Hems G
Br J Cancer. 1980 Mar;41(3):429-37. doi: 10.1038/bjc.1980.67.
Changes of breast-cancer (BC) mortality for all women in England and Wales between 1911 and 1975, and for the social-class gradient during the 1950s, were not related to changes in child-bearing. The changes in BC mortality for all women were associated with changes in consumption of fat, sugar and animal protein 1-2 decades earlier. A decline in mortality around 1935 was not obviously related to changes in fat or sugar, but dietary data were sparse. The social-class gradient of BC mortality almost disappeared during the 1950s; rates declined for the upper classes but increased for the lower. These opposite changes could have resulted from the opposite changes in diets of the upper and lower classes which occurred in the early 1940s. In contrast, the geographical variation of BC mortality within the United Kingdom, by region or by urban-rural aggregate area, was closely correlated with child-bearing but poorly correlated with diet. The poor correlation with diet might be a consequence of the small range of variation of diet between regions of the United Kingdom. The regional gradient of BC mortality was low in 1961, a decade after the period of food rationing when regional variation in diet would have been reduced. This suggested that diet did contribute to the regional variation of BC mortality within the United Kingdom, perhaps jointly with contributions from child-bearing.
1911年至1975年间，英格兰和威尔士所有女性的乳腺癌死亡率变化，以及20世纪50年代社会阶层梯度的变化，均与生育变化无关。所有女性乳腺癌死亡率的变化与10至20年前脂肪、糖和动物蛋白的摄入量变化有关。1935年左右死亡率的下降与脂肪或糖的变化没有明显关联，但饮食数据稀少。20世纪50年代，乳腺癌死亡率的社会阶层梯度几乎消失；上层阶级的死亡率下降，而下层阶级的死亡率上升。这些相反的变化可能是由于20世纪40年代初上层和下层阶级饮食的相反变化所致。相比之下，英国国内按地区或城乡总体区域划分的乳腺癌死亡率地理差异与生育密切相关，但与饮食的相关性较差。与饮食相关性较差可能是由于英国各地区饮食变化范围较小。1961年，即食物配给期结束十年后，乳腺癌死亡率的区域梯度较低，当时饮食的区域差异可能已经减小。这表明饮食确实对英国国内乳腺癌死亡率的区域差异有影响，可能与生育的影响共同作用。
