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Breast cancer risk factors in Italian women: a multicentric case-control study.

To evaluate the importance of several risk factors for breast cancer in the Italian female population, a large multicentric case-control study was conducted in 10 breast clinics in Italy. The study included 1,556 women affected by breast cancer, histologically and/or cytologically confirmed. Controls were 1,505 women admitted to a hospital in the same town, matched with cases for residence and with the same age distribution of the Italian female population. The risk factors considered in this study were family history of breast cancer, reproductive history, height and weight, use of oral contraceptives, other hormonal therapies and smoking history. The results of this study confirm the significant role of a positive family history of breast cancer (RR = 2.37); the relative risk was even higher when a first-degree relative was affected or the breast cancer was bilateral. The analysis of the reproductive history showed a significant trend of increasing risk with increasing age at first birth and, although less evident, with increasing number of children. Quetelet's index (kg/m-2) was positively correlated with breast cancer risk, mostly in postmenopausal women. Among other studied factors, only late age at menopause confirmed an increased risk for breast cancer, whereas age at menarche, use of oral contraceptives and smoking histories did not show any significant correlation with breast cancer risk. These results are in substantial agreement with other international studies, but represent an interesting contribution to studies about the Italian female population.

Abortion, Spontaneous↗

Determinants of breastfeeding duration in Peninsular Malaysia.

The health benefits of breastfeeding to infants and mothers have been well recognised. This study applies linear regression analysis to assess the determinants of breastfeeding duration of first born using data from the Second Malaysian Family Life Survey. The proportion of women who breastfed their first child is 82 percent, of which 97 percent reported their breastfeeding duration. The distribution of breastfeeding duration has a mean of 5.7 months and a median of two months. Important determinants of breastfeeding duration include maternal age, ethnicity, period of first birth, husband's occupation and work status of the woman.

Adolescent↗

The association between breast cancer and diet and other factors.

To explore the effects of diet and other factors on breast cancer development, a case-control study was conducted in Tianjin between 1986-87. After adjusting for confounding factors, it was found that factors associated with increased risk of breast cancer included --early age at menarche; late age at menopause; late age at first birth; high Qutelet's index; histories of breast wound, disease and benign tumor; and a family history of malignant tumor, high fat, high calorie, low vegetable intake; elevated serum cholesterol and LDL-cholesterol; and lower levels of serum HDL-cholesterol and whole blood selenium.

Breast Neoplasms↗

Pregnancy weight gain and breast cancer risk.

BACKGROUND: Elevated pregnancy estrogen levels are associated with increased risk of developing breast cancer in mothers. We studied whether pregnancy weight gain that has been linked to high circulating estrogen levels, affects a mother's breast cancer risk. METHODS: Our cohort consisted of women who were pregnant between 1954-1963 in Helsinki, Finland, 2,089 of which were eligible for the study. Pregnancy data were collected from patient records of maternity centers. 123 subsequent breast cancer cases were identified through a record linkage to the Finnish Cancer Registry, and the mean age at diagnosis was 56 years (range 35 - 74). A sample of 979 women (123 cases, 856 controls) from the cohort was linked to the Hospital Inpatient Registry to obtain information on the women's stay in hospitals. RESULTS: Mothers in the upper tertile of pregnancy weight gain (>15 kg) had a 1.62-fold (95% CI 1.03-2.53) higher breast cancer risk than mothers who gained the recommended amount (the middle tertile, mean: 12.9 kg, range 11-15 kg), after adjusting for mother's age at menarche, age at first birth, age at index pregnancy, parity at the index birth, and body mass index (BMI) before the index pregnancy. In a separate nested case-control study (n = 65 cases and 431 controls), adjustment for BMI at the time of breast cancer diagnosis did not modify the findings. CONCLUSIONS: Our study suggests that high pregnancy weight gain increases later breast cancer risk, independently from body weight at the time of diagnosis.

Journal Article↗

Plasma levels of leptin and mammographic density among postmenopausal women: a cross-sectional study.

