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Pooled analysis of active smoking and breast cancer risk

Principal Investigator

Name
Mia Gaudet

Institution
American Cancer Society

Email
mia.gaudet@cancer.org

About this CDAS Project

Study
PLCO (Learn more about this study)

Project ID
2012-0050

Initial CDAS Request Approval
May 30, 2012

Title
Pooled analysis of active smoking and breast cancer risk

Summary
Approximately 130 epidemiologic studies and seven national and international consensus reviews of the literature 1-7 have been published on active cigarette smoking and breast cancer risk. Despite this wealth of data and strong biological rationale for a positive association, a lack of consensus remains on the issue of smoking and breast cancer due partly to inconsistent considerations of key methodological issues in individual studies. The consensus reviews 1-7 have noted that the smoking-breast cancer association may be biased by several factors including (a.) timing of exposure at early ages and/or long duration of smoking, (b.) confounding by alcohol, mammographic screening, age at menopause, body mass index (BMI), socioeconomic status, reproductive patterns, and use of postmenopausal hormones, (c.) definition of the relevant outcome (e.g., estrogen receptor (ER) positive breast cancer), and (d.) interaction with family history of breast cancer. We seek to investigate these issues in a large pooled analysis of prospective cohort studies.

Aims

Our goal is to address the remaining methodological issues in the debate of the association between smoking and breast cancer. 1. To estimate multivariable-adjusted hazards ratios (95% confidence intervals) associations of smoking status, duration, intensity, and initiation (age and relative to menarche and first birth) with risk of breast cancer 2. To stratify associations by alcohol status 3. To stratify associations by family history of breast cancer 4. To stratify cases by estrogen receptor status and estimate associations for smoking status and related characteristics

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