© 1998 by Oxford University Press
Journal Of The National Cancer Institute, Vol 90, 389-394, Copyright © 1998 by Oxford University Press
M Mezzetti, C La Vecchia, A Decarli, P Boyle, R Talamini and S Franceschi
BACKGROUND: The percentages of breast cancer cases in a given population
attributable to specific risk factors (i.e., the population- attributable
risks) can be calculated; determination of such risks associated with
potentially modifiable risks factors, such as diet (e.g., levels of
consumption of fruits, vegetables, vitamins, etc.), alcohol consumption,
exercise, and body weight, are necessary to focus prevention strategies.
METHODS: With the use of data from a case- control study conducted in Italy
from June 1991 through April 1994 on 2569 breast cancer case subjects and
2588 control subjects, we calculated multivariate odds ratios and
population-attributable risks for breast cancer in relation to dietary
beta-carotene and vitamin E intake, alcohol consumption, physical activity,
and, for postmenopausal women, body mass index. RESULTS: Among all
subjects, the following attributable risks for the indicated risk factors
were observed: 10.7% (95% confidence interval [CI] = 4.4%-17.0%) for high
alcohol intake (i.e., >20 g/day), 15.0% (95% CI = 7.4%-22.9%) for low
beta-carotene intake (i.e., <3366 microg/day), 8.6% (95% CI =
-0.4%-17.5%) for low vitamin E intake (i.e., <8.5 mg/day), and 11.6%
(95% CI = -0.1%-23.3%) for low levels of physical activity. The risks
associated with alcohol and beta-carotene intake were larger among
premenopausal women, and the risk associated with physical activity was
larger among postmenopausal women. Being overweight accounted for 10.2 %
(95% CI = 0.2%-20.2%) of breast cancer cases in postmenopausal women.
Beta-carotene plus alcohol accounted for 28.1% (95% CI = 16.8-39.4) of the
cases. Beta-carotene and physical activity accounted for 32% (95% CI =
14.3-49.8), and these three factors together accounted for 33% (95% CI =
19.9-46.1) of the breast cancer cases in the overall dataset. CONCLUSION:
Exposure to a few selected and potentially modifiable risk indicators
explained about one third of the cases of breast cancer in this Italian
population, indicating the theoretical scope for prevention of the disease.
ARTICLES
Population attributable risk for breast cancer: diet, nutrition, and physical exercise
Istituto Europeo di Oncologia, Milan, Italy.
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