Abstract
Changes of breast-cancer (BC) mortality for all women in England and Wales between 1911 and 1975, and for the social-class gradient during the 1950s, were not related to changes in child-bearing. The changes in BC mortality for all women were associated with changes in consumption of fat, sugar and animal protein 1-2 decades earlier. A decline in mortality around 1935 was not obviously related to changes in fat or sugar, but dietary data were sparse. The social-class gradient of BC mortality almost disappeared during the 1950s; rates declined for the upper classes but increased for the lower. These opposite changes could have resulted from the opposite changes in diets of the upper and lower classes which occurred in the early 1940s. In contrast, the geographical variation of BC mortality within the United Kingdom, by region or by urban-rural aggregate area, was closely correlated with child-bearing but poorly correlated with diet. The poor correlation with diet might be a consequence of the small range of variation of diet between regions of the United Kingdom. The regional gradient of BC mortality was low in 1961, a decade after the period of food rationing when regional variation in diet would have been reduced. This suggested that diet did contribute to the regional variation of BC mortality within the United Kingdom, perhaps jointly with contributions from child-bearing.
Highlights
Summary.-Changes of breast-cancer (BC) mortality for all women in England and Wales between 1911 and 1975, and for the social-class gradient during the 1950s, were not related to changes in child-bearing
Considering only the main items of diet, BC mortality rates of different countries were positively correlated with fat (Lea, 1966; Carroll, 1975) animal protein (Drasar & Irving, 1973) and sugar (Hems, 1970)
In the present study several gradients of BC mortality in the United Kingdom were analysed in the hope that they might show whether BC mortality rates depended on fat or animal protein
Summary
Breast cancer mortality rates-.Rates for all women in England and Wales, published annually by the Registrar General, were compiled by Case & Pearson (1957) and Case et al (1968) as mean age-specific rates for 5-year intervals from.J911-15 to 1961-65. Mean relative risks of breast cancer for regions, urban-rural aggregate areas and social classes were computed by weighting these risk factors by the proportions of the population with each parity or age at marriage, available for women aged 45-49 years in 1951 for England and Wales (General Register Office, 1959) and for Scotland (General Registry Office, 1956). Diet.-Annual estimates of diet in the U.K., determined by direct survey, have been published since 1950 (National Food Survey Committee, 1952-) These reports give detailed information on the variation of diet with time, by region and urban-rural area, by income group and, for three years 1956-58, by social class based on the Registrar General's Occupational Classification (National Food Survey Committee, 1958-60). Data on diet before 1950, obtained in occasional surveys for the United Kingdom and for different income groups, have been collated by Greaves & Hollingsworth (1966)
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