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Diet and Breast Cancer Risk: Results From a Population-Based, Case-Control Study in Sweden

Diet and Breast Cancer Risk: Results From a Population-Based, Case-Control Study in Sweden Abstract Background: We describe an epidemiologic analytical study of the relationship between current diet and breast cancer risk. Method: The study design is a case-control analysis. Cases were recruited from a mammography screening program used within the national health care system; the control subjects were selected from subjects free of breast cancer in the same population. A total of 380 cases and 525 control subjects, frequency-matched for age, month of mammography, and county of residence, were identified. Of these, 265 cases and 432 control subjects were included in this analysis. Odds ratios for breast cancer in relation to food and nutrient intake were the main outcome measures. Results: Exposure in the highest quartile of β-carotene intake gave an odds ratio of 0.6 (95% confidence interval, 0.4 to 1.0). No increased risk was noted with high fat intake. Breast cancer risk was associated with alcohol intake only when alcohol was analyzed in quartiles: odds ratio, 1.6 (95% confidence interval, 1.0 to 2.4) for the highest quartile of intake vs the lowest. Stratified analyses showed that a high fat intake might decrease the protective effect of β-carotene intake. Risks did not change appreciably with adjustment for total energy intake or known breast cancer risk factors. Conclusions: As in most other studies, no strong risk factors for breast cancer have been identified in the current diet. The negative association between breast cancer risk and β-carotene intake may be supported by a plausible mechanism, but our finding concerning alcohol should be interpreted cautiously since there was no dose-response relationship and the biological mechanism for a threshold effect at very low levels of consumption is unclear.(Arch Intern Med. 1994;154:1805-1811) References 1. Howe GR, Hirohata T, Hislop TG, et al. Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies . J Nati Cancer Inst. 1990;82:561-569.Crossref 2. Willett W. The search for the causes of breast and colon cancer . Nature . 1989; 338:389-394.Crossref 3. Schatzkin A, Greenwald P, Byar DP, Clifford CK. The dietary fat-breast cancer hypothesis is alive . JAMA . 1989;261:3284-3287.Crossref 4. Adami HO, Adams G, Boyle P, et al. Breast cancer etiology . Int J Cancer. 1990; ( (suppl 5) ):22-39. 5. Committee on Diet, Nutrition and Cancer: Assembly of Life Sciences, National Research Council, National Academy of Sciences . Diet, Nutrition and Cancer . Washington, DC: National Academic Press; 1982. 6. Self S, Prentice R, Iverson D, et al. Statistical design of the Women's Health Trial . Control Clin Trials. 1988;9:119-136.Crossref 7. Longnecker MP, Berlin JA, Orza MJ, Chalmers TC. A meta-analysis of alcohol consumption in relation to risk of breast cancer . JAMA. 1988;260:652-656.Crossref 8. Plant ML. Alcohol and breast cancer: a review . Int J Addict 1992;27:107-128. 9. Byers T, Perry G. Dietary carotenes, vitamin C, and vitamin E as protective antioxidants in human cancers . Ann Rev Nutr. 1992;12:139-159.Crossref 10. Giovannucci E, Stampfer MJ, Colditz GA, et al. A comparison of prospective and retrospective assessments of diet in the study of breast cancer . Am J Epidemiol. 1991;134:714. Abstract. 11. Tabar L, Fagerberg CJG, Gad A, et al. Reduction in mortality from breast cancer after mass screening with mammography . Lancet . 1985;1:829-832.Crossref 12. Christensson T. Menopausal age of females with hypercalcemia: a study including cases with primary hyperparathyroidism, detected in a health screening . Acta Med Scand. 1976;200:361-365.Crossref 13. Bengtsson C, Lindquist 0, Redvall L. Is the menopausal age rapidly changing? Maturitas. 