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  • 1
    Electronic Resource
    Electronic Resource
    Fertility Problems and Breast Cancer Risk in Young Women: a Case-Control Study in the United States (1998)
    Springer
    Cancer causes & control 9 (1998), S. 331-339 
    Details
    ISSN: 1573-7225
    Keywords: Breast cancer ; infertility ; pregnancy ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Late age at first birth and nulliparity are established risk factors for breast cancer, yet the extent to which fertility problems contribute to these associations remains largely unexplored. Here, we examine self-reported fertility problems as a risk factor for breast cancer in young women. Methods: We used a population-based case-control study of 2,173 cases and 1,990 controls aged 20 to 54 years in the United States. Structured in-person interviews were used to elicit detailed information on established and potential breast cancer risk factors. Information was collected on pregnancy details, including difficulties becoming pregnant or maintaining a pregnancy. Results: Self-reported difficulty in becoming pregnant or maintaining a pregnancy was reported by 450 cases and 377 controls. Overall, there was little association between these fertility problems and risk of breast cancer (odds ratio [OR] = 1.05). Parity was associated with a decreased risk of breast cancer in women both with (OR = 0.71) and without (OR = 0.79) fertility problems. There was little evidence of an increased risk of breast cancer with later age at first full-term birth among women without fertility problems (ORage 35+ :age 〈20 = 1.13, 95 percent confidence interval [CI] = 0.7-1.9), but a relatively strong association among women with fertility problems (ORage 35+ :age 〈20 = 2.96, CI = 1.3-7.0). Among women with a first full-term birth at age 35 or older, fertility problems were associated with a twofold risk of breast cancer. Analyses of duration of unprotected sexual intercourse prior to first pregnancy as an alternative estimate of infertility produced similar results. Conclusions: Our study suggests that the association between late age at first birth and breast cancer is stronger among women with self-reported fertility problems than among women with no fertility problems. Cancer Causes and Control 1998, 9, 331-339
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008881305738
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  • 2
    Electronic Resource
    Electronic Resource
    Cigarette smoking and breast cancer risk among young women (United States) (1998)
    Springer
    Cancer causes & control 9 (1998), S. 583-590 
    Details
    ISSN: 1573-7225
    Keywords: Breast neoplasms ; cigarette smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To evaluate whether heavy cigarette smoking as a teenager or long-term smoking increases breast cancer risk or, alternatively, whether smoking acts as an anti-estrogen and reduces risk. Methods: Data from a multi-center, population-based, case-control study among women under age 55 were analyzed. Results: Among women under age 45, there was a modest inverse relation with current (OR=0.82, 95% CI=0.67, 1.01) but not past (OR=0.99, 95% CI=0.81, 1.21) smoking. Odds ratios were decreased for current smokers who began at an early age (0.59 for≤15, 95% CI=0.41, 0.85) or continued for long periods of time (0.70 for 〉21 years, 95% CI=0.52, 0.94). In subgroup analyses, reduced odds ratios were observed among current smokers who were ever users of oral contraceptives (0.79, 95% CI=0.63, 0.98), were in the lowest quartile of adult body size (0.53, 95% CI=0.34, 0.81), or never or infrequently drank alcohol (0.68, 95% CI=0.47, 0.98). Among women ages 45-54, there was little evidence for an association with smoking. Conclusions: These results suggest that breast cancer risk among women under age 45 may be reduced among current smokers who began smoking at an early age, or long-term smokers, but require confirmation from other studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008868922799
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  • 3
    Electronic Resource
    Electronic Resource
    Breastfeeding and breast cancer risk (1995)
    Springer
    Cancer causes & control 6 (1995), S. 199-208 
    Details
    ISSN: 1573-7225
    Keywords: Breast cancer ; breast feeding ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A population-based case-control study of breast cancer with a focus on premenopausal women under 45 years of age, conducted in three geographic regions of the United States, enabled the evaluation of risk in relation to varying breastfeeding practices. Among premenopausal parous women (1,211 cases, 1,120 random-digit-dialing controls), a history of breastfeeding for two or more weeks was associated with a relative risk (RR) of 0.87 (95 percent confidence interval [CI]=0.7–1.0). This relationship was not altered substantially by removing from the reference group women who had problems with breastfeeding in the first two weeks, including those with insufficient milk production. Risk was not related substantially to number of children breastfed or length of breastfeeding, although a relatively low risk was observed among those breastfeeding for the longest duration examined (RR=0.67, CI=0.4–1.1 for an average period per child of 72 or more weeks). Women who began to breastfeed at a young age (〈22 years) experienced the greatest reduction in risk, but other timing parameters (e.g., interval since first or last breastfeeding) were not predictive of risk. Risks were not modified substantially by age or menopause status, although the number of menopausal subjects examined was limited. Use of medications to stop breast milk was unrelated to risk (RR=1.04). The results of this study do not support the notion that breastfeeding substantially reduces breast cancer risk; however, this may reflect the fact that most of our study subjects breastfed only for limited periods of time (average breastfeeding per child of 30 weeks). Further studies are needed to clarify the relationship of breastfeeding to breast cancer risk, and to determine possible etiologic mechanisms underlying any observed associations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00051791
