American Journal of Epidemiology Vol. 153, No. 11 : 1071-1078
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Fracture History and Risk of Breast and Endometrial Cancer
1 University of Wisconsin Comprehensive Cancer Center, Madison, WI.
2 Fred Hutchinson Cancer Research Center, Seattle, WA.
3 Department of Epidemiology, Harvard School of Public Health, Boston, MA.
4 Department of Community Medicine, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
5 Department of Nutrition, Harvard School of Public Health, Boston, MA.
6 Channing Laboratory, Department of Medicine, Harvard Medical School, and Brigham and Women's Hospital, Boston, MA.
Fractures in postmenopausal women may serve as a surrogate measure of bone density, reflecting long-term lower estrogen levels, and lower estrogen levels appear to be inversely associated with breast and endometrial cancer. Breast cancer cases aged 50–79 years (n = 5,559) and endometrial cancer cases aged 40–79 years (n = 739) were enrolled in a US case-control study in 1992–1994 to evaluate the relation between fractures and risk of breast and endometrial cancer. Controls for the breast cancer analysis (n = 5,829) and the endometrial cancer analysis (n = 2,334) were randomly selected from population lists (driver's license and Medicare files). Information on fracture history and other risk factors was obtained by telephone interview. Compared with women without a fracture in the past 5 years, the odds ratios for women with a history of fracture were 0.80 (95% confidence interval (CI): 0.68, 0.94) for breast cancer and 0.59 (95% CI: 0.40, 0.89) for endometrial cancer. Height loss (
2.5 cm) and recent fracture history were associated with the lowest risk of breast cancer (odds ratio = 0.62, 95% CI: 0.46, 0.83) and endometrial cancer (odds ratio = 0.15, 95% CI: 0.05, 0.43). These data suggest that the endogenous hormonal factors associated with increased fracture risk are also related to decreased breast cancer risk and, more strongly, to endometrial cancer risk.
breast neoplasms; case-control studies; endometrial neoplasms; fractures; hormones; postmenopause
Abbreviations: BMI, body mass index; CI, confidence interval; LCL, lower confidence limit; OR, odds ratio
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