Association between adherence to World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention and mammographic density in Spanish women attending screening programs (DDM-Spain)
Wednesday, 20 August 2014: 5:00 PM
Summit Hall, Egan Center Room 3 (Dena'ina Center)
Leandro Prieto-Castillo, MPH
,
Carlos III Health Institute, Madrid, Spain
Adela Castelló, PhD
,
CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
Maria Ederra, MPH
,
Public Health Institute, Pamplona, Spain
Dolores Salas, PhD
,
General Directorate of Public Health, Valencia, Spain
Carmen Vidal, MPH
,
Catalonian Institute of Oncology (ICO), L´Hospitalet de Llobregat (Barcelona), Spain
Carmen Sánchez-Contador, MPH
,
Regional Authority for Health and Consumer Affairs, Palma de Mallorca, Spain
Carmen Santamariña, MPH
,
Galician Regional Health Authority, A Coruña, Spain
Carmen Pedraz-Pingarrón, MPH
,
General Directorate of Public Health, Burgos, Spain
Pilar Moreo, MPH
,
Aragon Health Service, Zaragoza, Spain
Beatriz Pérez-Gómez, PhD
,
Carlos III Health Institute, Madrid, Spain
Virginia Lope, PhD
,
Instituto de Salud Carlos III. National Center for Epidemiology, Madrid, Spain
Jesús Vioque, PhD
,
CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
Marina Pollán, PhD
,
CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
INTRODUCTION: : High mammographic density (MD) is used as a phenotype risk marker for developing breast cancer. In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued 8 general and 2 special recommendations for cancer prevention based on available evidence. We explored the association between adherence to WCRF/AICR recommendations and mammographic density.
METHODS: We enrolled 3558 women aged 45-68 years recruited in seven Spanish breast cancer screening centers. MD was measured by an experienced radiologist, on the craniocaudal mammogram using the Boyd´s semiquantitative scale. We constructed a score (0-8) based on 8 of the 10 WCRF/AICR recommendations. The score was grouped in 4 categories: 0-3, >3 to <4, 4 to <5, 5-8, and its association with MD was evaluated using ordinal logistic regression models with random center-specific intercepts, adjusting by age, body mass index, parity, menopausal status and family history of breast cancer.
RESULTS: Women with higher adherence to WCRF/AICR recommendations showed a decreased risk of having higher MD (OR[5-8]vs[0-3]=0.75; 95% CI=0.58-0.97 and ORunit-increase=0.93; 95% CI=0.87-0.99; p-trend=0.025). This preventive effect was similar in pre and postmenopausal women. Specific recommendations such as “eat mostly foods of plant origin” and “limit consumption of energy-dense foods and avoid sugary drinks” showed the strongest effect on MD, OR=0.69 (95% CI:0.47-1.02) and OR=0.75 (95% CI: 0.55-1.01), respectively.
CONCLUSIONS: A higher adherence to the WCRF/AICR recommendations may reduce mammographic density, an important risk factor for breast cancer.
