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, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
PLoS One. 2015 Jul 24;10(7):e0132684. doi: 10.1371/journal.pone.0132684. eCollection 2015.
Mammographic density (MD) is considered a strong predictor of Breast Cancer (BC). The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) recommendations for cancer prevention.
Data of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain) collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1)Maintain adequate body weight; R2)Be physically active; 3R)Limit the intake of high density foods; R4)Eat mostly plant foods; R5)Limit the intake of animal foods; R6)Limit alcohol intake; R7)Limit salt and salt preserved food intake; R8)Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale) was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out.
A higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99). The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99) and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042). Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01), practicing physical activity (OR = 0.68 95%CI:0.48;0.96) and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86) and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05) were the recommendations showing the strongest associations with MD.
postmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific recommendations for screening attendants with high MD and therefore at higher risk of developing BC.
乳腺密度（MD）被认为是乳腺癌（BC）的一个强有力的预测因子。本研究的目的是探讨 MD 与世界癌症研究基金会和美国癌症研究所（WCRF/AICR）癌症预防建议的依从性之间的关系。
使用 2007 年 10 月 7 日至 2008 年 7 月 14 日从一项基于人群的多中心横断面研究（DDM-西班牙）中收集的 3584 名参加筛查的女性的数据，计算出一个评分，该评分衡量了与 WCRF/AICR 建议的依从程度：R1）保持适当的体重；R2）积极锻炼身体；R3）限制高密食品的摄入；R4）多吃植物性食物；R5）限制动物性食物的摄入；R6）限制酒精摄入；R7）限制盐和盐腌制食品的摄入；R8）通过饮食满足营养需求。使用具有随机中心特定截距的有序逻辑模型评估评分与 MD（由一名放射科医生使用半定量量表评估）之间的关系，该模型调整了 MD 的主要决定因素。还按绝经状态和吸烟状态进行了分层分析。
更高程度的遵循 WCRF/AICR 建议与较低的 MD 相关（OR1 单位增加=0.93，95%CI：0.86；0.99）。在绝经后妇女（OR=0.91，95%CI：0.84；0.99）和非吸烟者（OR=0.87，95%CI：0.80；0.96 对于非吸烟者，OR=1.01，95%CI：0.91；1.12 对于吸烟者，P 交互=0.042）中，这种关联更强。在非吸烟者中，保持适当的体重（OR=0.81，95%CI：0.65；1.01）、进行身体活动（OR=0.68，95%CI：0.48；0.96）和适度摄入高密食品（OR=0.58，95%CI：0.40；0.86）和酒精饮料（OR=0.76，95%CI：0.55；1.05）与 MD 的关联最强。
绝经后妇女和非吸烟者对 WCRF/AICR 指南的依从性越高，MD 越低。这些结果可能为设计针对 MD 较高且因此患乳腺癌风险较高的筛查参与者的特定建议提供指导。
