Mammographic density and markers of socioeconomic status: a cross-sectional study
Mammographic density and markers of socioeconomic status: a cross-sectional study
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DOI：
10.1186/1471-2407-10-35
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发表时间：
2010-02-09
期刊：
影响因子：
3.8
通讯作者：
Silva, Isabel dos Santos
中科院分区：
文献类型：
--
作者：
Aitken, Zoe;Walker, Kate;Silva, Isabel dos Santos
背景资料：社会经济地位（SES）已知与乳腺癌风险呈正相关，但其与乳腺摄影密度（乳腺癌易感性的标志物）的关系尚不清楚。本研究的目的是探讨是否乳房X线摄影密度不同的SES，并确定潜在的人体测量，生活方式和生殖因素导致这种variation.Methods：在一个横断面研究的乳房X线摄影密度在487绝经前women，SES进行了评估，从问卷调查数据使用最高达到的正规教育水平，五分之一的人口普查派生的汤森分数和城市/农村分类的居住地。使用计算机辅助方法在数字化胶片上测量乳腺摄影密度。通过拟合线性回归模型来评估SES变量与乳腺摄影密度之间的关联，并对相关变量进行调整。在未调整的模型中，百分比密度与SES呈正相关，百分比密度的绝对差异为6.3%。（95%CI 1.6%，10.5%），最高和最低汤森五分位数之间的差异为6.6%（95%CI-0.7%，12.9%）。这些关联主要是由这些SES变量和透亮区之间的强负相关驱动的，并在调整体重指数（BMI）后减弱。几乎没有证据表明生殖因素可以解释这种关联。SES与BMI调整前后乳腺致密组织的数量无关。经汤森评分校正后，教育对密度百分比的影响仍然存在。乳腺X线检查的措施并没有根据城市/农村placesofresidence.Conclusions不同：观察到的百分密度SES梯度在乳腺癌的风险已知SES梯度。尽管与密度百分比可能是SES差异在乳腺癌风险中的中介的假设一致，但密度百分比中的SES梯度主要由SES和BMI之间的负相关性驱动。尽管如此，由于密度会影响屏幕胶片乳腺X射线摄影的灵敏度，在高SES女性中发现的较高百分比密度意味着这些女性患癌症的风险较高，但早期发现癌症的可能性较低。
Background: Socioeconomic status (SES) is known to be positively associated with breast cancer risk but its relationship with mammographic density, a marker of susceptibility to breast cancer, is unclear. This study aims to investigate whether mammographic density varies by SES and to identify the underlying anthropometric, lifestyle and reproductive factors leading to such variation.Methods: In a cross-sectional study of mammographic density in 487 pre-menopausal women, SES was assessed from questionnaire data using highest achieved level of formal education, quintiles of Census-derived Townsend scores and urban/rural classification of place of residence. Mammographic density was measured on digitised films using a computer-assisted method. Linear regression models were fitted to assess the association between SES variables and mammographic density, adjusting for correlated variables.Results: In unadjusted models, percent density was positively associated with SES, with an absolute difference in percent density of 6.3% (95% CI 1.6%, 10.5%) between highest and lowest educational categories, and of 6.6% (95% CI -0.7%, 12.9%) between highest and lowest Townsend quintiles. These associations were mainly driven by strong negative associations between these SES variables and lucent area and were attenuated upon adjustment for body mass index (BMI). There was little evidence that reproductive factors explained this association. SES was not associated with the amount of dense tissue in the breast before or after BMI adjustment. The effect of education on percent density persisted after adjustment for Townsend score. Mammographic measures did not vary according to urban/rural place of residence.Conclusions: The observed SES gradients in percent density paralleled known SES gradients in breast cancer risk. Although consistent with the hypothesis that percent density may be a mediator of the SES differentials in breast cancer risk, the SES gradients in percent density were mainly driven by the negative association between SES and BMI. Nevertheless, as density affects the sensitivity of screen-film mammography, the higher percent density found among high SES women would imply that these women have a higher risk of developing cancer but a lower likelihood of having it detected earlier.