A prospective study of educational background and breast cancer among Japanese women

Fujino, Yoshihisa; Mori, Mitsuru; Tamakoshi, Akiko; Sakauchi, Fumio; Suzuki, Sadao; Wakai, Kenji; Tokudome, Shinkan; Yoshimura, Takesumi

doi:10.1007/s10552-008-9154-5

Cited by 17 publications

(14 citation statements)

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“…(Heck and Pamuk, 1997;Braaten et al, 2004;Fujino et al, 2008;Palmer et al, 2012). The present study found that reproductive factors were distributed differentially across different levels of education.…”

Section: Discussionsupporting

confidence: 47%

The relationship between education level and mammographic density

Sung

Song

2015

European Journal of Cancer Prevention

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To further understand the factors that contribute to interindividual variation in mammographic density, we evaluated the relationship between education level and each component of the mammographic density measures. Study participants included 535 women between 40 and 65 years of age who received a mammogram for a population-based twin and family study. Mammographic density was measured from digital mammograms using a computer-assisted thresholding method. To avoid negative confounding by obesity level, we calculated BMI-adjusted mammographic measures. Thereafter, each of the mammographic density measures was t-transformed using its mean value and SD for each age strata. The level of education was chosen as a marker representing socioeconomic status at the individual level. A linear mixed model considering familial correlations was used for analyses. In the unadjusted analysis for all women, the BMI-adjusted nondense area gradually decreased with an increase in education level (P for trend=0.017). This association persisted after adjusting for menstrual and reproductive factors. When we repeated the analysis according to menopausal status, an inverse association between education level and nondense area was evident in premenopausal women, whereas the inverse association attenuated to a statistically insignificant level after adjusting for menstrual and reproductive factors in postmenopausal women. Absolute dense area and percentage dense area were not associated with education level. The significant association between nondense area and education level after eliminating the effect of age and BMI suggests that socioeconomic factors may have an influential role in determining the amount of fat tissue in the breast.

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Section: Discussionsupporting

confidence: 47%

The relationship between education level and mammographic density

Sung

Song

2015

European Journal of Cancer Prevention

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“…After World War II, the number of women in the Japanese workforce has risen,45 which has produced a declining birthrate 46,47. This societal shift may have resulted in relevant changes in the population distribution of breast cancer risk factors, such as higher socioeconomic status,48 higher body mass index, fewer births, and later age at first birth 42,49. Consequently, breast cancer risk profiles may be more similar for foreign- and US-born Japanese women than for other Asian populations, causing a narrowing in the incidence rate gap between Japanese immigrants to the United States and those who are US-born.…”

Section: Discussionmentioning

confidence: 99%

Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Migrant Status

et al. 2010

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Objectives We estimated trends in breast cancer incidence rates for specific Asian populations in California to determine if disparities exist by immigrant status and age. Methods To calculate rates by ethnicity and immigrant status, we obtained data for 1998 through 2004 cancer diagnoses from the California Cancer Registry and imputed immigrant status from Social Security Numbers for the 26% of cases with missing birthplace information. Population estimates were obtained from the 1990 and 2000 US Censuses. Results Breast cancer rates were higher among US- than among foreign-born Chinese (incidence rate ratio [IRR] = 1.84; 95% confidence interval [CI] = 1.72, 1.96) and Filipina women (IRR = 1.32; 95% CI=1.20, 1.44), but similar between US- and foreign-born Japanese women. US-born Chinese and Filipina women who were younger than 55 years had higher rates than did White women of the same age. Rates increased over time in most groups, as high as 4% per year among foreign-born Korean and US-born Filipina women. From 2000–2004, the rate among US-born Filipina women exceeded that of White women. Conclusions These findings challenge the notion that breast cancer rates are uniformly low across Asians and therefore suggest a need for increased awareness, targeted cancer control, and research to better understand underlying factors.

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“…Since World War II, the number of women in the Japanese workforce has risen,66 leading to a declining birth rate 67,68. This societal shift may have resulted in changes in the population distribution of breast cancer risk factors such as higher SES,69 higher body mass index, lower parity, and later age at first birth,68,70 as well as in factors that may affect survival. This may explain why foreign- and US-born Japanese women were more similar than were immigrant and nonimmigrant members of the other Asian populations we studied.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Breast Cancer Survival Among Asian Women by Ethnicity and Immigrant Status: A Population-Based Study

et al. 2010

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Objectives-We investigated heterogeneity in ethnic composition and immigrant status among US Asians as an explanation for disparities in breast cancer survival.Methods-We enhanced data from the California Cancer Registry and the Surveillance, Epidemiology, and End Results program through linkage and imputation to examine the effect of immigrant status, neighborhood socioeconomic status, and ethnic enclave on mortality among Chinese, Japanese, Filipino, Korean, South Asian, and Vietnamese women diagnosed with breast cancer from 1988 to 2005 and followed through 2007.Results-US-born women had similar mortality rates in all Asian ethnic groups except the Vietnamese, who had lower mortality risk (hazard ratio [HR]=0.3; 95% confidence interval [CI]=0.1, 0.9). Except for Japanese women, all foreign-born women had higher mortality than did US-born Japanese, the reference group. HRs ranged from 1.4 (95% CI=1.2, 1.7) among Koreans to 1.8 (95% CI=1.5, 2.2) among South Asians and Vietnamese. Little of this variation was explained by differences in disease characteristics. Conclusions-Survival after breast cancer is poorer among foreign-than US-born Asians.Research on underlying factors is needed, along with increased awareness and targeted cancer control.Breast cancer incidence rates have been shown to differ markedly across distinct ethnic subpopulations of US Asian women, 1-3 and studies of outcomes after breast cancer similarly have detected wide variation in stage at diagnosis and survival patterns across groups. [4][5][6][7][8][9] For example, in a population-based study, we reported that 5-year survival probabilities and proportions of late-stage disease were as poor in Filipinas as in African American women and that Japanese women had more favorable stage and survival Correspondence should be sent to Scarlett Lin Gomez, PhD, Northern California Cancer Center, 2201 Walnut Ave, Suite 300, Fremont, CA 94538 (scarlett@nccc.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link. ContributorsS. L. Gomez supervised the collection of data, originated the study, and supervised all aspects of its implementation. S. J. Shema conducted the data analysis. All authors helped to conceptualize ideas, interpret findings, and review drafts of the article.Note. The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California's Department of Health Services, the National Cancer Institute, the Centers for Disease Control and Prevention, or their contractors and subcontractors is not intended and should not be inferred. Human Participant ProtectionThis study was approved by the Northern California Cancer Center institutional review board. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2011 May 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript distributions than did non-Hispanic White women. 7 Identifying and explaining such disparities are important for public health efforts to ...

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A prospective study of educational background and breast cancer among Japanese women

Abstract: The present results suggested that cancer prevention strategies should recognize women with a higher educational level as a high risk group for breast cancer.

Cited by 17 publications

References 28 publications

The relationship between education level and mammographic density

The relationship between education level and mammographic density

Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Migrant Status

Disparities in Breast Cancer Survival Among Asian Women by Ethnicity and Immigrant Status: A Population-Based Study

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