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Body Mass Index, Height, and Postmenopausal Breast Cancer Mortality in a Prospective Cohort of US Women

Jennifer M. Petrelli, Eugenia E. Calle, Carmen Rodriguez and Michael J. Thun
Cancer Causes & Control
Vol. 13, No. 4 (May, 2002), pp. 325-332
Published by: Springer
Stable URL: http://www.jstor.org/stable/3553849
Page Count: 8
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Body Mass Index, Height, and Postmenopausal Breast Cancer Mortality in a Prospective Cohort of US Women
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Abstract

Objective: Epidemiologic evidence suggests a positive association between body mass, adult height, and postmenopausal breast cancer. However, most studies have not been large enough to examine the association across a very wide range of body mass or height, and few studies have assessed the relationship between body mass or height and postmenopausal breast cancer mortality. Methods: The relation between body mass index (BMI) and height and postmenopausal breast cancer mortality was examined in the American Cancer Society's Cancer Prevention Study II (CPS-II), a large prospective mortality study of US adults enrolled in 1982. After 14 years of follow-up, 2852 breast cancer deaths were observed among 424,168 postmenopausal women who were cancer-free at interview. Cox proportional hazards modeling was used to estimate relative risks and to control for potential confounding. Results: Breast cancer mortality rates increased continually and substantially with increasing BMI (rate ratio (RR) = 3.08, 95% confidence interval (CI) = 2.09-4.51 for BMI ≥ 40.0 compared to BMI 18.5-20.49). If causal, the multivariate-adjusted RR estimates in this study correspond to approximately 30-50% of breast cancer deaths among postmenopausal women in the US population being attributable to overweight. Breast cancer mortality also increased with increasing height up to 66 inches with RR = 1.64, (95% CI = 1.23-2.18) in women 66 inches tall compared to those <60 inches. Conclusions: Postmenopausal obesity is an important and potentially avoidable predictor of fatal breast cancer in this study. These results underscore the importance of maintaining moderate weight throughout adult life.

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