INTRODUCTION: Obesity has been linked to increased risk of breast cancer in postmenopausal women. Increased peripheral production of estrogens has been regarded as the main cause for this association, but other features of increased body fat mass may also play a part. Leptin is a protein produced mainly by adipose tissue and may represent a growth factor in cancer. We examined the association between leptin plasma levels and mammographic density, a biomarker for breast cancer risk. METHODS: We included data from postmenopausal women aged 55 and older, who participated in a cross-sectional mammography study in Tromsø, Norway. Mammograms, plasma leptin measurements as well as information on anthropometric and hormonal/reproductive factors were available from 967 women. We assessed mammographic density using a previously validated computer-assisted method. Multiple linear regression analysis was applied to investigate the association between mammographic density and quartiles of plasma leptin concentration. Because we hypothesized that the effect of leptin on mammographic density could vary depending on the amount of nondense or fat tissue in the breast, we also performed analyses on plasma leptin levels and mammographic density within tertiles of mammographic nondense area. RESULTS: After adjusting for age, postmenopausal hormone use, number of full-term pregnancies and age of first birth, there was an inverse association between leptin and absolute mammographic density (P(trend) = 0.001). When we additionally adjusted for body mass index and mammographic nondense area, no statistically significant association between plasma leptin and mammographic density was found (P(trend) = 0.16). Stratified analyses suggested that the association between plasma leptin and mammographic density could differ with the amount of nondense area of the mammogram, with the strongest association between leptin and mammographic absolute density in the stratum with the medium breast fat content (P(trend) = 0.003, P for interaction = 0.05). CONCLUSION: We found no overall consistent association between the plasma concentration of leptin and absolute mammographic density. Although weak, there was some suggestion that the association between leptin and mammographic density could differ with the amount of fat tissue in the breast.

Adipose Tissue↗

BRCA2 mutation carriers, reproductive factors and breast cancer risk.

BACKGROUND: Germline mutations in the BRCA genes dramatically increase the risk of breast cancer. In the general population, breast cancer risk is affected by age at menarche, by age at first birth, by the number of births and by the duration of breast feeding. Whether this is true for mutation carriers is not clear. METHODS: In a case-control study, nested in a population-based cohort of the Icelandic Cancer Detection Clinic, two groups of cases were defined, matched on year of birth, on age at diagnosis and on age when giving information on reproductive factors: 100 carriers of the Icelandic founder BRCA2 mutation 999del5, and 361 BRCA2-negative cases. The mean age at diagnosis was 48 years. There were 1000 women in a matched group of unaffected controls. Conditional logistic regression was used for the analysis. RESULTS: An increased number of births was associated with a decreased risk of breast cancer in BRCA2-negative cases but not in BRCA2-positive cases. A negative association between risk and duration of breast feeding was observed only in the mutation carriers. These associations were not statistically significant, but the effects of the two variables differed significantly according to mutation status (P = 0.007 and P = 0.045 for interaction with number of births and with duration of breast feeding, respectively). This was maintained when limiting the analysis to women diagnosed older than the age of 40 years. CONCLUSION: The association between breast cancer and the number of pregnancies and between breast cancer and the duration of breast feeding was not the same for carriers and noncarriers of a detrimental BRCA2 mutation. In the context of other epidemiological and laboratory studies, this may indicate that the product of the BRCA2 gene has a function relating to the differentiation of epithelial tissue in the breast.

Adult↗

African-Caribbean men remanded to Brixton Prison. Psychiatric and forensic characteristics and outcome of final court appearance.

BACKGROUND: African-Caribbean men are over-represented in psychiatric and forensic services and in the prison population. A failure of community services to engage mentally ill African-Caribbean men and their presentation through the criminal justice system culminates in a repeated pattern of forensic service and criminal justice system contact. METHOD: We carried out a cross-sectional survey during a one-year period of a sample of potentially mentally ill men remanded to HMP Brixton in south London. Men were interviewed to establish their place of birth, first language, socio-demographic profile, ethnicity, psychiatric diagnosis, levels of alcohol and substance misuse, criminality, violence involved in their index offence, past psychiatric and forensic contacts and outcome of court appearance. RESULTS: Two hundred and seventy-seven men were interviewed. In comparison with White men, African-Caribbean men were more often diagnosed as having schizophrenia and were more often sent to hospital under a mental health act order. African-Caribbean men were remanded in custody despite more stable housing conditions and more favourable indices of lifetime criminality, substance misuse and violence. CONCLUSIONS: Community services, including diversion schemes, should be especially sensitive to African-Caribbean men with schizophrenia who 'fall out of care', who are not diverted back into care and are therefore unnecessarily remanded.

