Traditional breast cancer risk factors in Filipina Americans compared with Chinese and Japanese Americans in Los Angeles county

Background: Filipina Americans have one of the highest breast cancer incidence rates among Asian Americans for poorly understood reasons. Methods: Breast cancer risk factors were investigated in a population-based study of Filipina (790 cases, 587 controls), Japanese (543 cases, 510 controls), and Chinese (913 cases, 904 controls) Americans. Cases were identified by the Los Angeles County Cancer Surveillance Program, and controls were matched to cases on age, ethnicity, and neighborhood. Multivariable conditional logistic regression was performed by Asian ethnicity. Results: In Filipina, Chinese, and Japanese Americans, breast cancer risk decreased significantly with increasing parity (all P_trend < 0.0001). Breast cancer risk increased with increasing quartiles of cumulative menstrual months in premenopausal (P_trend=0.019) and postmenopausal Filipina (P_trend = 0.008), in premenopausal (P_trend = 0.0003) but not postmenopausal Chinese (P_trend = 0.79), and in neither premenopausal (P_trend = 0.092) nor postmenopausal (P_trend = 0.75) Japanese Americans. For postmenopausal Filipina and Japanese, greater weight gain since age 18 (P_trend = 0.019 and 0.053, respectively), high current body mass index (both P_trend < 0.01), and greater waist circumferences (both P_trend < 0.04) were statistically significant; these associations were weaker for postmenopausal Chinese women. Conclusions: Cumulative menstrual months and body size factors were statistically significant risk factors for Filipina. Total menstrual months were associated with breast cancer among Chinese but not for Japanese, while body size factors were significantly associated with risk among Japanese but not among Chinese. Impact: Characterization of breast cancer risk factors in Filipina will help to generate hypotheses for their high breast cancer incidence.