Association of skirt size and postmenopausal breast cancer risk in older women: a cohort study within the UK Collaborative Trial of Ovarian Cancer Screening
Several studies suggest that overall and central-obesity are associated with increased breast cancer (BC) risk in postmenopausal-women. However, there are no studies investigating changes of central obesity and BC. We report on the association of BC risk with self-reported skirt size (SS; waist-circumference proxy) changes between 20s and postmenopausal-age.
UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) involving the nine trial centres in England.
Postmenopausal-women aged >50 with no known history of BC prior to or on the day of completion of the study-entry questionnaire.
At recruitment and at study entry, women were asked to complete a questionnaire. Women were followed-up via ‘flagging’ at the NHS Information Centre in England and the Hospital Episode Statistics.
Time to initial BC diagnosis.
Between 2 January 2005 and 1 July 2010, 92 834 UKCTOCS participants (median age 64.0) completed the study-entry questionnaire. During median follow-up of 3.19 years (25th–75th centile: 2.46–3.78), 1090 women developed BC. Model adjusted analysis for potential confounders showed body mass index (BMI) at recruitment to UKCTOCS (HR for a 5 unit change=1.076, 95% CI 1.012 to 1.136), current SS at study entry (HR=1.051; 95% CI 1.014 to 1.089) and change in SS per 10 years (CSS) (HR=1.330; 95% CI 1.121 to 1.579) were associated with increased BC risk but not SS at 25 (HR=1.006; 95% CI 0.958 to 1.056). CSS was the most predictive singe adiposity measure and further analysis including both CSS and BMI in the model revealed CSS remained significant (HR=1.266; 95% CI 1.041 to 1.538) but not BMI (HR=1.037; 95% CI 0.970 to 1.109).
CSS is associated with BC risk independent of BMI. A unit increase in UK SS (eg, 12–14) every 10-years between 25 and postmenopausal-age is associated with postmenopausal BC risk by 33%. Validation of these results could provide women with a simple and easy to understand message.
Strengths and limitations of this study
To the best of our knowledge, this is the first study investigating the association between central obesity using skirt size (SS) as a proxy and breast cancer risk. Between 25 and postmenopausal age, an increase in SS by one unit every decade increased the risk of postmenopausal breast cancer by 33% while decrease in SS was associated with lowering of risk.
Our prospective cohort-study includes 94 000 women with comprehensive follow-up through data linkage to multiple national databases.
There is a possibility of underestimation of self-reported SS. However, if current SS at study entry is uniformly underestimated then there is merely rescaling of CSS so that the strength of the association is unaffected. Furthermore, recall bias of the SS at 25 maybe a limitation but unless this inability in reporting is systematically related to future breast cancer, measurement error can only result in underestimating the strength of the true association between CSS and breast cancer risk.
Given that obesity is now emerging as a global epidemic, from a public health prospective these findings are significant as they provide women with a simple and easy to understand message.
Sources and More Information:
Association of skirt size and postmenopausal breast cancer risk in older women: a cohort study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), BMJ Open 2014;4:e005400 doi:10.1136/bmjopen-2014-005400, 24.09.2014.
Skirt size increase ups breast cancer risk, NHS Choices, Cancer, September 25 2014.
Are safer methods of breast cancer screening becoming available?
” Even though mammography is the most widely used screening method for breast cancer, there are a number of valid arguments for alternative methods. Research has shown that mammograms are not the definitive answer to early detection, and in fact, can often cause more problems than they solve. So what is wrong with mammography? ”
Mammograms can add to cancer risk
High rate of false positive
High rate of false negatives
Estrogen distorts breast x-rays
Read 4 serious risks & problems with mammograms, NaturalNews.com, September 24, 2014.
Dane Morin-Delacroix constate en 1983 que ses quatre enfants sont tous nés avec des lésions et des malformations provoquées par le Distilbène prescrit lors de ses grossesses
Ces écrits relatent les aventures incroyables d’une mère de famille, qui découvre l’effarante réalité : Avec plus de 300 000 femmes elle a absorbé pendant ses grossesses un traitement qui a provoqué des cancers et des malformations sur les enfants qu’elles portaient… pouvant se transmettre aux générations suivantes !
