Until recently women in Japan were at very low risk of breast cancer (Ursin et al, 1994), particularly in the post-menopausal period when age-specific breast cancer rates remained essentially constant in contrast to the rates in the USA which continue to steadily increase in the post-menopausal period . Studies of plasma oestrogen concentrations in 'traditional' Asians (living in Asia) compared with Whites have found lower concentrations in the Asians (Goldin et al, 1986;Key et al, 1990;Shimizu et al, 1990). In particular, a study of post-menopausal Japanese women in Miyagi and non-Latina White women in Southern California found a 32% lower level of plasma oestrone (E1) and a 27% lower level of plasma oestradiol (E2) in the Japanese women (Shimizu et al, 1990).Breast cancer incidence rates in Japanese-American women now approach those of non-Latina White women (Ziegler et al, 1993). We therefore investigated whether post-menopausal plasma oestrogen and androstenedione (A; precursor of E1) levels in Japanese-American women were accordingly similar to those in (non-Latina) White women. The main comparison group was White women, as this group had been used as the comparison group in previous studies. We also included African-American women and Latina women to further our understanding of possible ethnic differences in estrogen metabolism.
SUBJECTS AND METHODS
SubjectsSubjects are part of a multi-ethnic cohort with an emphasis on studying diet and lifestyle characteristics in the aetiology of cancer. Details of this study are described elsewhere . The cohort included 215 251 subjects aged 40-75 years from Hawaii and Los Angeles county. These subjects had responded to a questionnaire mailed between 1993 and 1996. The response rates to the questionnaire were 25.5% in AfricanAmericans, 51.3% in Japanese-Americans, 21.3% in Latinas and 47.0% in Whites. The distributions of educational level and marital status of the cohort broadly resemble those reported by the US Census.Blood was collected from a random sample of healthy cohort members after receipt of informed consent. Participation in the blood collection phase has been over 70% in all ethnic groups. Eligible controls for this analysis included women who selfreported no history of cancer and in addition must either have experienced a natural menopause, or had both ovaries removed, or had a simple hysterectomy and be at least 55 years of age. Women who reported any hormone use in the 2 weeks before the blood draw were excluded. Sixty-six African-Americans, 30 JapaneseAmericans, 58 Latinas and 39 Whites were included in the study. Characteristics of these subjects are described in Table 1.
Laboratory methodsPlasma aliquots from study subjects were stored in liquid nitrogen until analysis. Plasma levels of A, E1 and E2 were measured by radioimmunoassays previously validated in our laboratory Ethnic differences in post-menopausal plasma oestrogen levels: high oestrone levels in Japanese-American women despite low weight Summary Breast cancer incidence in Japanese-America...