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ABSTRACT: Breast Cancer in a Multiethnic Cohort in Hawaii and
Los Angeles: Risk Factor-adjusted Incidence in Japanese Equals
and in Hawaiians Exceeds that in Whites
Few data exist on the extent to which the differences in breast
cancer risk between "racial-ethnic" groups in the United States
(US) are "explained" by differences in their distribution of
risk factors.
We have determined this for African-American (AA),
native Hawaiian (NH), Japanese-American (JA), Latina-US-born
(L-US), Latina-non-US-born (L-NUS), and white (W) women using
prospective incidence data on 88,712 postmenopausal women recruited
in 1993-1996.
We identified 1,757 incident breast cancer
cases through 1999 among these women (1,116 cases after excluding
women with a simple hysterectomy or missing risk factor data).
Data were available on seven "known" risk factors: ages at menarche
and first birth; parity; age at and type of menopause; weight;
hormone replacement therapy use; and alcohol consumption.
The
relative risks (RRs) of breast cancer (with the RR in Ws set
to 1.0) for the groups were as follows: W = 1.0; AA = 0.78; NH
= 1.33; JA = 0.99; L-US = 0.77; and L-NUS = 0.60. After adjustment
for the risk factors, the RRs were as follows: W = 1.0; AA =
0.98; NH = 1.65; JA = 1.11; L-US = 0.95; and L-NUSB = 0.84.
The
slightly greater risk of the JAs compared with the Ws is in sharp
contrast to the very low breast cancer rates that were observed
in "traditional" Japanese women and in early Japanese migrants.
The adjusted RR of NHs is 65% greater than that of Ws, and that
of migrant Latinas is 16% lower than that of Ws.
Elucidating
the causes of the high rates in NHs is now a major focus of our
efforts.
[09/11/2002; Cancer Epidemiology, Biomarkers and Prevention]
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