Weiderpass Elisabete, Braaten Tonje, Magnusson Cecilia, Kumle Merethe, Vainio Harri, Lund Eiliv, Adami Hans-Olov
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Cancer Epidemiol Biomarkers Prev. 2004 Jul;13(7):1121-7.
The prevalence of obesity at all ages is increasing epidemically worldwide. Information on the association between premenopausal breast cancer and body size during childhood and teenage years is scarce. In 1991 to 1992, a prospective cohort study was assembled in Norway and Sweden. We included in the analysis presented here 99,717 premenopausal women. During the follow-up period, which ended in December 1999, 733 of these women developed a primary invasive breast cancer. Overweight and obesity [body mass index (BMI) > 25 kg/m(2)] at enrollment was associated with a decreased risk of premenopausal breast cancer (P for linear trend = 0.007). Apparent associations between perceived body shape at age 7 and BMI at age 18, with heavier builds at both ages seemingly being protective for premenopausal breast cancer risk, lost their statistical significance after adjustment for BMI at cohort enrollment. Body size at age 7 was correlated with BMI at age 18 (r = 0.43); BMI at age 18 was correlated with adult BMI (r = 0.48). Changes in body size from age 7 or 18 to adulthood did not affect per se risk of premenopausal breast cancer risk. Height was related to risk, with a statistically significantly 30% reduced risk only in women shorter than 160 cm as compared with taller ones. The decreased risk of premenopausal breast cancer was observed in overweight and obese women without, but not in those with, a family history of breast cancer.
全球范围内,各年龄段肥胖症的患病率都在呈流行趋势上升。关于绝经前乳腺癌与儿童期和青少年期体型之间关联的信息很少。1991年至1992年,在挪威和瑞典开展了一项前瞻性队列研究。我们将此处分析纳入了99717名绝经前女性。在截至1999年12月的随访期内,这些女性中有733人患了原发性浸润性乳腺癌。入组时超重和肥胖(体重指数[BMI]>25kg/m²)与绝经前乳腺癌风险降低相关(线性趋势P值=0.007)。7岁时感知到的体型与18岁时的BMI之间的明显关联,以及两个年龄段体型较重似乎对绝经前乳腺癌风险有保护作用,但在对队列入组时的BMI进行调整后,这些关联失去了统计学意义。7岁时的体型与18岁时的BMI相关(r=0.43);18岁时的BMI与成人BMI相关(r=0.48)。从7岁或18岁到成年期体型的变化本身并不影响绝经前乳腺癌风险。身高与风险有关,与较高的女性相比,仅身高低于160cm的女性风险在统计学上显著降低30%。在没有乳腺癌家族史的超重和肥胖女性中观察到绝经前乳腺癌风险降低,但有乳腺癌家族史的超重和肥胖女性中未观察到。