© 1996 by Oxford University Press
Journal of the National Cancer Institute, Vol. 88, No. 10, 650-660,
May 15, 1996
© 1996 Oxford University Press
Relative Weight, Weight Change, Height, and Breast Cancer Risk in Asian-American Women
Division of Cancer Epidemiology and Genetics, National Cancer Institute Bethesda, MD
Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii Honolulu
Northern California Cancer Center Union City
Department of Preventive Medicine, University of Southern California School of Medicine Los Angeles
Information Management Services, Inc. Rockville, MD
Correspondence to: Regina G. Ziegler, Ph.D., M.P.H., National Institutes of Health, Executive Plaza North, Rm. 443. Bethesda, MD 20892-7374.
BACKGROUND:: Breast cancer incidence rates have historically been four to seven times higher in the United States than in China or Japan, although the reasons remain elusive. When Chinese, Japanese, or Filipino women migrate to the United States, their breast cancer risk rises over several generations and reaches that for white women in the United States, indicating that modifiable exposures are involved. In a previous report on this case-control study of breast cancer in Asian-American women, designed to take advantage of their diversity in risk and lifestyle, we demonstrated a sixfold gradient in risk by migration history, comparable to the international differences in breast cancer incidence rates.
PURPOSE:: In this analysis, we have examined the roles of adult height, adiposity, and weight change in breast cancer etiology.
METHODS:: A population-based, case-control study of breast cancer was conducted among women of Chinese, Japanese, and Filipino ethnicities, aged 20–55 years, living in San Francisco-Oakland (CA), Los Angeles (CA), and Oahu (HI) during the period from April 1, 1983, through June 30, 1987. We successfully interviewed 597 (70%) of 852 eligible case subjects and 966 (75%) of 1287 eligible control subjects from August 1985 through February 1989. Subjects were asked about current height, usual adult weight, and usual weight in each decade of life, excluding the most recent 3 years and any periods of pregnancy.
RESULTS:: Height, recent adiposity (weight in the current decade of life/height1.5), and recent weight change (between the current and preceding decades of life) were strong predictors of breast cancer risk after adjustment was made for accepted breast cancer risk factors. Risk doubled (relative risk [RR] = 2.01; 95% confidence interval [CI] = 1.16–3.49) over the 7-inch (17.8-cm) range in height (two-sided P for trend = .003), with comparable effects in both premenopausal and postmenopausal women. Except for reduced risk in the heavy, younger women (weight/height1.5>29 kg/m1.5 and <40 years old), risk was positively associated with usual adult adiposity. Trends in risk became more striking as adiposity in each succeeding decade of adult life was considered. Women in their 50s and in the top quintile of adiposity for their age group had twice the breast cancer risk (RR = 2.13; 95% CI = 1.17–3.87) of women in the bottom quintile (two-sided P for trend = .004). Women in their 50s, above the median adiposity for their age group, and with a recent gain of more than 10 pounds had three times the risk (RR = 3.01; 95% CI = 1.45–6.25) of women below the median adiposity and with no recent weight change. Recent weight loss was consistently associated with reduced risk (RRs of approximately 0.7) relative to no recent weight change.
CONCLUSIONS:: Adult adiposity, weight change, and height are critical determinants of breast cancer risk. Increased adiposity and weight gain in the decade preceding diagnosis are especially influential, suggesting that excess weight may function as a late stage promoter.
