Population attributable risks for modifiable lifestyle factors and breast cancer in <scp>N</scp>ew <scp>Z</scp>ealand women

Hayes, James E.; Richardson, Ann; Frampton, Chris

doi:10.1111/imj.12256

Cited by 33 publications

(30 citation statements)

References 37 publications

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“…7 Regarding postmenopausal breast cancer, the individual PAF observed for MHT was within the range observed in the literature (2.4 to 19.4%). [6][7][8]11,39,40 The results suggested that a statistically significant number of postmenopausal breast cancer cases could be attributed to the recent use of MHT, restricted to a combination of systemic oestrogen with a progestagen. 17 The postmenopausal individual PAF observed for BMI was within the range noted in the literature (0.2 to 24.8%), 7-10,39-41 as were those for alcohol (27.6 to 9.1%), [6][7][8]10,40 age at menopause (5.9 to 14.5%) [6][7][8]11 and age at menarche (7.7 to 18.8%) [5][6][7][8] The postmenopausal PAF associated with family history of breast cancer was lower than previously published estimations (5.7 to 15.7%) [5][6][7][8][9]11 because of a lower prevalence of family history in our study population (up to 20.4% in the literature vs. 7.3% in our population) and lower relative risk estimates (1.49 to 6.29 in the literature vs. 1.37 and 1.50 among premenopausal and postmenopausal women in our analyses, see Tables 1 and 2).…”

Section: Literature Confrontationmentioning

confidence: 99%

Proportion of premenopausal and postmenopausal breast cancers attributable to known risk factors: Estimates from the E3N‐EPIC cohort

Dartois

Fagherazzi

Baglietto

et al. 2016

Intl Journal of Cancer

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Breast cancer is the most frequently diagnosed cancer among women worldwide. Breast cancer risk factors have been widely explored individually; however, little is known about their combined impact. We included 67,634 women from the French E3N prospective cohort, aged 42-72 at baseline. During a 15-year follow-up period, 497 premenopausal and 3,138 postmenopausal invasive breast cancer cases were diagnosed. Population-attributable fractions (PAFs) were used to estimate cases proportions attributable to risk factors under hypothetical scenarios of lowest exposure. We examined overall premenopausal and postmenopausal invasive breast cancers and tumour subtypes (ER status and HER2 expression). Premenopausal breast cancer was not significantly attributable to non-behavioral (61.2%, 215.5 to 91.88%) nor to behavioral (39.9%, 271.0 to 93.9%) factors, contrary to postmenopausal breast cancer (41.9%, 4.5 to 68.7% and 53.5%, 12.8 to 78.7%, respectively). Individually, the highest statistically significant PAFs were obtained in premenopause for birth weight (33.6%, 5.7 to 56.6%) and age at menarche (19.8%, 5.2 to 33.6%) for non-behavioral factors and in postmenopause for history of benign breast diseases (14.9%, 11.6 to 18.0%) and age at menarche (9.7%, 3.9 to 15.5%) for non-behavioral factors and for body shape at menarche (17.1%, 9.7 to 24.3%), use of hormone replacement therapy (14.5%, 9.2 to 19.6%), dietary pattern (10.1%, 2.6 to 17.4%) and alcohol consumption (5.6%, 1.9 to 9.3%) for behavioral factors. These proportions were higher for ER1, HER22 and ER1/HER22 postmenopausal breast cancers. Our data support the hypothesis that in postmenopause, never starting unhealthy behaviors can reduce the number of diagnosed breast cancers.

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Section: Literature Confrontationmentioning

confidence: 99%

Proportion of premenopausal and postmenopausal breast cancers attributable to known risk factors: Estimates from the E3N‐EPIC cohort

Dartois

Fagherazzi

Baglietto

et al. 2016

Intl Journal of Cancer

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“…12 We used prevalence data from 2001 and cancer incidence data from 2010 to give a nominal latent period of about 10 years. To account for population ageing with time since exposure and the latent period, we used prevalence data for the age category that was 10 years younger than the corresponding cancer incidence age category (for example, cancer incidence in the 25-34 years age group in 2010 was attributed to insufficient physical activity in the [15][16][17][18][19][20][21][22][23][24] To estimate the proportion of people exercising at different levels, we first estimated the average total minutes individuals reporting each activity combination spent exercising per week (online supplementary file: Table S2). To do this, we assumed that people who reported two types of activity performed each for half the average duration for each activity and that those who reported all three types of activity performed each for one-third of the average duration.…”

Section: Exposure Prevalence Estimatesmentioning

confidence: 99%

Cancers in Australia in 2010 attributable to insufficient physical activity

Olsen

Wilson

Nagle

et al. 2015

Australian and New Zealand Journal of Public Health

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ObjectivesTo estimate the proportion and numbers of cancers occurring in Australia in 2010 attributable to insufficient levels of physical activity.MethodsWe estimated the population attributable fraction (PAF) of cancers causally associated with insufficient physical activity (colon, post-menopausal breast and endometrium) using standard formulae incorporating prevalence of insufficient physical activity (<60 minutes at least 5 days/week), relative risks associated with physical activity and cancer incidence. We also estimated the proportion change in cancer incidence (potential impact fraction [PIF]) that may have occurred assuming that everyone with insufficient activity levels increased their exercise by 30 minutes/week.ResultsAn estimated 1,814 cases of colon, post-menopausal breast and endometrial cancer were attributable to insufficient levels of physical activity: 707 (6.5%) colon; 971 (7.8%) post-menopausal breast; and 136 (6.0%) endometrial cancers. If those exercising below the recommended level had increased their activity level by 30 minutes/week, we estimate 314 fewer cancers (17% of those attributable to insufficient physical activity) would have occurred in 2010.ConclusionsMore than 1,500 cancers were attributable to insufficient levels of physical activity in the Australian population.ImplicationsIncreasing the proportion of Australians who exercise could reduce the incidence of several common cancers.

