Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa Women's Health Study

Michelle Harvie, Anthony Howell, Robert A. Vierkant, Nagi Kumar, James R Cerhan, Linda E. Kelemen, Aaron R. Folsom, Thomas A. Sellers

Research output: Contribution to journalArticle

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Abstract

Obesity and adult weight gain are well-established risk factors for postmenopausal breast cancer. Although there are a few studies demonstrating the contribution of adult weight gain to breast cancer risk, whether weight gain during a critical time period is specifically associated with risk, or whether subsequent weight loss among women who have gained weight will reduce the excess risk, is not firmly established. We investigated the association of changes in weight (loss or gain in excess of 5% of body weight) using two risk factor models: (a) age 18 to 30 years and age 30 years to menopause and (b) age 30 years to menopause and after the menopause to the baseline study in 1986 on risk of postmenopausal breast cancer in a prospective cohort of 33,660 postmenopausal women in Iowa. Over 15 years of follow-up, 1,987 cases of breast cancer occurred. Data were analyzed using proportional hazards regression models adjusted for established breast cancer risk factors. The most frequently observed pattern of body weight over time was a consistent increase; these women were observed to have the highest rates of breast cancer and served as the reference category for all comparisons. The lowest-risk groups were (a) women who maintained or lost weight from age 18 to 30 years and then lost weight from age 30 years to menopause [risk ratio (RR), 0.36; 95% confidence interval (95% CI), 0.22-0.60] and (b) women who maintained or lost weight from age 30 years to menopause and then lost weight after the menopause (RR, 0.48; 95% CI, 0.22-0.65). Women who gained weight from age 30 years to menopause but then lost weight after the menopause experienced risk reductions (RR, 0.77; 95% CI, 0.64-0.92) although perhaps slightly smaller in magnitude than women who maintained their weight in both time intervals (RR, 0.63; 95% CI, 0.55-0.73). Women who gained weight from age 18 to 30 years and then lost weight from age 30 years to menopause had comparable risk reductions (RR, 0.61; 95% CI, 0.46-0.8) with women who maintained their weight in both time intervals (RR, 0.73; 95% CI, 0.64-0.84). Women who gained weight during the period from age 30 years to menopause but who had stable weight after menopause had rates similar to the reference group. These data suggest prevention of weight gain between age 18 years and menopause or weight loss and maintenance during these years reduces risk of postmenopausal breast cancer.

Original languageEnglish (US)
Pages (from-to)656-661
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume14
Issue number3
DOIs
StatePublished - Mar 2005

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Women's Health
Menopause
Weight Gain
Weight Loss
Breast Neoplasms
Weights and Measures
Odds Ratio
Confidence Intervals
Risk Reduction Behavior
Body Weight
Proportional Hazards Models
Obesity
Maintenance

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa Women's Health Study. / Harvie, Michelle; Howell, Anthony; Vierkant, Robert A.; Kumar, Nagi; Cerhan, James R; Kelemen, Linda E.; Folsom, Aaron R.; Sellers, Thomas A.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 14, No. 3, 03.2005, p. 656-661.

Research output: Contribution to journalArticle

Harvie, Michelle ; Howell, Anthony ; Vierkant, Robert A. ; Kumar, Nagi ; Cerhan, James R ; Kelemen, Linda E. ; Folsom, Aaron R. ; Sellers, Thomas A. / Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa Women's Health Study. In: Cancer Epidemiology Biomarkers and Prevention. 2005 ; Vol. 14, No. 3. pp. 656-661.
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