International Journal of Epidemiology 2000;29:214-223
© International Epidemiological Association 2000
Variation in the interaction between familial and reproductive factors on the risk of breast cancer according to age, menopausal status, and degree of familiality
a Unité INSERM 521, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France.
b MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK.
c Cancer Epidemiology Unit, University of Toronto, 12 Queen's Park Crescent W, 3rd Floor, McMurrich Bldg, Toronto, Ontario, M5S 1A8, Canada.
d Centre Alexis Vautrin, 54511 Vandoeuvre les Nancy Cedex, France.
e Groupe d'Epidémiologie Métabolique, INSERM-CRLC, Centre de Recherche en Cancérologie, Rue des Apothicaires, Parc Euromédecine, 34094 Montpellier Cedex 5, France.
f Department of Epidemiology, Cancer Research Center, Russian Academy of Sciences, 24 Kashirskoje Shosse, 115478 Moscow, Russia.
g Département de Gynécologie Obstétricale, Hospices civils, 67000 Strasbourg, France.
h Department of Community, Occupational and Family Medicine, National University of Singapore, Singapore.
Reprint requests to: Dr Nadine Andrieu, Unité INSERM 521, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France. E-mail: nandrieu{at}igr.fr
Background Studies have found that reproductive factors might have a variable effect on the occurrence of breast cancer (BC) according to the existence or not of a family history of BC. The effect of a family history of BC on the risk of BC may also vary according to the age at diagnosis and the degree of kinship. This may confound the relation between familial risk and reproductive factors. A combined analysis was performed to study the interaction between familial risk and reproductive factors according to degree of familiality, age at interview and menopausal status.
Methods The present analysis included 2948 cases and 4170 controls in seven case-control studies from four countries. The combined relative risks were estimated using a Bayesian random-effects logistic regression model.
Results The main effects of reproductive life factors on the risk of BC are in agreement with previous studies. Two-way interactions between subject's age or menopausal status and a family history of BC were not significant. Although the three-way interaction between age, familial risk and parity was not significant, familial risk seemed to be increased slightly for women with high parity compared with women with low parity in the older age group, and seemed to be slightly decreased for women with high parity compared with women with low parity in younger women. The subject's age also appeared to have an effect on the interaction between familial risk and the age at first childbirth (P = 0.1).
Conclusions A possible influence of reproductive and menstrual factors on familial risk of BC has been suggested previously and was also evident in the present study. Three-way interactions between age, family history and parity or age at first childbirth might exist and they merit further investigation.
Keywords Breast cancer, familial risk, reproductive factors, interactions
Accepted 15 October 1999
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