Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.
Cancer Epidemiol Biomarkers Prev. 2018 May;27(5):566-574. doi: 10.1158/1055-9965.EPI-17-0885. Epub 2018 Feb 23.
Breast cancer incidence is lower in many U.S. ethnic minority and foreign-born population groups. Investigating whether migration and acculturation patterns in risk are reflected in disease biomarkers may help to elucidate the underlying mechanisms. We compared the distribution of breast cancer risk factors across U.S.-born white, African American and Hispanic women, and foreign-born Hispanic women ( = 477, ages 40-64 years, 287 born in Caribbean countries). We used linear regression models to examine the associations of migration history and linguistic acculturation with mammographic breast density (MBD), measured using computer-assisted methods as percent and area of dense breast tissue. The distribution of most breast cancer risk factors varied by ethnicity, nativity, and age at migration. In age- and body mass index-adjusted models, U.S.-born women did not differ in average MBD according to ethnicity, but foreign-born Hispanic women had lower MBD [e.g., -4.50%; 95% confidence interval (CI), -7.12 to -1.89 lower percent density in foreign- vs. U.S.-born Hispanic women]. Lower linguistic acculturation and lower percent of life spent in the United States were also associated with lower MBD [e.g., monolingual Spanish and bilingual vs. monolingual English speakers, respectively, had 5.09% (95% CI, -8.33 to -1.85) and 3.34% (95% CI, -6.57 to -0.12) lower percent density]. Adjusting for risk factors (e.g., childhood body size, parity) attenuated some of these associations. Hispanic women predominantly born in Caribbean countries have lower MBD than U.S.-born women of diverse ethnic backgrounds, including U.S.-born Hispanic women of Caribbean heritage. MBD may provide insight into mechanisms driving geographic and migration variations in breast cancer risk. .
乳腺癌的发病率在美国许多少数民族和外国出生的人群中较低。研究移民和风险适应模式是否反映在疾病生物标志物中，可能有助于阐明潜在的机制。我们比较了美国出生的白人、非裔美国人和西班牙裔女性以及外国出生的西班牙裔女性（=477 名，年龄 40-64 岁，287 名出生于加勒比国家）的乳腺癌风险因素分布。我们使用线性回归模型来研究移民史和语言文化适应与乳腺计算机辅助检测密度（MBD）的关联，MBD 用计算机辅助方法测量，以致密乳腺组织的百分比和面积表示。大多数乳腺癌风险因素的分布因种族、出生地和移民年龄而异。在年龄和体重指数调整模型中，根据种族，美国出生的女性的平均 MBD 没有差异，但外国出生的西班牙裔女性的 MBD 较低[例如，外国出生的西班牙裔女性比美国出生的西班牙裔女性的 MBD 低 4.50%（95%置信区间，-7.12 至-1.89）]。较低的语言文化适应和在美国度过的生命百分比也与较低的 MBD 相关[例如，西班牙语单语和双语与英语单语使用者相比，分别有 5.09%（95%置信区间，-8.33 至-1.85）和 3.34%（95%置信区间，-6.57 至-0.12）的密度较低]。调整风险因素（例如，儿童时期的体型、生育次数）后，这些关联中的一些有所减弱。主要出生于加勒比国家的西班牙裔女性的 MBD 低于具有不同族裔背景的美国出生女性，包括具有加勒比裔美国出生背景的美国出生的西班牙裔女性。MBD 可能为理解驱动乳腺癌风险的地理和移民变化的机制提供了一些线索。
