TY - JOUR
T1 - Breast cancer population attributable risk proportions associated with body mass index and breast density by race/ethnicity and menopausal status
AU - Breast Cancer Surveillance Consortium
AU - Bissell, Michael C.S.
AU - Kerlikowske, Karla
AU - Sprague, Brian L.
AU - Tice, Jeffery A.
AU - Gard, Charlotte C.
AU - Tossas, Katherine Y.
AU - Rauscher, Garth H.
AU - Trentham-Dietz, Amy
AU - Henderson, Louise M.
AU - Onega, Tracy
AU - Keegan, Theresa H.M.
AU - Miglioretti, Diana L.
N1 - Funding Information:
This research was funded by the NCI and the NIH Office of Research on Women's Health (3P01CA154292-07S1, to M.C.S. Bissell, K. Kerlikowske, and D.L. Miglioretti). Data collection for this work was supported by funding from the NCI (P01CA154292, to K. Kerlikowske, B.L. Sprague, G.H. Rauscher, A. Trentham-Dietz, L.M. Henderson, T. Onega, and D.L. Miglioretti; U54CA163303, to B.L. Sprague); the Patient-Centered Outcomes Research Institute (PCS-1504-30370, to K. Kerlikowske, B.L. Sprague, G.H. Rauscher, A. Trentham-Dietz, L.M. Henderson, T. Onega, D.L. Miglioretti); and the Agency for Healthcare Research and Quality (R01 HS018366-01A1, to G.H. Rauscher). Additional resources were funded by the UC Davis Comprehensive Cancer Center Support Grant awarded by the NCI (P30CA093373). The collection of cancer and vital status data used in this study was supported in part by several state public health departments and cancer registries throughout the United States. For a full description of these sources, please see: http://www.bcsc-research.org/work/acknowledgement.html.
Publisher Copyright:
© 2020 American Association for Cancer Research.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Overweight/obesity and dense breasts are strong breast cancer risk factors whose prevalences vary by race/ethnicity. The breast cancer population attributable risk proportions (PARP) explained by these factors across racial/ethnic groups are unknown. Methods: We analyzed data collected from 3,786,802 mammography examinations (1,071,653 women) in the Breast Cancer Surveillance Consortium, associated with 21,253 invasive breast cancers during a median of 5.2 years follow-up. HRs for body mass index (BMI) and breast density, adjusted for age and registry were estimated using separate Cox regression models by race/ethnicity (White, Black, Hispanic, Asian) and menopausal status. HRs were combined with observed risk-factor proportions to calculate PARPs for shifting overweight/obese to normal BMI and shifting heterogeneously/extremely dense to scattered fibroglandular densities. Results: The prevalences and HRs for overweight/obesity and heterogeneously/extremely dense breasts varied across races/ ethnicities and menopausal status. BMI PARPs were larger for postmenopausal versus premenopausal women (12.0%–28.3% vs. 1.0%–9.9%) and nearly double among postmenopausal Black women (28.3%) than other races/ethnicities (12.0%–15.4%). Breast density PARPs were larger for premenopausal versus postmenopausal women (23.9%–35.0% vs. 13.0%–16.7%) and lower among premenopausal Black women (23.9%) than other races/ethnicities (30.4%–35.0%). Postmenopausal density PARPs were similar across races/ethnicities (13.0%–16.7%). Conclusions: Overweight/obesity and dense breasts account for large proportions of breast cancers in White, Black, Hispanic, and Asian women despite large differences in risk-factor distributions. Impact: Risk prediction models should consider how race/ethnicity interacts with BMI and breast density. Efforts to reduce BMI could have a large impact on breast cancer risk reduction, particularly among postmenopausal Black women.
AB - Background: Overweight/obesity and dense breasts are strong breast cancer risk factors whose prevalences vary by race/ethnicity. The breast cancer population attributable risk proportions (PARP) explained by these factors across racial/ethnic groups are unknown. Methods: We analyzed data collected from 3,786,802 mammography examinations (1,071,653 women) in the Breast Cancer Surveillance Consortium, associated with 21,253 invasive breast cancers during a median of 5.2 years follow-up. HRs for body mass index (BMI) and breast density, adjusted for age and registry were estimated using separate Cox regression models by race/ethnicity (White, Black, Hispanic, Asian) and menopausal status. HRs were combined with observed risk-factor proportions to calculate PARPs for shifting overweight/obese to normal BMI and shifting heterogeneously/extremely dense to scattered fibroglandular densities. Results: The prevalences and HRs for overweight/obesity and heterogeneously/extremely dense breasts varied across races/ ethnicities and menopausal status. BMI PARPs were larger for postmenopausal versus premenopausal women (12.0%–28.3% vs. 1.0%–9.9%) and nearly double among postmenopausal Black women (28.3%) than other races/ethnicities (12.0%–15.4%). Breast density PARPs were larger for premenopausal versus postmenopausal women (23.9%–35.0% vs. 13.0%–16.7%) and lower among premenopausal Black women (23.9%) than other races/ethnicities (30.4%–35.0%). Postmenopausal density PARPs were similar across races/ethnicities (13.0%–16.7%). Conclusions: Overweight/obesity and dense breasts account for large proportions of breast cancers in White, Black, Hispanic, and Asian women despite large differences in risk-factor distributions. Impact: Risk prediction models should consider how race/ethnicity interacts with BMI and breast density. Efforts to reduce BMI could have a large impact on breast cancer risk reduction, particularly among postmenopausal Black women.
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U2 - 10.1158/1055-9965.EPI-20-0358
DO - 10.1158/1055-9965.EPI-20-0358
M3 - Article
C2 - 32727722
AN - SCOPUS:85098243943
VL - 29
SP - 2048
EP - 2056
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 10
ER -