1979;1:159-164.Crossref 14. Lee HP, Gourley L, Duffy SW, Ester J, Lee J, Day NE. Dietary effects on breast cancer risk in Singapore . Lancet . 1991;337:1197-1200.Crossref 15. Zaridze D, Lifanova Y, Maximovitch D, Day NE, Duffy SW. Diet, alcohol consumption and reproductive factors in a case-control study of breast cancer in Moscow . Int J Cancer . 1991;48:493-501.Crossref 16. Graham S, Hellmann R, Marshall J, et al. Nutritional epidemiology of postmenopausal breast cancer in western New York . Am J Epidemiol. 1991;134: 552-566. 17. Hunter DJ, Stampfer MJ, Colditz GA, et al. A prospective study of vitamins A, C, and E and breast cancer risk . Am J Epidemiol. 1991;134:715. Abstract. 18. Phillips RL. Role of life-style and dietary habits in risk of cancer among Seventh-Day Adventists . Cancer Res. 1975;35:3513-3522. 19. Negri E, La Vecchia C, Franceschi S, D'Avanzo B, Parazzini F. Vegetable and fruit consumption and cancer risk . Int J Cancer. 1991;48:350-354.Crossref 20. Ewertz M, Gill C. Dietary factors and breast-cancer risk in Denmark . Int J Cancer. 1990;46:779-784.Crossref 21. Richardson S, Gerber M, Cenee S. The role of fat, animal protein and some vitamin consumption in breast cancer: a case-control study in southern France . Int J Cancer. 1991;48:1-9. 22. Ingram DM, Nottage E, Roberts T. The role of diet in the development of breast cancer: a case-control study of patients with breast cancer, benign epithelial hyperplasia and fibrocystic disease of the breast . Br J Cancer. 1991;64:187-191.Crossref 23. Potischman N, McCulloch CE, Byers T, et al. Breast cancer and dietary and plasma concentrations of carotenoids and vitamin A . Am J Clin Nutr. 1990; 52:909-915. 24. Paganini-Hill A, Chao A, Ross RK, Henderson BE. Vitamin A, beta-carotene, and the risk of breast cancer: a prospective study . J Natl Cancer Inst. 1987;79:443-448. 25. Knekt P. Albanes D, Seppanen R, et al. Dietary fat and risk of breast cancer . Am J Clin Nutr. 1990;52:903-908. 26. Graham S, Marshall J, Mettlin C, Rzepka T, Nemoto T, Byers T. Diet in the epidemiology of breast cancer . Am J Epidemiol . 1982;116:68-75. 27. Krinsky NI. Carotenoids as chemopreventive agents . Prev Med. 1989;18:592-602.Crossref 28. Steinmetz KA, Potter JD. Vegetables, fruit and cancer, II: mechanisms . Cancer Causes Control. 1991;2:427-442.Crossref 29. Ziegler RG. Vegetables, fruits, and carotenoids and the risk of cancer . Am J Clin Nutr. 1991;53:251s-259s. 30. Santamaria L, Bianchi A. Cancer chemoprevention by supplemental carotenoids in animals and humans . Prev Med. 1989;18:603-623.Crossref 31. Steinmetz KA, Potter JD. Vegetables, fruit and cancer, I: epidemiology . Cancer Causes Control. 1991;2:325-357.Crossref 32. Willett WC, Hunter DJ, Stampfer MJ, et al. Dietary fat and fiber in relation to risk of breast cancer . JAMA . 1992;268:2037-2044.Crossref 33. Kushi LH, Sellers TA, Potter JD, et al. Dietary fat and postmenopausal breast cancer . J Natl Cancer Inst. 1992;84:1092-1099.Crossref 34. O'Connell DL, Hulka BS, Chambless LE, Wilkinson WE, Deubner DC. Cigarette smoking, alcohol consumption and breast cancer risk . J Natl Cancer Inst. 1987; 78:229-234. 35. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer . N Engl J Med. 1987;316:1174-1180.Crossref 36. Schatzkin A, Jones DY, Hoover RN, et al. Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first National Health and Nutrition Examination Survey . N Engl J Med. 1987;316:1169-1173.Crossref 37. Adami HO, Lund E, Bergström R, Meirik O. Cigarette smoking, alcohol consumption and risk of breast cancer in young women . Br J Cancer. 1988;58: 832-837.Crossref 38. Adami HO, McLaughlin JK, Hsing AW, et al. Alcoholism and cancer risk: a population-based cohort study . Cancer Causes Control. 1992;3:419-425.Crossref 39. Katsouyanni K, Willett W, Trichopoulos D, et al. Risk of breast cancer among Greek women in relation to nutrient intake . Cancer . 1988;61:181-185.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Diet and Breast Cancer Risk: Results From a Population-Based, Case-Control Study in Sweden

