Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease

Prospective study

T. Gathani, Raghib Ali, A. Balkwill, J. Green, G. Reeves, V. Beral, K. A. Moser

    Research output: Contribution to journalReview article

    Abstract

    Background:In the United Kingdom, breast cancer incidence is lower in South Asian and Black women than in White women, but the extent to which this is due to known risk factors is unknown. In a large prospective study, we describe breast cancer incidence by ethnicity, before and after adjustment for known risk factors for the disease.Methods:Women were recruited into the Million Women Study in 1996-2001, when information on reproductive and lifestyle factors known to influence the risk of breast cancer was obtained. Ethnicity was determined from study questionnaires and hospital admission data. Cox regression models were used to calculate adjusted relative risks (RR) for incident breast cancer in South Asians and Blacks compared with Whites.Results:Analyses included 5877 South Asian, 4919 Black, and 1 038 144 White women in England. The prevalence of 8 out of the 9 risk factors for breast cancer examined, differed substantially by ethnicity (P<0.001 for each), such that South Asian and Black women were at a lower risk of the disease than White women. During 12.2 years of follow-up incident breast cancer occurred in 217 South Asians, 180 Blacks, and 45 191 Whites. As expected, breast cancer incidence was lower in South Asians (RR=0.82, 95% CI 0.72-0.94) and Blacks (RR=0.85, 0.73-0.98) than in Whites when the analyses were adjusted only for age and region of residence. However, after additional adjustment for the known risk factors for the disease, breast cancer incidence was similar to that of Whites, both in South Asians (0.95, 0.83-1.09) and in Blacks (0.91, 0.78-1.05).Conclusion:South Asian and Black women in England have lower incidence rates of breast cancer than White women, but this is largely, if not wholly, because of differences in known risk factors for the disease.

    Original languageEnglish (US)
    Pages (from-to)224-229
    Number of pages6
    JournalBritish Journal of Cancer
    Volume110
    Issue number1
    DOIs
    StatePublished - Jan 1 2014

    Fingerprint

    England
    Prospective Studies
    Breast Neoplasms
    Incidence
    Proportional Hazards Models
    Life Style

    Keywords

    • breast cancer incidence
    • breast cancer risk factors
    • ethnicity

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

    Cite this

    Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease : Prospective study. / Gathani, T.; Ali, Raghib; Balkwill, A.; Green, J.; Reeves, G.; Beral, V.; Moser, K. A.

    In: British Journal of Cancer, Vol. 110, No. 1, 01.01.2014, p. 224-229.

    Research output: Contribution to journalReview article

    Gathani, T. ; Ali, Raghib ; Balkwill, A. ; Green, J. ; Reeves, G. ; Beral, V. ; Moser, K. A. / Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease : Prospective study. In: British Journal of Cancer. 2014 ; Vol. 110, No. 1. pp. 224-229.
    @article{c09f148359c04ccdafd9a975e8d405cd,
    title = "Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease: Prospective study",
    abstract = "Background:In the United Kingdom, breast cancer incidence is lower in South Asian and Black women than in White women, but the extent to which this is due to known risk factors is unknown. In a large prospective study, we describe breast cancer incidence by ethnicity, before and after adjustment for known risk factors for the disease.Methods:Women were recruited into the Million Women Study in 1996-2001, when information on reproductive and lifestyle factors known to influence the risk of breast cancer was obtained. Ethnicity was determined from study questionnaires and hospital admission data. Cox regression models were used to calculate adjusted relative risks (RR) for incident breast cancer in South Asians and Blacks compared with Whites.Results:Analyses included 5877 South Asian, 4919 Black, and 1 038 144 White women in England. The prevalence of 8 out of the 9 risk factors for breast cancer examined, differed substantially by ethnicity (P<0.001 for each), such that South Asian and Black women were at a lower risk of the disease than White women. During 12.2 years of follow-up incident breast cancer occurred in 217 South Asians, 180 Blacks, and 45 191 Whites. As expected, breast cancer incidence was lower in South Asians (RR=0.82, 95{\%} CI 0.72-0.94) and Blacks (RR=0.85, 0.73-0.98) than in Whites when the analyses were adjusted only for age and region of residence. However, after additional adjustment for the known risk factors for the disease, breast cancer incidence was similar to that of Whites, both in South Asians (0.95, 0.83-1.09) and in Blacks (0.91, 0.78-1.05).Conclusion:South Asian and Black women in England have lower incidence rates of breast cancer than White women, but this is largely, if not wholly, because of differences in known risk factors for the disease.",
    keywords = "breast cancer incidence, breast cancer risk factors, ethnicity",
    author = "T. Gathani and Raghib Ali and A. Balkwill and J. Green and G. Reeves and V. Beral and Moser, {K. A.}",
    year = "2014",
    month = "1",
    day = "1",
    doi = "10.1038/bjc.2013.632",
    language = "English (US)",
    volume = "110",
    pages = "224--229",
    journal = "British Journal of Cancer",
    issn = "0007-0920",
    publisher = "Nature Publishing Group",
    number = "1",

    }

    TY - JOUR

    T1 - Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease

    T2 - Prospective study

    AU - Gathani, T.