Adult↗

Identification of factors associated with high breast cancer risk in the mothers of children with soft tissue sarcoma.

Information on the past medical history of the mothers of a population-based series of 177 children with soft tissue sarcoma was obtained by interview and from medical records. Eight mothers developed breast cancer, six premenopausally, compared with 3.26 expected (P = .04), but no excess of other types of cancers was detected. High breast cancer risk was associated with the following factors in the index child: age at diagnosis less than 24 months (relative risk [RR], 7.84), embryonal rhabdomyosarcoma (RR, 3.74), and male sex (RR, 3.02). Characteristics in the mother associated with high breast cancer risk were the following: late age at first birth (RR, 5.13), late age at birth of index child (RR, 5.69), and high birth-rank order of index child (RR, 4.08). The results suggest there may be a subset of childhood soft tissue sarcoma with a predominantly genetic etiology. The association between premenopausal breast cancer in the mother, late age at birth of index child, and early onset of soft tissue sarcoma in the index child suggests that these three events are not independent and that interactions between genetic and other factors may be important. The identification of a group of women at high risk for breast cancer affords an opportunity for screening and early detection. The study of cancer family syndromes may provide insights into underlying mechanisms in cancer genetics.

Adult↗

Plasma adiponectin concentrations and risk of incident breast cancer.

INTRODUCTION: Previous retrospective case-control studies suggest that adiponectin, an obesity-related hormone, is inversely associated with breast cancer risk, particularly in postmenopausal women; however, no prospective studies exist. Therefore, we conducted a prospective case-control study nested within the Nurses' Health Study (NHS) and NHSII cohorts examining the association between plasma adiponectin concentrations and breast cancer risk. MATERIALS AND METHODS: Blood samples were collected from 1989 through 1990 (NHS) and 1996 through 1999 (NHSII); adiponectin was measured by RIA. The analysis included 1477 breast cancer cases diagnosed after blood collection and before June 2000 (NHS) or June 2003 (NHSII) who had one or two controls (n=2196) matched on age, menopausal status, postmenopausal hormone (PMH) use, fasting, and time of day and month of blood collection. We adjusted for body mass index at age 18, weight change from age 18 to blood draw, family history of breast cancer, history of benign breast disease, duration of PMH use, ages at menarche and first birth, and parity. RESULTS: Although we observed no association between adiponectin and breast cancer risk overall, there was a nearly significant interaction by menopausal status (P=0.08), with a relative risk, top vs. bottom quartile of 0.73 (95% confidence interval, 0.55-0.98; P trend=0.08) among postmenopausal women and 1.30 (95% confidence interval, 0.80-2.10; P trend=0.09) for premenopausal women. Among postmenopausal women, adiponectin appeared more strongly inversely associated in women who never used PMH (P heterogeneity=0.05) and women with low circulating estradiol levels (P heterogeneity=0.05). DISCUSSION: Our results suggest that adiponectin may be inversely associated with postmenopausal breast cancer risk, particularly in a low-estrogen environment.

Adiponectin↗

Oral contraceptives and the incidence of multiple sclerosis.

BACKGROUND: Experimental and clinical data suggest a protective effect of estrogens on the development and progression of MS. METHODS: We assessed whether MS incidence was associated with oral contraceptive use or parity in two cohort studies of U.S. women, the Nurses' Health Study (NHS; 121,700 women aged 30 to 55 years at baseline in 1976) and the Nurses' Health Study II (NHS II; 116,671 women aged 25 to 42 years at baseline in 1989). Participants with a diagnosis of MS before baseline were excluded. Oral contraceptive history and parity were assessed at baseline and updated biennially. During follow-ups of 18 years (NHS) and 8 years (NHS II) we documented a total of 315 definite or probable cases of MS. RESULTS: Neither use of oral contraceptives nor parity were significantly associated with the risk of MS. As compared with women who never used oral contraceptives, the age-adjusted relative risk (95% CI) was 1.2 (0.9, 1.5) for past users, and 1.0 (0.6, 1.7) for current users. Similar results were obtained after adjustment for latitude, ancestry, and other potential confounding factors. There was no clear trend of MS risk with either increasing duration of use or time elapsed since last use. Age at first birth was also not associated with the risk of MS. CONCLUSIONS: These prospective results do not support a lasting protective effect of oral contraceptive use or pregnancy on the risk of MS. The decision to use hormonal contraception should not be affected by its effects on the risk of MS.