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  • 4
    Electronic Resource
    Electronic Resource
    Diet and benign ovarian tumors (United States) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 389-401 
    Details
    ISSN: 1573-7225
    Keywords: case–control studies ; diet ; nutrition ; ovarian neoplasms ; risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: The relation between benign ovarian tumors (BOTs) and nutrients, primarily dietary fat, was examined using case–control data. Methods: 746 cases were diagnosed from 1 January 1992 to 31 December 1993. The 404 age- and hospital frequency-matched community controls were identified by random digit dialing. Six hundred seventy-three cases and 351 controls provided dietary information. Results: The risk of BOTs was elevated for the highest vs. lowest quartile of intake of total, vegetable, saturated, monounsaturated, and polyunsaturated fat. The corresponding age-, hospital-, total energy-, and body mass index-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are 1.3 (0.9–1.9), 1.7 (1.2–2.5), 1.2 (0.8–1.8), 1.3 (0.9–1.8), and 1.6 (1.1–2.3). After adjustment for polyunsaturated fat, the risk of BOTs only remained elevated for vegetable fat (highest vs. lowest quartile OR and 95% CI = 1.4 (0.8–2.3)). Elevated risks were observed for higher intakes of polyunsaturated fat with endometrioid, serous, and teratoma tumors. Higher intakes of vegetable fat, adjusted for polyunsaturated fat, increased the risk of endometrioid, mucinous, and serous tumors. Only the risk of serous BOTs was consistently lower for higher intakes of micronutrients, with the strongest reduction observed for sources of vitamin A. Estimates were not confounded by non-nutrient covariates. Conclusions: Polyunsaturated and vegetable fat may increase the risk of BOTs, while vitamin A may lower the risk of serous BOTs; however, these findings and lack of associations for other nutrients should be replicated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008921710400
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  • 5
    Electronic Resource
    Electronic Resource
    Menstrual risk factors and early-onset breast cancer (2000)
    Springer
    Cancer causes & control 11 (2000), S. 451-458 
    Details
    ISSN: 1573-7225
    Keywords: breast neoplasm ; menstruation ; risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Epidemiologic studies provide evidence for increased breast cancer risk among women with prolonged exposure to endogenous estrogens and progesterone. Menstrual cycle characteristics, such as early menarche, rapid initiation of regular ovulatory cycles, short cycle length, and more days of flow, all potentially contribute to higher cumulative ovarian hormone exposure. Methods: We assessed the associations between these characteristics and breast cancer risk in a population-based, case–control study of 1505 controls and 1647 newly diagnosed cases, all younger than 45 years of age. Results: Compared to women with menarche at ≥15 years, we observed some increase in risk for women with younger ages at menarche, although those with very early ages were not at particularly high risk [odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.1–1.9 for menarche at age 12 and OR = 1.2, 95% CI = 0.9–1.7 for menarche at age ≤10]. Women who reported having regular menstrual cycles within 2 years of menarche were at increased breast cancer risk (OR = 1.7, 95% CI = 1.2–2.3), compared to those never having regular cycles. Stratification by current body mass index revealed slightly stronger associations with menstrual characteristics among thinner women ( 〈 22.0 kg/m2) compared to heavier women ( 〉 28.8 kg/m2). Conclusions: These findings suggest that future studies should focus on clarifying how the interrelated effects of body size and menstrual factors, such as age at menarche and cycle regularity, contribute to breast cancer etiology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008956524669
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  • 6
    Electronic Resource
    Electronic Resource
    Gastroesophageal reflux disease, use of H2 receptor antagonists, and risk of esophageal and gastric cancer (2000)
    Springer
    Cancer causes & control 11 (2000), S. 231-238 
    Details
    ISSN: 1573-7225
    Keywords: esophageal neoplasms ; gastric neoplasms ; gastroesophageal reflux disease ; H2 receptor antagonists
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: The incidence of esophageal adenocarcinoma has risen rapidly in the past two decades, for unknown reasons. The goal of this analysis was to determine whether gastroesophageal reflux disease (GERD) or the medications used to treat it are associated with an increased risk of esophageal or gastric cancer, using data from a large population-based case–control study. Methods: Cases were aged 30–79 years, newly diagnosed with esophageal adenocarcinoma (n = 293), esophageal squamous cell carcinoma (n = 221), gastric cardia adenocarcinoma (n = 261), or non-cardia gastric adenocarcinoma (n = 368) in three areas with population-based tumor registries. Controls (n = 695) were chosen by random digit dialing and from Health Care Financing Administration rosters. Data were collected using an in-person structured interview. Results: History of gastric ulcer was associated with an increased risk of non-cardia gastric adenocarcinoma (OR 2.1, 95% CI 1.4–3.2). Risk of esophageal adenocarcinoma increased with frequency of GERD symptoms; the odds ratio in those reporting daily symptoms was 5.5 (95% CI 3.2–9.3). Ever having used H2 blockers was unassociated with esophageal adenocarcinoma risk (OR 0.9, 95% CI 0.5–1.5). The odds ratio was 1.3 (95% CI 0.6–2.8) in long-term (4 or more years) users, but increased to 2.1 (95% CI 0.8–5.6) when use in the 5 years prior to the interview was disregarded. Risk was also modestly increased among users of antacids. Neither GERD symptoms nor use of H2 blockers or antacids was associated with risk of the other three tumor types. Conclusions: Individuals with long-standing GERD are at increased risk of esophageal adenocarcinoma, whether or not the symptoms are treated with H2blockers or antacids.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008913828105
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