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“…We attributed 6.9% of the future breast cancer burden for postmenopausal women to any current MHT use. Comparison with previous PAF estimates (3.2%–27%) from different eras and countries is not meaningful because of (i) variation in the prevalence estimates, due to decline in MHT use following the publication of the Women's Health Initiative trial and other results around 2002; and (ii) variation in the hazard ratios, due to differences in the distribution of MHT composition and duration, with oestrogen‐progestogen MHT increasing breast cancer risk to a greater extent than oestrogen‐only MHT. We show for the first time that most of the MHT‐related future breast cancer burden is attributable to five or more years duration of use (6.4% out of 6.9%), with 4.0% of the burden avoidable by limiting use to less than 5 years; this is largely a consequence of a substantial proportion (79%) of MHT users being long term users.…”

Section: Discussionmentioning

confidence: 90%

“…42 We attributed 6.9% of the future breast cancer burden for postmenopausal women to any current MHT use. Comparison with previous PAF estimates (3.2%-27%) 6,9,13,14,19,23,24 from different eras and countries is not meaningful because of (i) variation in the prevalence estimates, due to decline in MHT use following the publication of the Women's Health BMI, body mass index; CI, confidence interval; HR, hazard ratio; MHT, menopausal hormone therapy; PAF, population attributable fraction; PR, prevalence. Note: some percentages do not add up to 100 because of rounding.…”

Section: Discussionmentioning

confidence: 99%

“…The burden of breast cancer preventable by modifications to certain causally related risk factors can be quantified by calculating population attributable fractions (PAFs). Only one cohort study has evaluated the individual and joint contributions of modifiable risk factors on the breast cancer burden for premenopausal women, and several have examined the breast cancer burden for postmenopausal women. All previous studies evaluated the complete removal of the exposure, even though a gradual reduction in exposure might be more realistic.…”

Section: Introductionmentioning

confidence: 99%

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The preventable burden of breast cancers for premenopausal and postmenopausal women in Australia: A pooled cohort study

Arriaga

Vajdic

Canfell

et al. 2019

Intl Journal of Cancer

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Estimates of the future breast cancer burden preventable through modifications to current behaviours are lacking. We assessed the effect of individual and joint behaviour modifications on breast cancer burden for premenopausal and postmenopausal Australian women, and whether effects differed between population subgroups. We linked pooled data from six Australian cohort studies (n = 214,536) to national cancer and death registries, and estimated the strength of the associations between behaviours causally related to cancer incidence and death using adjusted proportional hazards models. We estimated exposure prevalence from representative health surveys. We combined these estimates to calculate Population Attributable Fractions (PAFs) with 95% confidence intervals (CIs), and compared PAFs for population subgroups. During the first 10 years follow‐up, there were 640 incident breast cancers for premenopausal women, 2,632 for postmenopausal women, and 8,761 deaths from any cause. Of future breast cancers for premenopausal women, any regular alcohol consumption explains 12.6% (CI = 4.3–20.2%), current use of oral contraceptives for ≥5 years 7.1% (CI = 0.3–13.5%), and these factors combined 18.8% (CI = 9.1–27.4%). Of future breast cancers for postmenopausal women, overweight or obesity (BMI ≥25 kg/m2) explains 12.8% (CI = 7.8–17.5%), current use of menopausal hormone therapy (MHT) 6.9% (CI = 4.8–8.9%), any regular alcohol consumption 6.6% (CI = 1.5–11.4%), and these factors combined 24.2% (CI = 17.6–30.3%). The MHT‐related postmenopausal breast cancer burden varied by body fatness, alcohol consumption and socio‐economic status, the body fatness‐related postmenopausal breast cancer burden by alcohol consumption and educational attainment, and the alcohol‐related postmenopausal breast cancer burden by breast feeding history. Our results provide evidence to support targeted and population‐level cancer control activities.

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Population attributable risks for modifiable lifestyle factors and breast cancer in New Zealand women

Cited by 33 publications

References 37 publications

Proportion of premenopausal and postmenopausal breast cancers attributable to known risk factors: Estimates from the E3N‐EPIC cohort

Proportion of premenopausal and postmenopausal breast cancers attributable to known risk factors: Estimates from the E3N‐EPIC cohort

Cancers in Australia in 2010 attributable to insufficient physical activity

The preventable burden of breast cancers for premenopausal and postmenopausal women in Australia: A pooled cohort study

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