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420160038005
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: We describe an epidemiologic analytical study of the relationship between current diet and breast cancer risk. Method: The study design is a case-control analysis. Cases were recruited from a mammography screening program used within the national health care system; the control subjects were selected from subjects free of breast cancer in the same population. A total of 380 cases and 525 control subjects, frequency-matched for age, month of mammography, and county of residence, were identified. Of these, 265 cases and 432 control subjects were included in this analysis. Odds ratios for breast cancer in relation to food and nutrient intake were the main outcome measures. Results: Exposure in the highest quartile of β-carotene intake gave an odds ratio of 0.6 (95% confidence interval, 0.4 to 1.0). No increased risk was noted with high fat intake. Breast cancer risk was associated with alcohol intake only when alcohol was analyzed in quartiles: odds ratio, 1.6 (95% confidence interval, 1.0 to 2.4) for the highest quartile of intake vs the lowest. Stratified analyses showed that a high fat intake might decrease the protective effect of β-carotene intake. Risks did not change appreciably with adjustment for total energy intake or known breast cancer risk factors. Conclusions: As in most other studies, no strong risk factors for breast cancer have been identified in the current diet. The negative association between breast cancer risk and β-carotene intake may be supported by a plausible mechanism, but our finding concerning alcohol should be interpreted cautiously since there was no dose-response relationship and the biological mechanism for a threshold effect at very low levels of consumption is unclear.(Arch Intern Med. 1994;154:1805-1811) References 1. Howe GR, Hirohata T, Hislop TG, et al. Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies . J Nati Cancer Inst. 1990;82:561-569.Crossref 2. Willett W. The search for the causes of breast and colon cancer . Nature . 1989; 338:389-394.Crossref 3. Schatzkin A, Greenwald P, Byar DP, Clifford CK. The dietary fat-breast cancer hypothesis is alive . JAMA . 1989;261:3284-3287.Crossref 4. Adami HO, Adams G, Boyle P, et al. Breast cancer etiology . Int J Cancer. 1990; ( (suppl 5) ):22-39. 5. Committee on Diet, Nutrition and Cancer: Assembly of Life Sciences, National Research Council, National Academy of Sciences . Diet, Nutrition and Cancer . Washington, DC: National Academic Press; 1982. 6. Self S, Prentice R, Iverson D, et al. Statistical design of the Women's Health Trial . Control Clin Trials. 1988;9:119-136.Crossref 7. Longnecker MP, Berlin JA, Orza MJ, Chalmers TC. A meta-analysis of alcohol consumption in relation to risk of breast cancer . JAMA. 1988;260:652-656.Crossref 8. Plant ML. Alcohol and breast cancer: a review . Int J Addict 1992;27:107-128. 9. Byers T, Perry G. Dietary carotenes, vitamin C, and vitamin E as protective antioxidants in human cancers . Ann Rev Nutr. 1992;12:139-159.Crossref 10. Giovannucci E, Stampfer MJ, Colditz GA, et al. A comparison of prospective and retrospective assessments of diet in the study of breast cancer . Am J Epidemiol. 1991;134:714. Abstract. 11. Tabar L, Fagerberg CJG, Gad A, et al. Reduction in mortality from breast cancer after mass screening with mammography . Lancet . 1985;1:829-832.Crossref 12. Christensson T. Menopausal age of females with hypercalcemia: a study including cases with primary hyperparathyroidism, detected in a health screening . Acta Med Scand. 1976;200:361-365.Crossref 13. Bengtsson C, Lindquist 0, Redvall L. Is the menopausal age rapidly changing? Maturitas. 1979;1:159-164.Crossref 14. Lee HP, Gourley L, Duffy SW, Ester J, Lee J, Day NE. Dietary effects on breast cancer risk in Singapore . Lancet . 