Body size and breast cancer risk in a multiethnic population

描述（由申请人提供）：肥胖和体重增加是美国和其他西方国家重要的公共卫生问题，也是少数终生可改变的乳腺癌危险因素之一。尽管许多流行病学研究报告了各种体型测量的相关性，但对非裔美国人和西班牙裔女性进行的少数研究得出了不一致和不确定的结果。我们建议利用1995年至2003年在旧金山湾区进行的一项大型基于人群的病例对照研究的数据，评估与广泛的终生体型测量的关联。年龄在35-79岁之间的乳腺癌病例通过大湾区癌症登记处确定，对照组通过随机数字拨号确定。通过对2258例（596例白人，543例非洲裔美国人和1119例西班牙裔）和2706例对照（646例白人，598例非洲裔美国人，1462例西班牙裔）的面对面访谈收集了自我报告和测量的体型信息。该项目的目的是评估绝经前和绝经后乳腺癌风险与成年期和青春期身体尺寸的静态和动态测量的关系。使用逻辑回归，我们将估计与以下因素相关的多变量调整比值比：1)身高、体重、体重指数（BMI）在生命的每十年和参考年份；2)成人期不同时期体重增加及成人期体重范围；3)青春期的体型和相对体重；腰围和臀围以及腰臀比是衡量身体脂肪分布的指标。最后，我们将进行分层分析，以评估其他因素的调节作用，包括激素替代疗法的使用、年龄、绝经时间、乳腺癌家族史、雌激素和孕激素受体状态。我们还将评估体育活动和热量摄入的潜在调节作用。值得注意的研究优势包括样本量大，研究人群多民族组成，基于人群的研究设计，通过面对面访谈和测量对终生体型测量进行综合评估，以及其他潜在混杂风险因素的广泛数据。这项研究将对更好地了解乳腺癌的病因，尤其是体型在未充分研究人群（如非洲裔美国人和西班牙裔美国人）中的作用做出重要贡献。

DESCRIPTION (provided by applicant): Obesity and weight gain are significant public health issues in the US and other Western countries, and are among the few breast cancer risk factors that are potentially modifiable throughout life. Although many epidemiologic studies have reported on associations with various body size measures, the few studies conducted in African-American and Hispanic women have produced inconsistent and inconclusive results. We propose to assess associations with a wide range of lifetime body size measures utilizing data from a large population-based case-control study conducted in the San Francisco Bay area from 1995-2003. Breast cancer cases aged 35-79 years were identified through the Greater Bay Area Cancer Registry, controls through random-digit dialing. Information on self-reported and measured body size was collected through in- person interviews for 2,258 cases (596 Whites, 543 African-Americans, and 1,119 Hispanics) and 2,706 controls (646 Whites, 598 African-Americans, 1,462 Hispanics). The aims of this project are to assess associations of premenopausal and postmenopausal breast cancer risk with both static and dynamic measures of body size during adulthood and adolescence. Using logistic regression, we will estimate multivariate adjusted odds ratios associated with 1) height, weight, body mass index (BMI) in each decade of life and during the reference year; 2) weight gain at different time periods in adulthood and adult weight range; 3) body shape and comparative weight in adolescence; and 4) waist and hip circumferences, and waist-to-hip ratio as measures of body fat distribution. Lastly, we will perform stratified analyses to assess the modifying effects of other factors, including use of hormone replacement therapy, age, time since menopause, family history of breast cancer, and estrogen and progesterone receptor status. We will also assess the potentially modifying effects of physical activity and caloric intake. Notable study strengths include the large sample size, multiethnic composition of study population, population-based study design, comprehensive assessment of lifetime body size measures through in-person interviews and measurements, and extensive data on other potentially confounding risk factors. This study will make an important contribution towards a better understanding of breast cancer etiology, and the role of body size in particular, in understudied populations such as African-Americans and Hispanics.