Open Access Highly Accessed Research article

Breast cancer epidemiology according to recognized breast cancer risk factors in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Cohort

James V Lacey1*, Aimee R Kreimer23, Saundra S Buys4, Pamela M Marcus5, Shih-Chen Chang67, Michael F Leitzmann78, Robert N Hoover9, Philip C Prorok5, Christine D Berg2, Patricia Hartge9 and the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Project Team

Author Affiliations

1 Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA

2 Early Detection Research Group, Division of Cancer Prevention, National Institutes of Health, Rockville, Maryland, USA

3 Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA

4 Department of Internal Medicine, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

5 Biometry Research Group, Division of Cancer Prevention, National Institutes of Health, National Cancer Institute, Rockville Maryland, USA

6 Global Epidemiology Department, AstraZeneca, Wilmington, Delaware, USA

7 Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA

8 Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany

9 Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville Maryland, USA

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BMC Cancer 2009, 9:84  doi:10.1186/1471-2407-9-84

Published: 17 March 2009

Abstract

Background

Multidisciplinary attempts to understand the etiology of breast cancer are expanding to increasingly include new potential markers of disease risk. Those efforts may have maximal scientific and practical influence if new findings are placed in context of the well-understood lifestyle and reproductive risk factors or existing risk prediction models for breast cancer. We therefore evaluated known risk factors for breast cancer in a cancer screening trial that does not have breast cancer as a study endpoint but is large enough to provide numerous analytic opportunities for breast cancer.

Methods

We evaluated risk factors for breast cancer (N = 2085) among 70,575 women who were randomized in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Using Poisson regression, we calculated adjusted relative risks [RRs, with 95% confidence intervals (CIs)] for lifestyle and reproductive factors during an average of 5 years of follow-up from date of randomization.

Results

As expected, increasing age, nulliparity, positive family history of breast cancer, and use of menopausal hormone therapy were positively associated with breast cancer. Later age at menarche (16 years or older vs. < 12: RR = 0.81, 95% CI, 0.65–1.02) or menopause (55 years or older vs. < 45: RR = 1.29, 95% CI, 1.03–1.62) were less strongly associated with breast cancer than was expected. There were weak positive associations between taller height and heavier weight, and only severe obesity [body mass index (BMI; kg/m2) 35 or more vs. 18.5–24.9: RR = 1.21, 95% CI, 1.02–1.43] was statistically significantly associated with breast cancer.

Conclusion

The ongoing PLCO trial offers continued opportunities for new breast cancer investigations, but these analyses suggest that the associations between breast cancer and age at menarche, age at menopause, and obesity might be changing as the underlying demographics of these factors change.

Clinical Trials Registration

http://www.clinicaltrials.gov webcite, NCT00002540.