IMPLICATIONS:: Weight maintenance and/or reduction as an adult, possibly accompanied by specific changes in diet and physical activity, may have a significant and rapid impact on breast cancer risk. [J Natl Cancer Inst 1996;88:650–60]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K. E. Yun, H. S. Park, Y.-M. Song, and S.-I. Cho Increases in body mass index over a 7-year period and risk of cause-specific mortality in Korean men Int. J. Epidemiol., September 17, 2009; (2009) dyp282v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Sung, Y.-M. Song, D. A. Lawlor, G. D. Smith, and S. Ebrahim Height and Site-specific Cancer Risk: A Cohort Study of a Korean Adult Population Am. J. Epidemiol., July 1, 2009; 170(1): 53 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Korde, A. H. Wu, T. Fears, A. M.Y. Nomura, D. W. West, L. N. Kolonel, M. C. Pike, R. N. Hoover, and R. G. Ziegler Childhood Soy Intake and Breast Cancer Risk in Asian American Women Cancer Epidemiol. Biomarkers Prev., April 1, 2009; 18(4): 1050 - 1059. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kagawa-Singer, N. Pourat, N. Breen, S. Coughlin, T. Abend McLean, T. S. McNeel, and N. A. Ponce Breast and Cervical Cancer Screening Rates of Subgroups of Asian American Women in California Med Care Res Rev, December 1, 2007; 64(6): 706 - 730. [Abstract] [PDF]
|
|
|
|
|
|
C.-C. Hong, C. B. Ambrosone, J. Ahn, J.-Y. Choi, M. L. McCullough, V. L. Stevens, C. Rodriguez, M. J. Thun, and E. E. Calle Genetic Variability in Iron-Related Oxidative Stress Pathways (Nrf2, NQ01, NOS3, and HO-1), Iron Intake, and Risk of Postmenopausal Breast Cancer Cancer Epidemiol. Biomarkers Prev., September 1, 2007; 16(9): 1784 - 1794. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. L. Sullivan, F. H. Koegler, and J. L. Cameron Individual differences in physical activity are closely associated with changes in body weight in adult female rhesus monkeys (Macaca mulatta) Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2006; 291(3): R633 - R642. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Eliassen, G. A. Colditz, B. Rosner, W. C. Willett, and S. E. Hankinson Adult weight change and risk of postmenopausal breast cancer. JAMA, July 12, 2006; 296(2): 193 - 201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tseng, C. Byrne, K. A. Evers, W. T. London, and M. B. Daly Acculturation and breast density in foreign-born, u.s. Chinese women. Cancer Epidemiol. Biomarkers Prev., July 1, 2006; 15(7): 1301 - 1305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-C. Chang, R. G. Ziegler, B. Dunn, R. Stolzenberg-Solomon, J. V. Lacey Jr., W.-Y. Huang, A. Schatzkin, D. Reding, R. N. Hoover, P. Hartge, et al. Association of energy intake and energy balance with postmenopausal breast cancer in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol. Biomarkers Prev., February 1, 2006; 15(2): 334 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. T. Baltrus, J. W. Lynch, S. Everson-Rose, T. E. Raghunathan, and G. A. Kaplan Race/Ethnicity, Life-Course Socioeconomic Position, and Body Weight Trajectories Over 34 years: The Alameda County Study Am J Public Health, September 1, 2005; 95(9): 1595 - 1601. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Eng, M. D. Gammon, M. B. Terry, L. H. Kushi, S. L. Teitelbaum, J. A. Britton, and A. I. Neugut Body Size Changes in Relation to Postmenopausal Breast Cancer among Women on Long Island, New York Am. J. Epidemiol., August 1, 2005; 162(3): 229 - 237. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Harvie, A. Howell, R. A. Vierkant, N. Kumar, J. R. Cerhan, L. E. Kelemen, A. R. Folsom, and T. A. Sellers Association of Gain and Loss of Weight before and after Menopause with Risk of Postmenopausal Breast Cancer in the Iowa Women's Health Study Cancer Epidemiol. Biomarkers Prev., March 1, 2005; 14(3): 656 - 661. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Y. Au, R. D. Gascoyne, R. E. Gallagher, N. Le, R. D. Klasa, R. H. S. Liang, C. Choy, W. Foo, and J. M. Connors Hodgkin's lymphoma in Chinese migrants to British Columbia: a 25-year survey Ann. Onc., April 1, 2004; 15(4): 626 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. McTiernan Behavioral Risk Factors in Breast Cancer: Can Risk Be Modified? Oncologist, August 1, 2003; 8(4): 326 - 334. