first live birth, among parous women, was higher among cases (mean 24.9 years) than controls (mean 23.2 years); with increased breast cancer risk (OR = 2.53; 95% CI, 1.04–6.19 for age ≥ 30y compared to <20y, P for trend = 0.01). Of the lifestyle factors —body mass index, waist circumference, physical activity, alcohol and betel-nut intake, and education — only waist circumference (OR = 1.65; 95% CI 0.87–3.14 for the highest tertile group compared to the lowest, P for trend = 0.04) was significantly associated with breast cancer risk and only in Filipino women. The association with many other established risk factors, such as BMI, hormone use and physical activity, were in the expected direction but were not significant. Associations for family history of breast cancer and alcohol intake were not evident Conclusions: The results provide a basis for cancer prevention guidance for women in the Mariana Islands.