Cotterchio Michelle, Boucher Beatrice A, Kreiger Nancy, Mills Catherine A, Thompson Lilian U
Division of Preventive Oncology, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, Canada.
Cancer Causes Control. 2008 Apr;19(3):259-72. doi: 10.1007/s10552-007-9089-2. Epub 2007 Nov 9.
To evaluate whether phytoestrogen intake is associated with reduced breast cancer risk, using a novel phytoestrogen database.
Population-based breast cancer cases aged 25-74 years (diagnosed 2002-2003) were identified using Ontario Cancer Registry (n = 3,063) and controls (n = 3,430) were an age-stratified random sample of women identified through random digit dialing. An epidemiologic and Block food frequency questionnaire--expanded to include phytoestrogen-containing foods--was mailed to all subjects. The recently published Ontario phytoestrogen database was applied to FFQ responses to estimate intake. Multivariate logistic regression provided odds ratio (OR) estimates, while controlling for confounders.
Among all women, lignan intake was associated with a reduced breast cancer risk (Q5 vs. Q1 MVOR: 0.81, 95% CI: 0.65, 0.99); however, following stratification by BMI, this reduction in risk was statistically significant only among overweight (BMI > 25) women. Total phytoestrogen intake was also associated with a risk reduction among overweight women only. Among pre-menopausal women, total phytoestrogen intake was associated with a significant reduction in breast cancer risk among overweight women only (Q5 vs. Q1 MVOR: 0.51, 95% CI: 0.30, 0.87). Among post-menopausal women, no statistically significant association was observed between breast cancer risk and isoflavones or lignans.
Lignan intake may be associated with reduced breast cancer risk among pre-menopausal women, and our data suggest BMI modifies this association.
使用一个新的植物雌激素数据库评估植物雌激素摄入量是否与降低乳腺癌风险相关。
利用安大略癌症登记处确定年龄在25 - 74岁之间(2002 - 2003年确诊)的基于人群的乳腺癌病例(n = 3,063),并通过随机数字拨号识别年龄分层的女性随机样本作为对照(n = 3,430)。向所有受试者邮寄一份流行病学和布洛克食物频率问卷(已扩展以纳入含植物雌激素的食物)。将最近公布的安大略植物雌激素数据库应用于食物频率问卷的回答以估计摄入量。多因素逻辑回归在控制混杂因素的同时提供比值比(OR)估计值。
在所有女性中,木脂素摄入量与降低乳腺癌风险相关(第5分位数与第1分位数的多变量OR:0.81,95%置信区间:0.65,0.99);然而,按体重指数分层后,这种风险降低仅在超重(体重指数>25)女性中具有统计学意义。总植物雌激素摄入量也仅与超重女性的风险降低相关。在绝经前女性中,总植物雌激素摄入量仅与超重女性的乳腺癌风险显著降低相关(第5分位数与第1分位数的多变量OR:0.51,95%置信区间:0.30,0.87)。在绝经后女性中,未观察到乳腺癌风险与异黄酮或木脂素之间存在统计学显著关联。
木脂素摄入量可能与绝经前女性乳腺癌风险降低相关,且我们的数据表明体重指数会改变这种关联。