Waist–hip ratio and breast cancer risk in urbanized Nigerian women

Adebamowo, Clement; Ogundiran, Temidayo O.; Adenipekun, A; Oyesegun, Rasheed A; Campbell, O B; Akang, E. E. U.; Rotimi, Charles N.; Olopade, OI

doi:10.1186/bcr567

Cited by 60 publications

(21 citation statements)

References 36 publications

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“…These study findings confirmed our pilot data and another study in Nigerian population that WHR was associated with both pre- and post-menopausal breast cancer, although the two previous studies did not control for overall obesity [29,36]. A study conducted in North Carolina found that the positive association between WHR and breast cancer existed in African Americans [37], whereas a recent report from California showed no association between WHR and breast cancer in African Americans [38].…”

Section: Discussionsupporting

confidence: 90%

“…Data from other populations are not always consistent either, but two summaries might be made from review of the literature and this study. First, most studies showed that waist circumference or WHR was either positively associated with increased risk of breast cancer or there was no association [7–15,17–21,29,36,37]. while few studies found inverse association [22,39], suggesting that central obesity is more likely to be a risk factor and chance variability may be a reason for null association, especially when sample size is small.…”

Section: Discussionmentioning

confidence: 99%

“…The Nigerian Breast Cancer Study is a case-control study of breast cancer conducted in Ibadan, Nigeria. The study setting and design have been described previously [29,30]. Briefly, all consecutive female breast cancer patients aged 18 years or older attending the surgical oncology and radiotherapy clinics of the University College Hospital, Ibadan, Nigeria, from 1998 to 2009 were approached.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, it is important to evaluate the relationship of central obesity with breast cancer risk in indigenous African women. Using data from our pilot study [29], we previously reported a positive association of waist circumference and waist-hip ratio with breast cancer risk but the sample size was small in this pilot study. Here, we present findings from an analysis of more than 1,200 cases and 1,100 controls from the ongoing Nigerian Breast Cancer Study.…”

Section: Introductionmentioning

confidence: 99%

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Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study

Ogundiran

Huo

Adenipekun

et al. 2012

Cancer Causes Control

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Purpose The relationship between overall obesity and breast cancer risk has been well recognized, but the role of central obesity in breast cancer development is uncertain. Methods Between 1998 and 2009, 1233 invasive breast cancer cases and 1101 community controls were recruited into the Nigerian Breast Cancer Study at Ibadan, Nigeria. Logistic regressions were used to calculate multivariate odds ratio (OR) and 95% confidence intervals (CI), adjusting for age, body mass index (BMI), and other known risk factors for breast cancer. Results The OR for the highest quartile group of waist circumference relative to the lowest was 2.39 (95% CI: 1.59–3.60; P-trend<0.001). Comparing women with waist-hip ratio (WHR) in the lowest quartile group, the OR for women in the highest quartile category was 2.15 (95% CI: 1.61–2.85; P-trend<0.001). An inverse association was observed between hip circumference and breast cancer, with an OR of 0.36 for the highest quartile (95% CI: 0.24–0.55; P-trend<0.001). The effects of these three measures existed in both pre- and post-menopausal women. Of note, we found a significant interaction between WHR and BMI (P-interaction=0.016): the OR comparing the highest to lowest WHR quartile was 2.81 (95% CI: 1.90–4.16) for women with BMI<25 kg/m2 and 1.70 (95% CI: 1.11–2.61) for women with BMI ≥25 kg/m2. Conclusions These results suggest that central adiposity, measured by waist circumference and waist-hip ratio, was an important risk factor for breast cancer in Nigerian women, and the effect of central adiposity was strong in normal weight women.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study

Ogundiran

Huo

Adenipekun

et al. 2012

Cancer Causes Control

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“…Of 9163 retrieved references, 2680 references were excluded because of duplication, 6273 references did not relate to the objective of this review, and 160 references did not meet the eligibility criteria. Eventually, we included 50 studies in the meta-analysis including 15 cohort studies [4]–[6], [10], [15], [23]–[32] involving 2,104,203 people and 3,414,806 person-years and 35 case-control studies [8], [9], [33]–[65] involving 71,216 people. Some case-control and cohort studies evaluated breast cancer during premenopausal period, some during postmenopausal period and some during both periods.…”

