Lower breast cancer risk among women following lifestyle recommendations: a case-control study in Spain

Pollán, Marina

Lower breast cancer risk among women following lifestyle recommendations: a case-control study in Spain

Monday, 18 August 2014

Exhibit hall (Dena'ina Center)

Adela Castello, PhD , CIBERESP, Instituto de Salud Carlos III, Madrid, Spain

Miguel Martin, PhD , Instituto De Investigación Sanitaria Gregorio Marañón/Universidad Complutense,, Madrid, Spain

Amparo Ruiz, PhD , Institut Valencià d’Oncología, Valencia, Spain

Ana M Casas, PhD , Hospital Universitario Virgen Del Rocío, Sevilla, Spain

Jose M Baena-Cañada, PhD , Hospital Universitario Puerta Del Mar, 11009, Spain

Virginia Lope, PhD , CIBERESP, Instituto de Salud Carlos III, Madrid, Spain

Silvia Antolín, PhD , Complejo Hospitalario Universitario A Coruña, A Coruña, Spain

Manuel Ramos, PhD , Centro Oncológico De Galicia, A Coruña, Spain

Montserrat Muñoz, PhD , Hospital Clínic, Barcelona, Spain

Ana Lluch, PhD , Hospital Clinico Universitario de Valencia / INCLIVA, Universidad de Valencia, Valencia, Spain

Ana de Juan-Ferré, PhD , Hospital Universitario Marqués De Valdecilla, Santander, Spain

Carlos Jara, PhD , Hospital Universitario Fundación Alcorcón, Alcorcón, Spain

Maria A Jimeno, BS , Spanish Breast Cancer Research Group (GEICAM), San Sebastián De Los Reyes, Spain

Petra Rosado, PhD , Hospital Universitario Puerta Del Mar, Cadiz, Spain

Elena Díaz, PhD , Hospital Universitario Virgen Del Rocio, Sevilla, Spain

Vicente Guillem, PhD , Institut Valencià d’Oncología, Valencia, Spain

Eva Carrasco, PhD , Spanish Breast Cancer Research Group (GEICAM), San Sebastián De Los Reyes, Spain

Beatriz Pérez-Gómez, PhD , CIBERESP, Instituto de Salud Carlos III, Madrid, Spain

Jesús Vioque, PhD , Universidad Miguel Hernández, Sant Joan D'Alacant, Spain

Marina Pollán, PhD , CIBERESP, Instituto de Salud Carlos III, Madrid, Spain

INTRODUCTION: In 2007, the World Cancer Research Fund (WCRF) and the American Institute of Cancer Research (AICR) issued 8 general and 2 special recommendations for cancer prevention based on available evidence. The objective of this study was to explore the association between the WCRF/AICR recommendations and breast cancer risk.

METHODS: Epi-GEICAM is a nation-wide case-control study, 1019 cases from 23 hospitals were matched to 1019 controls by age and municipality of residence. The cases were sub classified by tumor subtype: 1) Estrogen Receptor(ER)+ or Progesterone Receptor(PR)+ with Human Epidermal Growth Factor Receptor 2(HER2)-; 2) HER2+; and 3) ER-,PR-&HER2- tumors. We constructed a score (0-9) based on 9 of the 10 WCRF/ AICR recommendations. The score was grouped in 4 categories (0 to <4, 4 to <5, 5 to <6 and ≥6) and its association with BC risk was evaluated using conditional logistic regression models adjusted by total calorie intake, smoking habit, age at first delivery, education, history of breast problems, family history of BC and menopausal status. Multinomial logistic regression models were used to evaluate the association of the WCRF/AICR score with each of the intrinsic BC subtypes. These models were adjusted by age, hospital, and the same set of potential confounders described above.

RESULTS: The women with higher score showed a decreased risk of BC (OR_[6-9]vs[0-4] =0.51; 95%CI=0.36-0.73 and OR_{unit-increase}=0.82; 95%CI =0.74-0.91; p-trend<0.001). This preventive effect was slightly more pronounced in postmenopausal women (OR_[6-9]vs[0-4] =0.43; 95%CI=0.26-0.70 and OR_{unit-increase}=0.81; 95%CI=0.71-0.93, p-trend=0.001) and in women with ER+/PR+&HER2- tumors (OR_[6-9]vs[0-4] =0.43; 95%CI =0.30-0.62 and OR_{unit-increase}=0.78; 95%CI=0.70-0.87; p-trend<0.001). However, none of the differences in the magnitude of risk by menopausal status and intrinsic tumor subtypes was statistically significant.

CONCLUSIONS: Adherence to the WCRF/AICR recommendations for cancer prevention might reduce breast cancer risk in both pre and postmenopausal women and all cancer subtypes.