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ORIGINAL INVESTIGATION Cigarette Smoking and the Incidence of Breast Cancer Fei Xue, MD, ScD; Walter C. Willett, MD, DrPH; Bernard A. Rosner, PhD; Susan E. Hankinson, ScD; Karin B. Michels, ScD, PhD Background: Tobacco smoke contains carcinogens, trend=.003) smoking, younger age at smoking initia- which may increase the risk of breast cancer (BC). Con- tion (P for trend=.01), longer duration of smoking (P for versely, cigarette smoking also has antiestrogenic ef- trend=.01), and more pack-years of smoking (P for fects, which may reduce the risk of BC. The association trend=.005). Premenopausal smoking was associated with between smoking and BC remains controversial. a slightly higher incidence of BC (HR,1.11; 95% CI, 1.07- 1.15 for every increase of 20 pack-years), especially smok- Methods: Prospective cohort study of 111 140 partici- ing before first birth (1.18; 1.10-1.27 for every increase pants of the Nurses’ Health Study from 1976 to 2006 for of 20 pack-years). Conversely, the direction of the asso- active smoking and 36 017 women from 1982 to 2006 ciation between postmenopausal smoking and BC was for passive smoking. inverse (0.93; 0.85-1.02 for every increase of 20 pack- years). Passive smoking in childhood or adulthood was Results: During 3 005 863
JAMA Internal Medicine – American Medical Association
Published: Jan 24, 2011
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