1991;337:1197-1200.Crossref 15. Zaridze D, Lifanova Y, Maximovitch D, Day NE, Duffy SW. Diet, alcohol consumption and reproductive factors in a case-control study of breast cancer in Moscow . Int J Cancer . 1991;48:493-501.Crossref 16. Graham S, Hellmann R, Marshall J, et al. Nutritional epidemiology of postmenopausal breast cancer in western New York . Am J Epidemiol. 1991;134: 552-566. 17. Hunter DJ, Stampfer MJ, Colditz GA, et al. A prospective study of vitamins A, C, and E and breast cancer risk . Am J Epidemiol. 1991;134:715. Abstract. 18. Phillips RL. Role of life-style and dietary habits in risk of cancer among Seventh-Day Adventists . Cancer Res. 1975;35:3513-3522. 19. Negri E, La Vecchia C, Franceschi S, D'Avanzo B, Parazzini F. Vegetable and fruit consumption and cancer risk . Int J Cancer. 1991;48:350-354.Crossref 20. Ewertz M, Gill C. Dietary factors and breast-cancer risk in Denmark . Int J Cancer. 1990;46:779-784.Crossref 21. Richardson S, Gerber M, Cenee S. The role of fat, animal protein and some vitamin consumption in breast cancer: a case-control study in southern France . Int J Cancer. 1991;48:1-9. 22. Ingram DM, Nottage E, Roberts T. The role of diet in the development of breast cancer: a case-control study of patients with breast cancer, benign epithelial hyperplasia and fibrocystic disease of the breast . Br J Cancer. 1991;64:187-191.Crossref 23. Potischman N, McCulloch CE, Byers T, et al. Breast cancer and dietary and plasma concentrations of carotenoids and vitamin A . Am J Clin Nutr. 1990; 52:909-915. 24. Paganini-Hill A, Chao A, Ross RK, Henderson BE. Vitamin A, beta-carotene, and the risk of breast cancer: a prospective study . J Natl Cancer Inst. 1987;79:443-448. 25. Knekt P. Albanes D, Seppanen R, et al. Dietary fat and risk of breast cancer . Am J Clin Nutr. 1990;52:903-908. 26. Graham S, Marshall J, Mettlin C, Rzepka T, Nemoto T, Byers T. Diet in the epidemiology of breast cancer . Am J Epidemiol . 1982;116:68-75. 27. Krinsky NI. Carotenoids as chemopreventive agents . Prev Med. 1989;18:592-602.Crossref 28. Steinmetz KA, Potter JD. Vegetables, fruit and cancer, II: mechanisms . Cancer Causes Control. 1991;2:427-442.Crossref 29. Ziegler RG. Vegetables, fruits, and carotenoids and the risk of cancer . Am J Clin Nutr. 1991;53:251s-259s. 30. Santamaria L, Bianchi A. Cancer chemoprevention by supplemental carotenoids in animals and humans . Prev Med. 1989;18:603-623.Crossref 31. Steinmetz KA, Potter JD. Vegetables, fruit and cancer, I: epidemiology . Cancer Causes Control. 1991;2:325-357.Crossref 32. Willett WC, Hunter DJ, Stampfer MJ, et al. Dietary fat and fiber in relation to risk of breast cancer . JAMA . 1992;268:2037-2044.Crossref 33. Kushi LH, Sellers TA, Potter JD, et al. Dietary fat and postmenopausal breast cancer . J Natl Cancer Inst. 1992;84:1092-1099.Crossref 34. O'Connell DL, Hulka BS, Chambless LE, Wilkinson WE, Deubner DC. Cigarette smoking, alcohol consumption and breast cancer risk . J Natl Cancer Inst. 1987; 78:229-234. 35. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer . N Engl J Med. 1987;316:1174-1180.Crossref 36. Schatzkin A, Jones DY, Hoover RN, et al. Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first National Health and Nutrition Examination Survey . N Engl J Med. 1987;316:1169-1173.Crossref 37. Adami HO, Lund E, Bergström R, Meirik O. Cigarette smoking, alcohol consumption and risk of breast cancer in young women . Br J Cancer. 1988;58: 832-837.Crossref 38. Adami HO, McLaughlin JK, Hsing AW, et al. Alcoholism and cancer risk: a population-based cohort study . Cancer Causes Control. 1992;3:419-425.Crossref 39. Katsouyanni K, Willett W, Trichopoulos D, et al. Risk of breast cancer among Greek women in relation to nutrient intake . Cancer . 1988;61:181-185.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 22, 1994

References