The proportion of postmenopausal breast cancer cases in the Netherlands attributable to lifestyle-related risk factors

Abstract

We aimed to estimate the proportion of Dutch postmenopausal breast cancer cases in 2010 that is attributable to lifestyle-related risk factors. We calculated population attributable fractions (PAFs) of potentially modifiable risk factors for postmenopausal breast cancer in Dutch women aged >50 in 2010. First, age-specific PAFs were calculated for each risk factor, based on their relative risks for postmenopausal breast cancer (from meta-analyses) and age-specific prevalence in the population (from national surveys) around the year 2000, assuming a latency period of 10 years. To obtain the overall PAF, age-specific PAFs were summed in a weighted manner, using the age-specific breast cancer incidence rates (2010) as weights. 95 % confidence intervals for PAF estimates were derived by Monte Carlo simulations. Of Dutch women >40 years, in 2000, 51 % were overweight/obese, 55 % physically inactive (<5 days/week 30 min activity), 75 % regularly consumed alcohol, 42 % ever smoked cigarettes and 79 % had a low-fibre intake (<3.4 g/1000 kJ/day). These factors combined had a PAF of 25.7 % (95 % CI 24.2–27.2), corresponding to 2,665 Dutch postmenopausal breast cancer cases in 2010. PAFs were 8.8 % (95 % CI 6.3–11.3) for overweight/obesity, 6.6 % (95 % CI 5.2–8.0) for alcohol consumption, 5.5 % (95 % CI 4.0–7.0) for physical inactivity, 4.6 % (95 % CI 3.3–6.0) for smoking and 3.2 % (95 % CI 1.6–4.8) for low-fibre intake. Our findings imply that modifiable risk factors are jointly responsible for approximately one out of four Dutch postmenopausal breast cancer cases. This suggests that incidence rates can be lowered substantially by living a more healthy lifestyle.Electronic supplementary materialThe online version of this article (doi:10.1007/s10549-015-3447-7) contains supplementary material, which is available to authorized users.

Association between healthy lifestyle score and breast cancer

“…In addition, Gemert et al showed that modifiable risk factors were directly responsible for about one out of four postmenopausal BC cases. Modifiable risk factors composed of BMI, physical inactivity, alcohol consumption, smoking and low dietary fiber intake [23]. In the E3N cohort, adherence of postmenopausal women to a healthy lifestyle by following the recommendations for smoking, BMI, alcohol consumption, fruit and vegetable consumption, and PA, prevented BC by 6.3% [24].…”

DNA methylation differences at regulatory elements are associated with the cancer risk factor age in normal breast tissue

“…Established risk factors for breast cancer include age, reproductive and family history, as well as body mass index (BMI) [5,33]. Indeed, modeled breast cancer risk factors have been shown to account for approximately half of breast cancer cases [34,35]. However, the biological mechanisms by which specific risk factors impact disease risk are not well understood.…”

Atividade física e câncer: evidências epidemiológicas e perspectivas para prevenção do câncer no Brasil

“…Previous studies suggested that, on average, 12% of breast cancers and 18% of colon cancers are attributable to lack physical activity (Friedenreich et al, 2010;Parkin et al, 2011;Wang et al, 2012;Hayes et al, 2013;Brenner, 2014;Park et al, 2014;Olsen et al, 2015;Van Gemert et al, 2015; Azevedo e Wilson, 2016;Brenner et al, 2017;Charafeddine et al, 2017;Naing et al, 2017). These results are similar to our PAF estimates, although comparing results is challenging due to methodological heterogeneity between studies (Table S4).…”