American Journal of Epidemiology Vol. 150, No. 12: 1316-1324
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Waist Circumference, Waist: Hip Ratio, and Risk of Breast Cancer in the Nurses' Health Study
1Department of Nutrition, Harvard School of Public Health Boston, MA
2Department of Community and Preventive Medicine, Mount Sinai School of Medicine New York, NY
3Channing Laboratory, Harvard Medical School and Brigham and Women's Hospital Boston, MA
4Department of Medicine, Harvard Medical School and Brigham and Women's Hospital Boston, MA
5Department of Epidemiology, Harvard School of Public Health Boston, MA
6Harvard Center for Cancer Prevention, Harvard School of Public Health Boston, MA
7Division of Preventive Medicine, Harvard Medical School and Brigham and Women's Hospital Boston, MA
8Department of Biostatistics, Harvard School of Public Health Boston, MA
9Department of Environmental Health, Harvard School of Public Health Boston, MA
Reprint requests to the Nurses' Health Study, Channing Laboratory, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115.
This study examined prospectively the associations of waist circumference and waist: hip circumference ratio with risk of breast cancer. A total of 47,382 US registered nurses who reported their waist and hip circumferences in 1986 were followed up through May 1994 for identification of incident cases of breast cancer. During 333,097 person-years of follow-up, 1, 037 invasive breast cancers were diagnosed. In proportional hazards analyses, waist circumference was nonsignificantly related to risk of premenopausal breast cancer but was significantly associated with postmenopausal breast cancer after adjustment for established breast cancer risk factors (for the highest quintile of wast circumference vs. the lowest, relative risk (RR) = 1.34; 95% confidence interval (CI): 1.05, 1.72). When the analysis was limited to postmenopausal women who had never received hormone replacement therapy, a stronger positive association was found (RR = 1.88; 95% CI: 1.25, 2.85). After the data were further controlled for body mass index, the positive association was only slightly atenuated (RR = 1.83; 95% CI: 1.12, 2.99). Among past and current postmenopausal hormone users, no significant associations were found. Similar but slightly weaker associations were observed between waist: hip ratio and breast cancer risk. These data suggest that greater waist circumference increases risk of breast cancer, especially among postmenopausal women who are otherwise at lower risk because of never having used estrogen replacement hormones. Am J Epidemiol 1999; 150: 1316-24.
abdomen; body constitution; breast neoplasms; obesity
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