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Combined effect of childbearing, menstrual events, and body size on age-specific breast cancer risk.

Abstract

Pike et al. (Nature 1983;303:767-70) and Moolgavkar et al. (JNCI 1980;65:59-69) proposed quantitative theories for the effect on age-specific breast cancer risk of ages at menarche, first childbirth, and menopause. Here the incidence rate functions predicted by these theories are fit to data for 1,884 women of all ages with breast cancer and 3,432 matched controls admitted to San Francisco Bay area hospitals in 1970-1977. A third function describing age-specific breast cancer risk based on the timing of childbearing and menstrual events is presented, and its fit to the data is compared with that of the functions of Pike et al. and Moolgavkar et al. None of the three fully accounted for the protective effects of early age at first childbirth in premenopausal women or of early age at menopause in parous postmenopausal women. To account for the effects of total parity and body mass (Quetelet) index on risk of breast cancer occurrence, the authors developed a fourth incidence rate function by extending the third. Goodness of fit to the data of the fourth function is demonstrated. Age-specific relative risks of breast cancer according to childbearing, menstrual events, and body size are estimated from the fourth function. The main qualitative findings are that 1) the protective effects of late menarche and of early first full-term pregnancy are greater in premenopausal than in postmenopausal women; 2) first full-term pregnancy initially boosts the level of risk, but incidence rates increase with age more slowly thereafter; 3) among the parous, multiparity is protective both in premenopausal and postmenopausal women, regardless of age at first full-term pregnancy; 4) both nulliparous and lean women are more protected by early menopause than are parous and overweight women; 5) increased body mass index is protective before, but detrimental after, menopause; and 6) postmenopausal incidence rates increase with age more rapidly among overweight than among lean women.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Family, Community, and Preventive Medicine, Stanford University School of Medicine, CA 94305.

    ,

    Source

    American journal of epidemiology 128:5 1988 Nov pg 962-79

    MeSH

    Adolescent
    Adult
    Age Factors
    Aged
    Aged, 80 and over
    Body Constitution
    Breast Neoplasms
    Female
    Humans
    Maternal Age
    Menarche
    Menopause
    Middle Aged
    Parity
    Pregnancy
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    3189296

    Citation

    Kampert, J B., et al. "Combined Effect of Childbearing, Menstrual Events, and Body Size On Age-specific Breast Cancer Risk." American Journal of Epidemiology, vol. 128, no. 5, 1988, pp. 962-79.
    Kampert JB, Whittemore AS, Paffenbarger RS. Combined effect of childbearing, menstrual events, and body size on age-specific breast cancer risk. Am J Epidemiol. 1988;128(5):962-79.
    Kampert, J. B., Whittemore, A. S., & Paffenbarger, R. S. (1988). Combined effect of childbearing, menstrual events, and body size on age-specific breast cancer risk. American Journal of Epidemiology, 128(5), pp. 962-79.
    Kampert JB, Whittemore AS, Paffenbarger RS. Combined Effect of Childbearing, Menstrual Events, and Body Size On Age-specific Breast Cancer Risk. Am J Epidemiol. 1988;128(5):962-79. PubMed PMID: 3189296.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Combined effect of childbearing, menstrual events, and body size on age-specific breast cancer risk. AU - Kampert,J B, AU - Whittemore,A S, AU - Paffenbarger,R S,Jr PY - 1988/11/1/pubmed PY - 2001/3/28/medline PY - 1988/11/1/entrez KW - Age Factors KW - Americas KW - Biological Characteristics KW - Biology KW - Body Weight KW - Breast Cancer--determinants KW - California KW - Cancer KW - Demographic Factors KW - Developed Countries KW - Developing Countries KW - Diseases KW - Estimation Technics KW - Fertility KW - Fertility Measurements KW - Health KW - Health Status Indexes KW - Maternal Age KW - Menarche KW - Menopause KW - Menstruation KW - Neoplasms KW - North America KW - Northern America KW - Parental Age KW - Parity KW - Physiology KW - Population KW - Population At Risk--women KW - Population Characteristics KW - Population Dynamics KW - Reproduction KW - Research Methodology KW - United States SP - 962 EP - 79 JF - American journal of epidemiology JO - Am. J. Epidemiol. VL - 128 IS - 5 N2 - Pike et al. (Nature 1983;303:767-70) and Moolgavkar et al. (JNCI 1980;65:59-69) proposed quantitative theories for the effect on age-specific breast cancer risk of ages at menarche, first childbirth, and menopause. Here the incidence rate functions predicted by these theories are fit to data for 1,884 women of all ages with breast cancer and 3,432 matched controls admitted to San Francisco Bay area hospitals in 1970-1977. A third function describing age-specific breast cancer risk based on the timing of childbearing and menstrual events is presented, and its fit to the data is compared with that of the functions of Pike et al. and Moolgavkar et al. None of the three fully accounted for the protective effects of early age at first childbirth in premenopausal women or of early age at menopause in parous postmenopausal women. To account for the effects of total parity and body mass (Quetelet) index on risk of breast cancer occurrence, the authors developed a fourth incidence rate function by extending the third. Goodness of fit to the data of the fourth function is demonstrated. Age-specific relative risks of breast cancer according to childbearing, menstrual events, and body size are estimated from the fourth function. The main qualitative findings are that 1) the protective effects of late menarche and of early first full-term pregnancy are greater in premenopausal than in postmenopausal women; 2) first full-term pregnancy initially boosts the level of risk, but incidence rates increase with age more slowly thereafter; 3) among the parous, multiparity is protective both in premenopausal and postmenopausal women, regardless of age at first full-term pregnancy; 4) both nulliparous and lean women are more protected by early menopause than are parous and overweight women; 5) increased body mass index is protective before, but detrimental after, menopause; and 6) postmenopausal incidence rates increase with age more rapidly among overweight than among lean women. SN - 0002-9262 UR - https://www.unboundmedicine.com/medline/citation/3189296/Combined_effect_of_childbearing_menstrual_events_and_body_size_on_age_specific_breast_cancer_risk_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/oxfordjournals.aje.a115070 DB - PRIME DP - Unbound Medicine ER -