ABSTRACT
PURPOSE: The role of alcohol in young-onset breast cancer (YOBC) is unclear. We examined associations between lifetime alcohol consumption and YOBC in the Young Women's Health History Study, a population-based case-control study of breast cancer among Non-Hispanic Black and White women < 50 years of age. METHODS: Breast cancer cases (n = 1,812) were diagnosed in the Metropolitan Detroit and Los Angeles County SEER registry areas, 2010-2015. Controls (n = 1,381) were identified through area-based sampling and were frequency-matched to cases by age, site, and race. Alcohol consumption and covariates were collected from in-person interviews. Weighted multivariable logistic regression was conducted to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations between alcohol consumption and YOBC overall and by subtype (Luminal A, Luminal B, HER2, or triple negative). RESULTS: Lifetime alcohol consumption was not associated with YOBC overall or with subtypes (all ptrend ≥ 0.13). Similarly, alcohol consumption in adolescence, young and middle adulthood was not associated with YOBC (all ptrend ≥ 0.09). An inverse association with triple-negative YOBC, however, was observed for younger age at alcohol use initiation (< 18 years vs. no consumption), aOR (95% CI) = 0.62 (0.42, 0.93). No evidence of statistical interaction by race or household poverty was observed. CONCLUSIONS: Our findings suggest alcohol consumption has a different association with YOBC than postmenopausal breast cancer-lifetime consumption was not linked to increased risk and younger age at alcohol use initiation was associated with a decreased risk of triple-negative YOBC. Future studies on alcohol consumption in YOBC subtypes are warranted.
Subject(s)
Alcohol Drinking , Breast Neoplasms , Triple Negative Breast Neoplasms , Female , Humans , Alcohol Drinking/epidemiology , Alcohol Drinking/adverse effects , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Case-Control Studies , Receptor, ErbB-2 , Receptors, Progesterone , Risk Factors , Triple Negative Breast Neoplasms/epidemiology , Triple Negative Breast Neoplasms/etiology , Black or African American , White , Age of OnsetABSTRACT
PURPOSE: To evaluate the association between lifetime personal cigarette smoking and young-onset breast cancer (YOBC; diagnosed <50 years of age) risk overall and by breast cancer (BC) subtype, and whether risk varies by race or socioeconomic position (SEP). METHODS: Data are from the Young Women's Health History Study (YWHHS), a population-based case-control study of non-Hispanic Black (NHB) and White (NHW) women, ages 20-49 years (n = 1812 cases, n = 1381 controls) in the Los Angeles County and Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) registry areas, 2010-2015. Lifetime personal cigarette smoking characteristics and YOBC risk by subtype were examined using sample-weighted, multivariable-adjusted polytomous logistic regression. RESULTS: YOBC risk associated with ever versus never smoking differed by subtype (Pheterogeneity = 0.01) with risk significantly increased for Luminal A (adjusted odds ratio [aOR] 1.34; 95% confidence interval [CI] 1.06-1.68) and HER2-type (aOR 1.97; 95% CI 1.23-3.16), and no association with Luminal B or Triple Negative subtypes. Additionally, ≥30 years since smoking initiation (versus never) was statistically significantly associated with an increased risk of Luminal A (aOR 1.55; 95% CI 1.07-2.26) and HER2-type YOBC (aOR 2.77; 95% CI 1.32-5.79), but not other subtypes. In addition, among parous women, smoking initiated before first full-term pregnancy (versus never) was significantly associated with an increased risk of Luminal A YOBC (aOR 1.45; 95% CI 1.11-1.89). We observed little evidence for interactions by race and SEP. CONCLUSION: Findings confirm prior reports of a positive association between cigarette smoking and Luminal A YOBC and identify a novel association between smoking and HER2-type YOBC.
Subject(s)
Breast Neoplasms , Cigarette Smoking , Adult , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Case-Control Studies , Cigarette Smoking/adverse effects , Cigarette Smoking/epidemiology , Female , Humans , Middle Aged , Pregnancy , Receptor, ErbB-2 , Receptors, Estrogen , Receptors, Progesterone , Risk Factors , Young AdultABSTRACT
In contextual studies, group compositions are often extracted from individual data in the sample, in order to estimate the group compositional effects [e.g., school socioeconomic status (SES) effect] controlling for interindividual differences in multilevel models. As the same variable is used at both group level and individual level, an appropriate decomposition of between and within effects is a key to providing a clearer picture of these organizational and individual processes. The current study developed a new approach with within-group finite population correction (fpc). Its performances were compared with the manifest and latent aggregation approaches in the decomposition of between and within effects. Under a moderate within-group sampling ratio, the between effect estimates from the new approach had a lesser degree of bias and higher observed coverage rates compared with those from the manifest and latent aggregation approaches. A real data application was also used to illustrate the three analysis approaches.