Castelló Adela, Martín Miguel, Ruiz Amparo, Casas Ana M, Baena-Cañada Jose M, Lope Virginia, Antolín Silvia, Sánchez Pedro, Ramos Manuel, Antón Antonio, Muñoz Montserrat, Bermejo Begoña, De Juan-Ferré Ana, Jara Carlos, Chacón José I, Jimeno María A, Rosado Petra, Díaz Elena, Guillem Vicente, Lluch Ana, Carrasco Eva, Pérez-Gómez Beatriz, Vioque Jesús, Pollán Marina
Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Group, IIS Puerta de Hierro (IDIPHIM), Majadahonda, Madrid, Spain.
Medical Oncology Unit, Hospital Clínico Universitario San Carlos, Madrid, Spain; Medical Oncology Unit, Instituto De Investigación Sanitaria Gregorio Marañón/ Universidad Complutense, Madrid, Spain.
PLoS One. 2015 May 15;10(5):e0126096. doi: 10.1371/journal.pone.0126096. eCollection 2015.
According to the "World Cancer Research Fund" and the "American Institute of Cancer Research" (WCRF/AICR) one in four cancer cases could be prevented through a healthy diet, weight control and physical activity.
To explore the association between the WCRF/AICR recommendations and risk of breast cancer.
During the period 2006 to 2011 we recruited 973 incident cases of breast cancer and 973 controls from 17 Spanish Regions. We constructed a score based on 9 of the WCRF/AICR recommendations for cancer prevention:: 1)Maintain adequate body weight; 2)Be physically active; 3)Limit the intake of high density foods; 4)Eat mostly plant foods; 5)Limit the intake of animal foods; 6)Limit alcohol intake; 7)Limit salt and salt preserved food intake; 8)Meet nutritional needs through diet; S1)Breastfeed infants exclusively up to 6 months. We explored its association with BC by menopausal status and by intrinsic tumor subtypes (ER+/PR+ & HER2-; HER2+; ER&PR-&HER2-) using conditional and multinomial logistic models respectively.
Our results point to a linear association between the degree of noncompliance and breast cancer risk. Taking women who met 6 or more recommendations as reference, those meeting less than 3 showed a three-fold excess risk (OR=2.98(CI95%:1.59-5.59)), especially for postmenopausal women (OR=3.60(CI95%:1.24;10.47)) and ER+/PR+&HER2- (OR=3.60(CI95%:1.84;7.05)) and HER2+ (OR=4.23(CI95%:1.66;10.78)) tumors. Noncompliance of recommendations regarding the consumption of foods and drinks that promote weight gain in premenopausal women (OR=2.24(CI95%:1.18;4.28); p for interaction=0.014) and triple negative tumors (OR=2.93(CI95%:1.12-7.63)); the intake of plant foods in postmenopausal women (OR=2.35(CI95%:1.24;4.44)) and triple negative tumors (OR=3.48(CI95%:1.46-8.31)); and the alcohol consumption in ER+/PR+&HER2- tumors (OR=1.52 (CI95%:1.06-2.19)) showed the strongest associations.
Breast cancer prevention might be possible by following the "World Cancer Research Fund" and the "American Institute of Cancer Research" recommendations, even in settings like Spain, where a high percentage of women already comply with many of them.
根据“世界癌症研究基金会”和“美国癌症研究学会”（WCRF/AICR）的研究，四分之一的癌症病例可通过健康饮食、体重控制和体育活动来预防。
探讨WCRF/AICR建议与乳腺癌风险之间的关联。
在2006年至2011年期间，我们从西班牙17个地区招募了973例乳腺癌新发病例和973名对照。我们根据WCRF/AICR的9项癌症预防建议构建了一个评分：1）保持适当体重；2）积极进行体育活动；3）限制高密度食物的摄入；4）多吃植物性食物；5）限制动物性食物的摄入；6）限制酒精摄入；7）限制盐和腌制食品的摄入；8）通过饮食满足营养需求；S1）纯母乳喂养婴儿至6个月。我们分别使用条件逻辑模型和多项逻辑模型，按绝经状态和内在肿瘤亚型（ER+/PR+&HER2-；HER2+；ER&PR-&HER2-）探讨其与乳腺癌的关联。
我们的结果表明不遵守建议的程度与乳腺癌风险之间存在线性关联。以符合6项或更多建议的女性为参照，符合少于3项建议的女性患癌风险高出三倍（OR=2.98（95%CI：1.59-5.59）），尤其是绝经后女性（OR=3.60（95%CI：1.24；10.47））以及ER+/PR+&HER2-（OR=3.60（95%CI：1.84；7.05））和HER2+（OR=4.23（95%CI：1.66；10.78））肿瘤患者。绝经前女性中不遵守关于食用会促进体重增加的食物和饮料的建议（OR=2.24（95%CI：1.18；4.28）；交互作用p=0.014）以及三阴性肿瘤患者（OR=2.93（95%CI：1.12-7.63））；绝经后女性中植物性食物的摄入（OR=2.35（95%CI：1.24；4.44））以及三阴性肿瘤患者（OR=3.48（95%CI：1.46-8.31））；ER+/PR+&HER2-肿瘤患者中的酒精消费（OR=1.52（95%CI：1.06-2.19））显示出最强的关联。
遵循“世界癌症研究基金会”和“美国癌症研究学会”的建议可能有助于预防乳腺癌，即使在像西班牙这样已有很高比例女性已遵守其中许多建议的地区也是如此。
