The Combined Association of Modifiable Risk Factors with Breast Cancer Risk in the Women's Health Initiative

Cancer Prevention Research
Rhonda ArthurThomas E Rohan

Abstract

Although several modifiable risk factors have been independently associated with risk of breast cancer, few studies have investigated their joint association with breast cancer risk. Using a healthy lifestyle index (HLI) score, we assessed the association of a combination of selected modifiable risk factors (diet, alcohol, physical activity, BMI, and smoking) with risk of invasive breast cancer in the Women's Health Initiative (WHI). This study comprised 131,833 postmenopausal women, of whom 8,168 had breast cancer, who were enrolled in the WHI Observational Study or the WHI clinical trials. Cox proportional hazards regression was used to estimate the HRs and 95% confidence intervals (CI) for the association of the score with the risk of developing breast cancer overall and according to specific breast cancer clinicopathologic characteristics. There was a 4% reduction in the risk of breast cancer per unit increase in the HLI score. Compared with those with an HLI score in the lowest quintile level, those in the highest quintile level had 30%, 37%, and 30% lower risk for overall, ER+/PR+, and HER2+ breast cancer, respectively (HR = 0.70; 95% CI, 0.64-0.76; 0.63, 0.57-0.69; and 0.70; 0.55-0.90, respectively). We also observed inv...Continue Reading

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Citations

Jan 4, 2020·Journal of the National Cancer Institute·Rhonda S ArthurThomas E Rohan
Aug 8, 2020·Frontiers in Nutrition·Raquel Santana da CruzSonia de Assis
Jan 16, 2020·Nutrition Journal·Batoul GhosnAhmad Esmaillzadeh
May 20, 2018·Cancer Prevention Research·Christine M Friedenreich, Anne McTiernan
Jan 19, 2021·Environmental Research·Mette SørensenOle Raaschou-Nielsen

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