Metabolic conditions and breast cancer risk among Los Angeles County Filipina Americans compared with Chinese and Japanese Americans

Abstract

Accumulating evidence suggests that the aggregation of common metabolic conditions (high blood pressure, diabetes and dyslipidemia) is a risk factor for breast cancer. Breast cancer incidence has risen steadily in Asian American women, and whether these metabolic conditions contribute to breast cancer risk in certain Asian American subgroups is unknown. We investigated the role of physician-diagnosed hypertension, high cholesterol and diabetes separately, and in combination, in relation to the risk of breast cancer in a population-based case-control study of 2,167 Asian Americans diagnosed with breast cancer and 2,035 age and ethnicity matched control women in Los Angeles County. Compared to Asian American women who did not have any of the metabolic conditions, those with 1, 2 or 3 conditions showed a steady increase in risk (respective odds ratios were 1.12, 1.42 and 1.62; P trend = 0.001) with adjustment for covariates including body mass index. Similar significant trends were observed in Filipina Americans (P trend = 0.021), postmenopausal women (P trend =0.001), Asian women who were born in the United States (US) (P trend = 0.052) and migrants who have lived in the US for at least 20 years (P trend = 0.004), but not migrants who lived in the US for <20 years (P trend = 0.64). These results suggest that westernization in lifestyle (diet and physical inactivity) and corresponding increase in adiposity have contributed to the rising prevalence of these metabolic conditions, which in turn, are associated with an increase in breast cancer.

Neutrophil-to-lymphocyte ratio, obesity, and breast cancer risk in Chinese population

“…[ 4 – 9 ] Meanwhile, studies on MetS, another potential risk factor with an increasing prevalence worldwide, produced inconsistent results, especially in Asians. [ 24 – 28 ] In the present study, we found a much higher NLR in pre/perimenopausal women, compared with postmenopausal women (1.93 ± 0.85 vs 1.72 ± 0.76, P < .001). Similar conclusion was drawn in a study of Chen et al that women <50 years old had significantly higher NLR than women of 51 to 70 years of age.…”

Differences in cancer incidence by broad ethnic group in England, 2013–2017

“…Currently, lower prevalence of the most harmful cancer risk factors, and perhaps the 'healthy migrant effect' (migrant populations often being in better health than the indigenous population in their new home country), largely outweighs the harmful effect of deprivation to provide a 'cancer protective' effect of non-White minority ethnicity [4,58,59]. But there is evidence that as minority ethnic groups become more established in their adopted home nations, their risk factor prevalence and corresponding cancer incidence rates become increasingly similar to those of the indigenous population [60][61][62]. This coupled with overall higher rates of deprivation in non-White minority ethnic groups could in future mean the association between deprivation and cancer incidence is actually compounded in these groups.…”

The influence of metabolic factors and ethnicity on breast cancer risk, treatment and survival: The Oslo ethnic breast cancer study

“…Thus, our findings both extend and are in part supported by others. A stronger association of BMI, weight gain and WHR with breast cancer risk was observed in postmenopausal Asian and Asian-American women than in non-Hispanic white women [24], and a dose-response association was found between unfavorable metabolic factors (high BP, diabetes and dyslipidemia) and breast cancer risk among Asian-Americans born or residing in the USA for >20 years [25]. Ethnic disparities in BMI and risk for other chronic diseases have been observed [26], and, based on the same population as in the present study, a high prevalence of obesity-dependent type 2 diabetes was found among women from Pakistan and Sri Lanka [6].…”