Menopausal hormone therapy and breast cancer risk: effect modification by body mass through life

被引:5
作者
Sandvei, Marie Softeland [1 ,2 ,3 ]
Vatten, Lars J. [1 ]
Bjelland, Elisabeth Krefting [4 ,5 ]
Eskild, Anne [4 ,6 ]
Hofvind, Solveig [7 ]
Ursin, Giske [7 ,8 ,9 ]
Opdahl, Signe [1 ]
机构
[1] Norwegian Univ Sci & Technol, Fac Med & Hlth Sci, Dept Publ Hlth & Nursing, Postboks 8905, N-7491 Trondheim, Norway
[2] Nordland Hosp Bodo, Dept Canc & Palliat Care, Bodo, Norway
[3] Univ Tromso, Dept Clin Med, Tromso, Norway
[4] Akershus Univ Hosp, Dept Obstet & Gynecol, Lorenskog, Norway
[5] Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden
[6] Univ Oslo, Inst Clin Med, Campus Ahus, Oslo, Norway
[7] Canc Registry Norway, Inst Populat Based Res, Oslo, Norway
[8] Univ Oslo, Inst Basic Med Sci, Oslo, Norway
[9] Univ Southern Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA
关键词
Breast cancer; Menopausal hormone therapy; Body-mass index; Epidemiology; Cohort study; ESTROGEN-PLUS-PROGESTIN; HEALTHY POSTMENOPAUSAL WOMEN; REPLACEMENT THERAPY; MAMMOGRAPHIC DENSITY; SIZE; WEIGHT; CHILDHOOD; AGE; HYSTERECTOMY; ADOLESCENCE;
D O I
10.1007/s10654-018-0431-7
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
It is not known whether increased breast cancer risk caused by menopausal hormone therapy (HT) depends on body mass patterns through life. In a prospective study of 483,241 Norwegian women aged 50-69years at baseline, 7656 women developed breast cancer during follow-up (2006-2013). We combined baseline information on recalled body mass in childhood/adolescence and current (baseline) body mass index (BMI) to construct mutually exclusive life-course body mass patterns. We assessed associations of current HT use with breast cancer risk according to baseline BMI and life-course patterns of body mass, and estimated relative excess risk due to interaction (RERI). Within all levels of baseline BMI, HT use was associated with increased risk. Considering life-course body mass patterns as a single exposure, we used women who remained at normal weight through life as the reference, and found that being overweight as young was associated with lower risk (hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.76-0.94), whereas women who gained weight had higher risk (HR 1.20, 95% CI 1.12-1.28). Compared to never users of HT who were overweight as young, HT users who either remained at normal weight or gained weight in adulthood were at higher risk than expected when adding the separate risks (RERI 0.52, 95% CI 0.09-0.95, and RERI 0.37, 95% CI -0.07-0.80), suggesting effect modification. Thus, we found that women who remain at normal weight or gain weight in adulthood may be more susceptible to the risk increasing effect of HT compared to women who were overweight as young.
引用
收藏
页码:267 / 278
页数:12
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