Obesity, mortality, and life years lost associated with breast cancer in nonsmoking US Women, National Health Interview Survey, 1997-2000.
BACKGROUND
The relationship between obesity and breast cancer has been extensively investigated. However, how obesity and breast cancer interplay to affect mortality and life expectancy of women in the United States has not been well studied.


METHODS
We used data from the National Health Interview Survey, 1997-2000. Our sample included nonsmoking, nonpregnant women who reported a body mass index of at least 18.5 kg/m(2) and no cancer other than breast cancer at the time of the survey. A survival model with Gamma frailty and Gompertz baseline was used to estimate relative risks of total mortality and project life years lost associated with breast cancer by obesity status and age.


RESULTS
Breast cancer increased risk of mortality depending on degree of obesity and decreased life years by 1 to 12 years depending on race, age, and obesity status. Relative risks for death increased with degree of obesity. Obese women under age 50 across all racial groups were predicted to lose the most life years; racial groups other than whites and blacks lost the most life years (11.9 y), followed by whites (9.8 y) and blacks (9.2 y).


CONCLUSIONS
The number of life years lost associated with breast cancer was more marked for more obese than for less obese women and for women under age 50 and women aged 70 or older than for women aged 50 through 69. Public health initiatives should put more emphasis on the prevention and control of obesity for these target populations.
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8100, St Louis, MO 63110. E-mail: changsh@wudosis.wustl.edu.
Su-Hsin
SH
Chang
Lisa M
LM
Pollack
Graham A
GA
Colditz
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000401:mortality*; D003430:Cross-Sectional Studies; D015444:Exercise / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008017:Life Expectancy; D008875:Middle Aged; D009313:National Health Programs; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology / Q000401:mortality; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States; D044465:White People / Q000706:statistics & numerical data