American Journal of Epidemiology Vol. 151, No. 7: 715-722
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Age at Any Full-term Pregnancy and Breast Cancer Risk
1School of Public Health and Graduate Institute of Epidemiology, College of Public Health, National Taiwan University Taipei, Taiwan
2Department of Epidemiology, Harvard School of Public Health Boston, MA
3UMass Memorial Cancer Center, UMass Memorial Health Care Worcester, MA
4Public Health Sciences, Fred Hutchinson Cancer Research Center Seattle, WA
5Comprehensive Cancer Center, University of Wisconsin Madison, WI
6Epidemilogy Branch, National Institute of Environmental Health Sciences Research Triangle Park, NC
7Department of Obstetrics and Gynecology, University of Chicago Chicago, IL
8Department of Community and Family Medicine and the Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center Lebanon, NH
9Department of Environmental Health, Boston University School of Public Health Boston, MA
10Department of Medicine, University of Vermont Medical Center Burlington, VT
11Division of Disease Control, Maine Bureau of Health Augusta, ME
Reprint requests to Dr. Chung-cheng Hsieh, UMass Memorial Cancer Center, 373 Plantation Street, Suite 211, Worcester, MA 01605
The authors analyzed data from two multistate, population-based case-control studies to investigate the association between age at any full-term pregnancy (FP) and breast cancer risk. Study subjects included breast cancer cases aged 20–79 years identified from four statewide cancer registries and randomly selected controls interviewed from 1988 to 1996. Complete information on a comprehensive set of risk factors for breast cancer was available for 9,891 cases and 12,271 controls. The large number of subjects enabled simultaneous adjustment of the covariates and efficient application of various modeling approaches. Overall, each 5-year increase in age at first FP was associated with an odds ratio of 1.07 (95% confidence interval (CI): 1.01, 1.13) for breast cancer. The corresponding estimates were odds ratio = 1.02 (95% CI: 1.00, 1.05) for age at second through ninth FPs. For age at last FP, the effect estimate (odds ratio = 1.01, 95% CI: 0.97, 1.06) was indistinguishable from that for other FPs after the first. In this analysis, a modest and transient increase in breast cancer risk after childbirth was also observed. The relatively greater effect of age at first FP is consistent with the existence of a long-term effect of early first FP on the differentiation of mammary cells, causing them to become less susceptible to carcinogenesis. Am J Epidemiol 2000;151:715–22.
breast neoplasms; reproductive history; risk factors
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