Adult↗

A method of record linkage.

In cancer epidemiology, prospective approaches are very important both in testing etiological hypotheses and in evaluating preventive procedures. Prospective studies, however, are very difficult and expensive, because a large number of people and a long period of observation are necessary for a satisfactory study. As a data source for follow-up studies, population-based cancer registry is very useful. The Osaka Cancer Registry has been in operation since December, 1962. Since 1968 the data processing, including the work of collation, has been semicomputerized. In order to identify cancer patients, we use the following six indices: date of birth, first Chinese character of a person's family name, address a: city, ward, town or village, address b: further details. i.e., street, avenue, section, hamlet etc., site, and sex. When we have data on the collation indices for the subjects to be followed up, we can conduct follow-up studies easily and accurately, using a semicomputerized collation method similar to that in the cancer registration system. Because the master file of the Osaka Cancer Registry contains the data of cancer cases reported and all cancer deaths among the residents of Osaka Prefecture, we can follow up the subjects living in Osaka Prefecture and obtain data about vitually all cancer incidences and deaths among them. In this follow-up method by means of record linkage to the cancer registry, some considerations should be taken into account for the following factors; coverage of cancer data in the Osaka Cancer Registry, reliability of the collation method, and address of the subjects to be followed up. As an example of a study with this method, we present the follow-up study of the screenees of a mass screening program for stomach cancer.

Computers↗

Early childbearing patterns and women's labor force behavior in later life.

The purpose of this research is to evaluate the consequences of early childbearing decisions for women's labor force activity in later life. Within a life course framework, women's early childbearing activities may be linked to later life decisions. Women between ages 55 and 64 are evaluated from the 1984 Survey of Income and Program Participation. Two measures of early family roles are considered: total fertility (number of children ever born) and timing of first-birth (childless, prior to age 30, and 30+). Results provide some limited support that early childbearing roles do in fact have a long-term impact on the employment decisions of women. Women who delay childbearing are somewhat more likely to remain in the labor force during their later years whereas women who remain childless are more likely to have exited the labor force.

Adult↗

God, faith, and death: the impact of biological and religious correlates on mortality.

Marked denominational mortality differentials have been documented for various time periods and geographic locations. From a historical perspective, death rates among Catholics are often found to be higher than those among Protestants or Jews. Using a conceptual model based on the life history approach, biomedical and sociocultural factors of causation are extrapolated. In total, 5513 historical entries from family reconstitution were available. Selection of data was guided by the inclusion of information about religious affiliation. Only married couples with children as well as single mothers were considered. Of these, 1855 entries were of Roman Catholic (C), 1143 of Lutheran/Protestant (L/P), and 609 of Reformed Calvinist (R) denomination. With a focus on both adult and subadult mortality, this study attempted to document that the cultural patterns associated with religious behavior are merely proximate determinants, while the ultimate causes are biological in nature. Survival prospects depended on demographic and familial characteristics such as age-at-first-birth, spacing and stopping behavior, infant care, and targeted sibship size, rather than religiosity.

Adult↗

Variations in gestation length in a colony of pipistrelle bats (Pipistrellus pipistrellus) from year to year.

Gestation length in a colony of pipistrelle bats varied by 10 days in two consecutive years when the weather conditions during early gestation differed appreciably. Plasma progesterone concentrations and corpus luteum volume increased during pregnancy to reach a maximum about 6 days before the first births. Pipistrelles maintained high body temperatures during pregnancy if the food supply was adequate. The rate of fetal development therefore appears to be determined by maternal body temperature, which becomes reduced by shortage of food in cold weather.

Animals↗

[Breeding and rearing of the volcano rabbit (Romerolagus diazi) in captivity].