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Lagiou, C.-C. Hsieh, D. Trichopoulos, B. Xu, J. Wuu, L. Mucci, R. Tamimi, H.-O. Adami, and S. Cnattingius Birthweight differences between USA and China and their relevance to breast cancer aetiology Int. J. Epidemiol., April 1, 2003; 32(2): 193 - 198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Wu, F. Z. Stanczyk, A. Seow, H.-P. Lee, and M. C. Yu Soy Intake and Other Lifestyle Determinants of Serum Estrogen Levels among Postmenopausal Chinese Women in Singapore Cancer Epidemiol. Biomarkers Prev., September 1, 2002; 11(9): 844 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Chang, X. Wu, H. Yu, and M. R. Spitz Plasma Concentrations of Insulin-like Growth Factors among Healthy Adult Men and Postmenopausal Women: Associations with Body Composition, Lifestyle, and Reproductive Factors Cancer Epidemiol. Biomarkers Prev., August 1, 2002; 11(8): 758 - 766. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. J. Vitzthum, G. R. Bentley, H. Spielvogel, E. Caceres, J. Thornburg, L. Jones, S. Shore, K. R. Hodges, and R. T. Chatterton Salivary progesterone levels and rate of ovulation are significantly lower in poorer than in better-off urban-dwelling Bolivian women Hum. Reprod., July 1, 2002; 17(7): 1906 - 1913. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-W. Yu, Y.-C. Yang, S.-Y. Yang, S.-W. Cheng, Y.-F. Liaw, S.-M. Lin, and C.-J. Chen Hormonal Markers and Hepatitis B Virus-Related Hepatocellular Carcinoma Risk: a Nested Case-Control Study Among Men J Natl Cancer Inst, November 7, 2001; 93(21): 1644 - 1651. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. C. Willett Diet and Cancer: One View at the Start of the Millennium Cancer Epidemiol. Biomarkers Prev., January 1, 2001; 10(1): 3 - 8. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. A Wiseman Breast cancer hypothesis: a single cause for the majority of cases J Epidemiol Community Health, November 1, 2000; 54(11): 851 - 858. [Abstract] [Full Text]
|
|
|
|
|
|
P. A. van den Brandt, D. Spiegelman, S.-S. Yaun, H.-O. Adami, L. Beeson, A. R. Folsom, G. Fraser, R. A. Goldbohm, S. Graham, L. Kushi, et al. Pooled Analysis of Prospective Cohort Studies on Height, Weight, and Breast Cancer Risk Am. J. Epidemiol., September 15, 2000; 152(6): 514 - 527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Hunt and E. A. Sickles Effect of Obesity on Screening Mammography: Outcomes Analysis of 88,346 Consecutive Examinations Am. J. Roentgenol., May 1, 2000; 174(5): 1251 - 1255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. I Li, J. L Stanford, and J. R Daling Anthropometric variables in relation to risk of breast cancer in middle-aged women Int. J. Epidemiol., April 1, 2000; 29(2): 208 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Thune, I. Njolstad, M.-L. Lochen, and O. H. Forde Physical Activity Improves the Metabolic Risk Profiles in Men and Women: The Tromso Study Arch Intern Med, August 10, 1998; 158(15): 1633 - 1640. [Abstract] [Full Text]
|
|
|
|
|
|
Z. Huang, S. E. Hankinson, G. A. Colditz, M. J. Stampfer, D. J. Hunter, J. E. Manson, C. H. Hennekens, B. Rosner, F. E. Speizer, and W. C. Willett Dual Effects of Weight and Weight Gain on Breast Cancer Risk JAMA, November 5, 1997; 278(17): 1407 - 1411. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Berger, C. A. Bodian, J. A. Jackson, S. Woloshin, L. Schwartz, K. Goldenberg, I. Thune, and E. Lund Exercise and Breast Cancer N. Engl. J. Med., September 4, 1997; 337(10): 708 - 709. [Full Text]
|
|
|
|
|
|
I. Thune, T. Brenn, E. Lund, and M. Gaard Physical Activity and the Risk of Breast Cancer N. Engl. J. Med., May 1, 1997; 336(18): 1269 - 1275. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. G. Ziegler Anthropometry and Breast Cancer J. Nutr., May 1, 1997; 127 (5): 924S - 924S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Ballard-Barbash, D. F. Birt, M. Kestin, and I. B. King Perspectives on Integrating Experimental and Epidemiologic Research on Diet, Anthropometry and Breast Cancer J. Nutr., May 1, 1997; 127 (5): 936S - 936S. [Abstract] [Full Text] [PDF]
|
|