A CASE-CONTROL INTERVIEW STUDY OF BREAST-CANCER AMONG JAPANESE A-BOMBSURVIVORS .1. MAIN EFFECTS

Women with breast cancer (cases = 196) and without the disease (contro ls = 566), selected from the Life Span Study sample of A-bomb survivor s and nonexposed residents of Hiroshima and Nagasaki, Japan, and match ed on age at the time of the bombings, city, and estimated radiation d ose, were interviewed about reproductive and medical history. A primar y purpose of the study was to identify strong breast cancer risk facto rs that could be investigated further for possible interactions with r adiation dose. As expected, age at first full-term pregnancy was stron gly and positively related to risk. Inverse associations were observed with number of births and total, cumulative period of breast feeding, even after adjustment for age at first full-term pregnancy. Histories of treatment for dysmenorrhea and for uterine or ovarian surgery were associated positively and significantly with risk at ages 55 or older , a finding that requires additional study. Other factors related to r isk at older ages were the Quetelet index (weight [kg]/height [cm]2) a t age 50, history of thyroid disease, and hypertension. Neither age at menarche nor age at menopause was associated significantly with risk. Subjects appeared to be poorly informed about history of breast cance r or other cancer in themselves or in their close relatives; this find ing suggests that innovative strategies may be required when studying familial cancer patterns in Japanese populations.