American Journal of Epidemiology Vol. 147, No. 4: 333-341
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Arterial Calcification Found on Breast Cancer Screening Mammograms and Cardiovascular Mortality in Women
The DOM Project
1 Julius Center for Patient Oriented Research, Utrecht University Utrecht, the Netherlands
2 Preventicon, Breast Cancer Screening Center Utrecht, Utrecht, the Netherlands.
3 Department of Internal Medicine, Academic Hospital Utrecht, Utrecht, the Netherlands.
Reprint requests to Dr. Paulus A.H. van Noord, Julius Center for Patient Oriented Research, Utrecht University, P.O. Box 80035, 3508 TA Utrecht, the Netherlands.
Breast arterial calcification (BAC) has been associated with diabetes and hypertension. This prompted the authors to study the relation between BAC and cardiovascular mortality in a cohort of 12,239 women aged 50–68 years who participated in a population-based breast cancer screening project (DOM Project) in Utrecht, the Netherlands, during the period 1975–1977. Mortality data from 16–19 years of follow-up were available. The occurrence of outcome events was compared in terms of hazard ratios. Cardiovascular risk factors, including age, diabetes mellitus, hypertension, parity, Quetelet index, and smoking, were studied to identify possible confounders. Arterial calcification was seen in 9% of the women. The hazard ratio for overall mortality was 1.29 (95% confidence interval 1.06–1.58) in women with BAC detected on screening mammograms in comparison with women without BAC after correction for the above-mentioned factors. An excess of all-cause mortality was found in diabetic women with BAC (hazard ratio = 1.74, 95% confidence interval 1.19–2.56), which was also present in subgroups of coronary mortality. These results indicate that BAC is associated with an increased risk of subsequent cardiovascular death in women over age 50 years and in diabetic women in particular. Am J Epidemiol 1998; 147: 333–41.
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