Section: Resultsmentioning

confidence: 99%

Effect of Body Mass Index on Breast Cancer during Premenopausal and Postmenopausal Periods: A Meta-Analysis

et al. 2012

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ObjectiveThere is no universal consensus on the relationship between body mass index (BMI) and breast cancer. This meta-analysis was conducted to estimate the overall effect of overweight and obesity on breast cancer risk during pre- and post-menopausal period.Data SourcesAll major electronic databases were searched until April 2012 including Web of Knowledge, Medline, Scopus, and ScienceDirect. Furthermore, the reference lists and related scientific conference databases were searched.Review MethodsAll prospective cohort and case-control studies investigating the association between BMI and breast cancer were retrieved irrespective of publication date and language. Women were assessed irrespective of age, race and marital status. The exposure of interest was BMI. The primary outcome of interest was all kinds of breast cancers confirmed pathologically. Study quality was assessed using the checklist of STROBE. Study selection and data extraction were performed by two authors separately. The effect measure of choice was risk ratio (RRi) and rate ratio (RRa) for cohort studies and odds ratio (OR) in case-control studies.ResultsOf 9163 retrieved studies, 50 studies were included in meta-analysis including 15 cohort studies involving 2,104,203 subjects and 3,414,806 person-years and 35 case-control studies involving 71,216 subjects. There was an inverse but non-significant correlation between BMI and breast cancer risk during premenopausal period: OR = 0.93 (95% CI 0.86, 1.02); RRi = 0.97 (95% CI 0.82, 1.16); and RRa = 0.99 (95% CI 0.94, 1.05), but a direct and significant correlation during postmenopausal period: OR = 1.15 (95% CI 1.07, 1.24); RRi = 1.16 (95% CI 1.08, 1.25); and RRa = 0.98 (95% CI 0.88, 1.09).ConclusionThe results of this meta-analysis showed that body mass index has no significant effect on the incidence of breast cancer during premenopausal period. On the other hand, overweight and obesity may have a minimal effect on breast cancer, although significant, but really small and not clinically so important.

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Longitudinal Study on the Role of Body Size in Premenopausal Breast Cancer

Michels

Terry²,

Willett³

2006

Arch Intern Med

142

131

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Background: A high body mass index (BMI) has been related to a reduced risk of breast cancer in premenopausal women. The mechanisms underlying this association have not been elucidated. Methods: We explored whether factors affecting ovulation may explain the inverse association between BMI (calculated as weight in kilograms divided by the square of height in meters) and breast cancer in 113 130 premenopausal participants in the Nurses' Health Study II. During 1 225 520 person-years of prospective follow-up between 1989 and 2003, 1398 incident cases of invasive breast cancer were diagnosed. Weight, height, ovulatory infertility, menstrual cycle patterns, and a multitude of covariates were assessed throughout follow-up. Cox proportional hazards regression was used to compute hazard ratios and 95% confidence intervals (CIs). Results: We observed a significant linear inverse trend between current BMI and breast cancer incidence (PϽ.001) that was not explained by menstrual cycle characteristics or infertility due to an ovulatory disorder (covariate-adjusted hazard ratio for breast cancer in women with a BMI Ն30 vs 20.0-22.4, 0.81; 95% CI, 0.68-0.96). We found BMI at age 18 years to be the strongest predictor of breast cancer incidence (covariate-adjusted hazard ratio for breast cancer in women with a BMI at age 18 years Ն27.5 vs 20.0-22.4, 0.57; 95% CI, 0.41-0.81). Conclusions: Body size during the early phases of adult life seems to be particularly important in the development of premenopausal breast cancer. Factors other than anovulation are likely to mediate the protection conferred by a high BMI.

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Waist–hip ratio and breast cancer risk in urbanized Nigerian women

Cited by 60 publications

References 36 publications

Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study

Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study

Effect of Body Mass Index on Breast Cancer during Premenopausal and Postmenopausal Periods: A Meta-Analysis

Longitudinal Study on the Role of Body Size in Premenopausal Breast Cancer

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