In August, 1979, one female and three male wild volcano rabbits (Romerolagus diazi) were obtained and attempts have been made to rear and breed them in the laboratory. Mating was attempted from the 3rd month after the volcano rabbits were obtained and the first birth (two offspring) occurred after about one year. Thereafter, the same female gave birth three times and a total of 10 offspring have been obtained. Four females and three males could be weaned. The period of gestation was estimated as 34-48 days. The body weights at birth were 25-27 g for females and 32 g for males, and after three weeks, the weights had increased to 80-130 g for females and 95-128 g for males. Weaning was possible at 3 weeks of age. Volcano rabbits are small with an adult body weight of 400-600 g and they are also gentle animals. They should prove valuable if they can be established as laboratory animals in the future.

Animal Husbandry↗

[Occurrence of white Japanese field vole (Microtus montebelli) in the laboratory].

Some field voles with a white coat color were found in the breeding process in the laboratory, originated from a wild population captured in the riverside of the Arakawa in Okegawa, Saitama prefecture in Japan. They had been raised in a room and fed with pelleted feed for herbivore. An attempt was made to analyze their breeding records and mode of inheritance for the white coat color. As a result, the average litter size was 3.80 +/- 1.52, and the age of the first birth was 121 +/- 46.8 in days. This shows that most of the characters of the white voles are not different from those of the agouti ones. From the results of the mating tests, it might be concluded that an autosomal recessive gene was responsible for the appearance of the white coat color.

Animals↗

[Biological and hematochemical characteristics of herbivorous common voles (Microtus arvalis Pallas)].

In 1979, some pairs of voles (Microtus arvalis Pallas) were introduced to our laboratory from Hungary. Thereafter, they were successfully bred and increased in number, as experimental small animals for herbivorous domestic animals. They have been raised in a room and fed with pelleted feed for herbivores and chopped hay-cubes. We can change the high-fiber-containing rations from the chopped hay-cube to the alfalfa pellet that is widely available in laboratories. Regarding the breeding characteristics of the voles, the average litter size was 5.44 +/- 1.64, and the age at the first birth was 55.4 +/- 10.7 days. Some voles with white coats were found during the breeding process in our laboratory. Hematochemical characteristics of the voles were determined and the following characteristics were noted. Red blood cell counts of the voles were higher than those of other experimental animals (rat, mouse). White blood cell counts of the voles were lower than those of the other animals. The electrophoretic patterns of serum protein differed markedly from those of other experimental animals. The gamma-globulin concentrations of the voles were very low, and A/G ratios were high. Blood glucose concentrations of the voles were lower than those of the other mono-gastric experimental animals. Activities of serum enzymes (GOT, GPT, ALP) were higher than those of other experimental animals (rat, mouse, cow).

Animal Feed↗

Vitamin-mineral supplement use among preschool children in the United States.

OBJECTIVE: To estimate the prevalence of recent supplement use in a national sample of preschool children and to examine the relationship of maternal and child characteristics, past maternal supplement use practices, familial, health services, and child health factors associated with supplement use. METHODS: We used data on 8285 preschool children whose mothers were interviewed for the 1991 Longitudinal Follow-up to the 1988 National Maternal and Infant Health Survey. Data collection was conducted either by telephone or personal interview. The sample is representative of the estimated 3. 8 million US born children in 1988 and alive in 1991. The outcome measures are whether the child was given any vitamin and mineral supplements at least 3 days a week in the 30 days before the interview and the type of supplement received. Statistical techniques included bivariate and weighted multiple logistic regression analysis. RESULTS: More than half of all US 3-year-olds (54.4%) were given some vitamin and mineral supplement. The most common supplements consumed were multivitamin-mineral with iron (59% of supplement users) and multivitamin-mineral without iron (26.4%). Children who received any supplements tended to have mothers who are non-Hispanic White, older, more educated, married, insured, receiving care from a private health care provider, have greater household income, and took supplements during pregnancy. Child health characteristics associated with supplement use included first birth order and having eating problems or poor appetites. CONCLUSIONS: More than half of US preschool children used vitamin and mineral supplements. The sociodemographic and health predictors identified for supplement use suggest that groups at risk for nonuse are likely the same groups whose circumstances may predispose a need for supplementation.

Aged↗