Abstract
BackgroundFemale breast cancer incidence rates in Utah are among the lowest in the U.S. The influence of the Church of Jesus Christ of Latter-day Saint (LDS or Mormon) religion on these rates, as well as on disease-specific survival, will be explored for individuals diagnosed with breast cancer in Utah from 1985 through 1999.MethodsPopulation-based records for incident female breast cancer patients were linked with membership records from the LDS Church to determine religious affiliation and, for LDS Church members, level of religiosity. Incidence rates were age-adjusted to the 2000 U.S. standard population using the direct method. Cox proportional hazards model was used to compare survival among religiously active LDS, less religiously active LDS, and non-LDS with simultaneous adjustment for prognostic factors.ResultsAge-adjusted breast cancer incidence rates were consistently lower for LDS than non-LDS in Utah from 1985 through 1999. Rates were lower among LDS compared with non-LDS across the age span. In 1995–99, the age-adjusted incidence rates were 107.6 (95% CI: 103.9 – 111.3) for LDS women and 130.5 (123.2 – 137.9) for non-LDS women. If non-LDS women in Utah had the same breast cancer risk profile as LDS women, an estimated 214 (4.8%) fewer malignant breast cancer cases would have occurred during 1995–99. With religiously active LDS serving as the reference group, the adjusted death hazard ratio for religiously less active LDS was 1.09 (0.94 – 1.27) and for non-LDS was 0.86 (0.75 – 0.98).ConclusionIn Utah, LDS lifestyle is associated with lower incidence rates of female breast cancer. However, LDS experience poorer survivability from breast cancer than their non-LDS counterparts. Parity and breastfeeding, while protective factors against breast cancer, may contribute to poorer prognosis of female breast cancer in LDS women.
Highlights
Female breast cancer incidence rates in Utah are among the lowest in the U.S The influence of the Church of Jesus Christ of Latter-day Saint (LDS or Mormon) religion on these rates, as well as on disease-specific survival, will be explored for individuals diagnosed with breast cancer in Utah from 1985 through 1999
This study focused on many factors previously shown to influence breast cancer, including age at first birth [8,9], number of pregnancies and number of births [10], lifetime duration of breastfeeding [10,11], and alcohol consumption [12]
It appears that the same factors that are associated with a lower incidence rate of breast cancer are associated with poorer prognosis once breast cancer is diagnosed
Summary
Female breast cancer incidence rates in Utah are among the lowest in the U.S The influence of the Church of Jesus Christ of Latter-day Saint (LDS or Mormon) religion on these rates, as well as on disease-specific survival, will be explored for individuals diagnosed with breast cancer in Utah from 1985 through 1999. A study based on Utah data from 1971 through 1985 showed that LDS women had significantly lower age-adjusted breast cancer incidence rates than did nonLDS women [6]. A recent cross-sectional study involving non-Hispanic white females in Utah compared breast cancer risk factor behaviors between LDS and non-LDS [7]. This study focused on many factors previously shown to influence breast cancer, including age at first birth [8,9], number of pregnancies and number of births (parity) [10], lifetime duration of breastfeeding [10,11], and alcohol consumption [12]. A cross-sectional study conducted in Utah in the late 1970s likewise found LDS women to have a later age at first pregnancy, more pregnancies, and lower prevalence of alcohol consumption [13]. Research has shown that reproductive factors which may decrease the risk of breast cancer development may explain poorer breast cancer survival [14]
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