    AU - Ali, Raghib

    AU - Balkwill, A.

    AU - Green, J.

    AU - Reeves, G.

    AU - Beral, V.

    AU - Moser, K. A.

    PY - 2014/1/1

    Y1 - 2014/1/1

    N2 - Background:In the United Kingdom, breast cancer incidence is lower in South Asian and Black women than in White women, but the extent to which this is due to known risk factors is unknown. In a large prospective study, we describe breast cancer incidence by ethnicity, before and after adjustment for known risk factors for the disease.Methods:Women were recruited into the Million Women Study in 1996-2001, when information on reproductive and lifestyle factors known to influence the risk of breast cancer was obtained. Ethnicity was determined from study questionnaires and hospital admission data. Cox regression models were used to calculate adjusted relative risks (RR) for incident breast cancer in South Asians and Blacks compared with Whites.Results:Analyses included 5877 South Asian, 4919 Black, and 1 038 144 White women in England. The prevalence of 8 out of the 9 risk factors for breast cancer examined, differed substantially by ethnicity (P<0.001 for each), such that South Asian and Black women were at a lower risk of the disease than White women. During 12.2 years of follow-up incident breast cancer occurred in 217 South Asians, 180 Blacks, and 45 191 Whites. As expected, breast cancer incidence was lower in South Asians (RR=0.82, 95% CI 0.72-0.94) and Blacks (RR=0.85, 0.73-0.98) than in Whites when the analyses were adjusted only for age and region of residence. However, after additional adjustment for the known risk factors for the disease, breast cancer incidence was similar to that of Whites, both in South Asians (0.95, 0.83-1.09) and in Blacks (0.91, 0.78-1.05).Conclusion:South Asian and Black women in England have lower incidence rates of breast cancer than White women, but this is largely, if not wholly, because of differences in known risk factors for the disease.

    AB - Background:In the United Kingdom, breast cancer incidence is lower in South Asian and Black women than in White women, but the extent to which this is due to known risk factors is unknown. In a large prospective study, we describe breast cancer incidence by ethnicity, before and after adjustment for known risk factors for the disease.Methods:Women were recruited into the Million Women Study in 1996-2001, when information on reproductive and lifestyle factors known to influence the risk of breast cancer was obtained. Ethnicity was determined from study questionnaires and hospital admission data. Cox regression models were used to calculate adjusted relative risks (RR) for incident breast cancer in South Asians and Blacks compared with Whites.Results:Analyses included 5877 South Asian, 4919 Black, and 1 038 144 White women in England. The prevalence of 8 out of the 9 risk factors for breast cancer examined, differed substantially by ethnicity (P<0.001 for each), such that South Asian and Black women were at a lower risk of the disease than White women. During 12.2 years of follow-up incident breast cancer occurred in 217 South Asians, 180 Blacks, and 45 191 Whites. As expected, breast cancer incidence was lower in South Asians (RR=0.82, 95% CI 0.72-0.94) and Blacks (RR=0.85, 0.73-0.98) than in Whites when the analyses were adjusted only for age and region of residence. However, after additional adjustment for the known risk factors for the disease, breast cancer incidence was similar to that of Whites, both in South Asians (0.95, 0.83-1.09) and in Blacks (0.91, 0.78-1.05).Conclusion:South Asian and Black women in England have lower incidence rates of breast cancer than White women, but this is largely, if not wholly, because of differences in known risk factors for the disease.

    KW - breast cancer incidence

    KW - breast cancer risk factors

    KW - ethnicity

    UR - http://www.scopus.com/inward/record.url?scp=84891884096&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84891884096&partnerID=8YFLogxK

    U2 - 10.1038/bjc.2013.632

    DO - 10.1038/bjc.2013.632

    M3 - Review article

    VL - 110

    SP - 224

    EP - 229

    JO - British Journal of Cancer

    JF - British Journal of Cancer

    SN - 0007-0920

    IS - 1

    ER -