Abstract
BackgroundThe breast cancer incidence in Asia is rising. To explore whether the etiology of breast cancer is different from the known risk factors from studies in Western countries, we conducted a nested case-control study using data from the Taiwan National Health Insurance Research Database (NHIRD).MethodsAll medical conditions based on the first three digits of the ICD-9 and a list of medical conditions based on literature review were retrieved for each case and control. The odds ratios (OR) and 95% confidence intervals (CI) of the associations between medical conditions and breast cancer risks were estimated using conditional logistic regression and adjusted for occupation, number of breast cancer screening, and the average number of outpatient visits prior the diagnosis. The associations were also estimated for younger (<50 years old) and older subjects separately.ResultsThe analyses included 4,884 breast cancer cases and 19,536 age-matched controls. Prior breast diseases (OR, 95% CI: 2.47, 2.26–2.71), obesity (1.43, 1.04–1.96), endometriosis (1.44, 1.15–1.80), uterine leiomyoma (1.20, 1.03–1.40), hypertensive diseases (1.14, 1.05–1.25), and disorders in lipid metabolism (1.13, 1.04–1.24) were associated with increased breast cancer risk. No heterogeneity was observed between age groups (<50 and ≥50 years old).ConclusionsIn addition to benign breast diseases, obesity, endometriosis, uterine leiomyoma, hypertensive diseases, and disorders of lipid metabolism were associated with a subsequent breast cancer risk.ImpactsOur results suggest that estrogen related factors may play an important role in breast cancer risks in the Taiwanese female population.
Highlights
Worldwide, breast cancer was the most common cancer and the most important cause of deaths from cancer in women in 2012 [1], and the incidence is still rising [2]
Prior breast diseases (OR, 95% confidence intervals (CI): 2.47, 2.26–2.71), obesity (1.43, 1.04–1.96), endometriosis (1.44, 1.15–1.80), uterine leiomyoma (1.20, 1.03–1.40), hypertensive diseases (1.14, 1.05– 1.25), and disorders in lipid metabolism (1.13, 1.04–1.24) were associated with increased breast cancer risk
In addition to benign breast diseases, obesity, endometriosis, uterine leiomyoma, hypertensive diseases, and disorders of lipid metabolism were associated with a subsequent breast cancer risk
Summary
Breast cancer was the most common cancer and the most important cause of deaths from cancer in women in 2012 [1], and the incidence is still rising [2]. Unlike what is reported in the western countries, young breast cancer patients in Taiwan seem to have higher prevalence of ER+ or PR+ tumors than the older patients [7,8]. These results suggested that westernization may not be the only explanation to the increase in breast cancer incidence. To explore whether the etiology of breast cancer is different from the known risk factors from studies in Western countries, we conducted a nested case-control study using data from the Taiwan National Health Insurance Research Database (NHIRD)
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