Diethylstilbestrol, teratogenesis, and carcinogenesis: medical/legal implications of its long-term sequelae, including third generation effects
1990 Study Abstract:
The spectrum of teratogenic and carcinogenic effects which can be exerted when the unborn child is exposed to diethylstilbestrol (DES) has been shown to be broad. Animal work indicates the need for vigilance as regards genetic susceptibility to DES sequelae. The emergence of third generation sequelae has been demonstrated in mice, and has been postulated to occur in humans. Given the emergent data establishing problems of infertility in men and women and of relatively late onset cancer, and the possibility that in utero exposure to DES may prime a variety of tissues to noxious environmental influences there is an urgent need for measures to provide just coverage for those harmed by the drug. The DES disaster also raises important ethical and reserch questions which demand attention.
Diethylstilbestrol, teratogenesis, and carcinogenesis: medical/legal implications of its long-term sequelae, including third generation effects, NCBI, PMID: 23511655, 1990;1(3):171-93. doi: 10.3233/JRS-1990-1301.
A Common Surgery for Women and the Cancer it Leaves Behind
” Since the 1990s, thousands of women have undertaken a surgical procedure that may have risked their lives.
After Dr. Amy Reed had surgery to remove uterine fibroids, involving a procedure known as power morcellation, she learned that it had worsened her prognosis by spreading a cancer she and her doctors didn’t know she had.
Dr. Reed became a vocal critic of power morcellators and the doctors who used them, dividing the medical community. Now doctors and companies are waiting for more-permanent guidance from the FDA.
This story, drawn from ongoing coverage in The Wall Street Journal, is a gripping human-interest account of public trust and the fallibility of modern medicine. ”
Dr. Noorchashm campaign against hysterectomy using electric power morcellation
Public testimony gets heated at FDA panel meeting on morcellation, OBGYNNews, video, JULY 11, 2014.
Health Alert: Many Women Have Died Because Deadly Cancers of the Uterus Are Being Spread by Gynecologists. Stop Morcellation of the Uterus in Minimally Invasive Surgery, Change, SIGN the Petition by Hooman Noorchashm.
Analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer
” A Cancer Research UK analysis out today reveals that 46 per cent of cancers in England are diagnosed at an advanced stage, when they are harder to treat successfully.
The figures come as a new report shows that if all areas diagnosed cancers as early as the best in England, for four types of cancer alone, this could save the NHS over £44 million in treatment costs and benefit over 11,000 patients each year. Extrapolating this to all types of cancer would imply an annual saving of nearly £210m, while helping to improve the survival prospects for more than 52,000 patients. ”
Sources and More Information:
Half of cancers diagnosed at late stage as report shows early diagnosis saves lives and could save the NHS money, CancerResearchUK, Press release, 22 September 2014.
Stilbosol patenting turned the cattle feed industry upside down in the mid fifties with its phenomenal use by the farmers and feeders
… ” One of the most important and far-reaching events in the department in the early 1950s was the patenting of defined levels of diethylstilbestrol (DES), a growth-promoting hormone, to feed beef cattle for improved growth and efficiency.
The saga includes how Wise Burroughs found that quality clover hay contained estrogens that enhanced growth, and how he, by studying the literature on DES, determined the levels to produce the desired effects, but not the negative ones. The work with the Iowa State College Research Foundation to secure the patent, the feud with colleagues at Ames and Purdue, the announcement at Cattle Feeder’s Day in 1954 that turned the feed industry upside down, the struggle to secure FDA approval, the involvement of President Hilton in the licensing done with Lilly, and the phenomenal use of Stilbosol by the feeders make a story worthy of the book about it by A.I. Marcus in 1994. The events changed the way new technology was utilized and controlled by the Food and Drug Adminstration. Eventually DES was banned in 1979. A portion of the proceeds from the patent built Lush Auditorium, and the use of DES enhanced the profitability of cattle feeding. ” …