Abstract

Abstract Background: Evidence from two retrospective case-control studies suggests that cadmium is associated with risk of breast cancer. The primary routes of cadmium exposure in the general population are smoking cigarettes and eating certain foods including vegetables, grains, and seafood. To our knowledge, no reports from prospective epidemiological studies of cadmium and breast cancer risk have been published. Methods: Dietary cadmium consumption was estimated for peri- or post-menopausal women in the VITamins And Lifestyle (VITAL) cohort by combining baseline food frequency questionnaire (FFQ) responses and US Food and Drug Administration Total Diet Study market basket survey data on the cadmium content of foods. Women reporting a personal history of breast cancer prior to enrollment in the study were excluded. The outcome of incident, invasive breast cancer was ascertained through linkage to the western Washington State Surveillance, Epidemiology, and End Results cancer registry. Women were censored at the earliest of diagnosis of in situ breast cancer, moving out of the catchment area, death, or withdrawal from the study. Multivariable adjusted Cox proportional hazards regression was applied to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for invasive breast cancer with increasing estimated dietary cadmium intake, adjusted for cigarette smoking history, total energy intake, total servings of vegetables and potatoes, and established breast cancer risk factors. Results: During an average of 6 years of follow-up, 794 invasive breast cancers were registered among 31,630 women included in analysis. No evidence of an association between dietary cadmium and invasive breast cancer risk was observed in the entire analytical cohort (aHR (95% CI) comparing highest to lowest quartile dietary cadmium: 0.94 (0.63–1.38) P-trend=0.4). Similar results were obtained in analysis restricted to never-users of hormone therapy, or never-smokers. Because cadmium may compete for binding sites with zinc, we examined the interaction between dietary cadmium and estimated total intake of zinc from diet, supplements, and multivitamins; no evidence of effect modification was observed. Conclusions: This study does not provide evidence in support of the hypothesis that dietary cadmium intake is a risk factor for breast cancer. However, non-differential measurement error in the estimate of cadmium intake was a limitation of the study that could have obscured an association. Citation Information: Cancer Prev Res 2011;4(10 Suppl):B55.

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