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Social inequalities and smoking-associated breast cancer - Results from a prospective cohort study

Permanent link
https://hdl.handle.net/10037/9007
DOI
https://doi.org/10.1016/j.ypmed.2015.01.004
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Date
2015-01-22
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Author
Bjerkaas, Eivind; Parajuli, Ranjan; Engeland, Anders; Maskarinec, Gertraud; Weiderpass, Elisabete; Gram, Inger Torhild
Abstract
Objective. The association between smoking and breast cancer has been found in most recent, large cohort studies. We wanted to investigate how smoking-associated breast cancer varies by level of education, a wellestablished measure of socioeconomic status.

Methods. We included 302,865 women with 7490 breast cancer cases. Participants were assigned to low, moderate or high level of education and analyzed by smoking status (ever/never), and stratified by birth cohorts (≤1950N). We used Cox proportional hazard to estimate hazard ratios (HRs) and confidence intervals (CIs), adjusting for age, number of children, age at first childbirth, BMI, age at enrollment and physical activity.

Results. Women born ≤1950 with low and moderate levels of education had a 40% increase in smokingassociated breast cancer risk (HR = 1.40, 95% CI 1.25–1.57 and HR = 1.14, 95% CI 1.05–1.24, respectively). Women in the same age group with high level of education did not have an increase in risk. No increased breast cancer risk was found among women born after 1950 for any level of education, when analyzed by smoking status. Longer duration of smoking before first childbirth was consistently associated with increasing risk of breast cancer in all three categories of education (all p for trends b 0.01).

Conclusion. Smoking for several years before first childbirth increases the risk of breast cancer, regardless of educational level.

Description
Published version also available at http://dx.doi.org/10.1016/j.ypmed.2015.01.004
Publisher
Elsevier
Citation
Preventive Medicine 2015, 73:125-129
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