Breast Cancer Anomalies

Abstract

SUMMARY.-The death rate from breast cancer among females in England and Wales which had been falling during at ages before 45 increased from 1960 to 1967; and at ages 45-64 there has been a progressive increase ever since 1955. Regional rates at the early ages were considerably higher in Greater London than in the north until 1961, but the difference then gradually disappeared; and at higher ages an excess in the south over that in the north and Wales has persisted at ages 45-64.Whilst the total mortality from breast and uterine cancers combined has shown little regional variation, the proportion of breast cancer in the total has been consistently higher in the south than in the north, and possible implications of this are discussed. Breast cancer rates in the regions are positively associated with the dietary intake per person of butter, cheese, liquid milk and green vegetables but this in itself does not prove a causative connection.SINCE it is incredible that during 1948-68 treatment of breast cancer has become less effective for survival or that certification of it as the cause of death has become appreciably more accurate, recent upward trends of age-specific death rates from the disease in England and Wales must indicate an increasing incidence of new cases and need serious attention.One of the unresolved problems uncovered by epidemiological studies of breast cancer is the curious dip or flattening of the incidence curve which occurs, in Scandinavian countries most notably, about the age of the menopause. This may indicate a bimodal distribution arising from existence of two types of breast cancer occurring before and after the menopause and affected predominantly by activity of the ovarian and adrenal glands respectively (de Waard et al., 1960). Indications that cancers appearing before middle age tend to be influenced by previous sex and marital history (Stocks, 1955) whereas those occurring later are often accompanied by hypertension and obesity support this hypothesis. If there is any truth in the dual nature of the associated factors one would expect that the relative trends of mortality over a period of years in different parts of the country might not be the same at ages under 45 as at later ages.

Age at First Birth, Dietary Practices and Breast Cancer Mortality in Various Italian Regions

“…The present analysis also confirms [3][4][5][6][7]9] the wellknown positive correlation of breast cancer mortality with several food items (meat, dairy products, sugar) and the negative one with cereals: the latter, however, was markedly reduced when allowance was made for gross internal product. In particular, it may be worth noting that the strongest positive correlations (and the least affected by allowance for other variables) were observed with milk consumption in the present inves tigation as well as in a similar study based on data from the 48 contiguous states and the District of Columbia in the United States [9], Of particular interest, moreover, is the finding that the positive simple correlation with wine consumption could be totally explained (and, actually, reversed) by simultaneous allowance for age at first birth, per caput gross internal product and total consumption.…”

“…The results of the present study, although based on data with obvious deficiencies and clearly incon clusive, are of some interest as they show that the variation in breast cancer mortality between various Italian regions strictly correlated with known risk factors for breast cancer and several exogenous vari ables previously analyzed in correlational studies at international [3][4][5][6] or national [7][8][9] levels. First, the general rule that the richer a country, the higher its mortality from breast cancer [4] is reflected in national Italian data, where the highest rates are observed in the richer Northern regions.…”

“…Further, studies of breast cancer incidence or mor tality on international [3][4][5][6] or national scales [7][8][9] have shown strong correlations with several dietary factors (mostly milk, meat or indices of fat and animal protein intake) [3][4][5][6][7]9], anthropometric variables (height and weight) [5] and fertility patterns (age at menarche and birth rates) [5,8,9]. F.vidence from correlational studies, however, found only partial con firmation in analytical epidemiological investigations, which showed strong associations between hormonal and reproductive factors (chiefly age at first birth, at menarche and at menopause) [10][11][12][13][14] and breast can cer risk, but failed to produce convincing evidence of any marked influence of specific dietary components (e.g., fats or micronutrients).…”

A case‐control study of diet and breast cancer in Argentina

“…The international variation of breast cancer incidence and mortality is considerable (Segi, 1978;Waterhouse er al., 1982), and is correlated with a number of environmental factors, including dietary indices (Armstrong and Doll, 1975;Stocks, 1970). Japanese-American women have experienced rates of breast cancer which resemble those of the US population rather than the lower rates among their contemporaries who remained in Japan (Buell, 1973).…”

Contemporary Themes: Congenital Malformations and the Problem of their Control

“…Mortality from neural tube defects between the 28th week of pregnancy and the end of the first year of life (stillbirths plus infant deaths) is much higher in the north and the west of England and Wales than it is in the south and the east. 8 In South Wales the incidence is much higher in the coal-mining valleys than it is in the coastal plain (Fig. 1).…”