title: The proportion of postmenopausal breast cancer cases in the Netherlands attributable to lifestyle-related risk factors.
abstract: We aimed to estimate the proportion of Dutch postmenopausal breast cancer cases in 2010 that is attributable to lifestyle-related risk factors. We calculated population attributable fractions (PAFs) of potentially modifiable risk factors for postmenopausal breast cancer in Dutch women aged >50 in 2010. First, age-specific PAFs were calculated for each risk factor, based on their relative risks for postmenopausal breast cancer (from meta-analyses) and age-specific prevalence in the population (from national surveys) around the year 2000, assuming a latency period of 10 years. To obtain the overall PAF, age-specific PAFs were summed in a weighted manner, using the age-specific breast cancer incidence rates (2010) as weights. 95 % confidence intervals for PAF estimates were derived by Monte Carlo simulations. Of Dutch women >40 years, in 2000, 51 % were overweight/obese, 55 % physically inactive (<5 days/week 30 min activity), 75 % regularly consumed alcohol, 42 % ever smoked cigarettes and 79 % had a low-fibre intake (<3.4 g/1000 kJ/day). These factors combined had a PAF of 25.7 % (95 % CI 24.2-27.2), corresponding to 2,665 Dutch postmenopausal breast cancer cases in 2010. PAFs were 8.8 % (95 % CI 6.3-11.3) for overweight/obesity, 6.6 % (95 % CI 5.2-8.0) for alcohol consumption, 5.5 % (95 % CI 4.0-7.0) for physical inactivity, 4.6 % (95 % CI 3.3-6.0) for smoking and 3.2 % (95 % CI 1.6-4.8) for low-fibre intake. Our findings imply that modifiable risk factors are jointly responsible for approximately one out of four Dutch postmenopausal breast cancer cases. This suggests that incidence rates can be lowered substantially by living a more healthy lifestyle.
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, Netherlands. w.vangemert@umcutrecht.nl.
authors.forename: W A
authors.initials: WA
authors.lastname: van Gemert
authors.affiliation: Netherlands Organisation for Applied Scientific Research, TNO, P.O. Box 2215, 2301 CE, Leiden, Netherlands.
authors.forename: C I
authors.initials: CI
authors.lastname: Lanting
authors.affiliation: Netherlands Organisation for Applied Scientific Research, TNO, PO Box 360, 3700 AJ, Zeist, Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Goldbohm
authors.affiliation: Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: van den Brandt
authors.affiliation: The Dutch Cancer Society (KWF), P.O. Box 75508, 1070 AM, Amsterdam, Netherlands.
authors.forename: H G
authors.initials: HG
authors.lastname: Grooters
authors.affiliation: Division of Human Nutrition, Wageningen University, P.O. Box 9101, 6700 HB, Wageningen, Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Kampman
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.
authors.forename: L A L M
authors.initials: LALM
authors.lastname: Kiemeney
authors.affiliation: Department of Epidemiology, the Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, Netherlands.
authors.forename: F E
authors.initials: FE
authors.lastname: van Leeuwen
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Monninkhof
authors.affiliation: Department of Public Health, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, Netherlands.|Comprehensive Cancer Centre South, PO Box 231, 5600 AE, Eindhoven, Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: de Vries
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, Netherlands.
authors.forename: P H
authors.initials: PH
authors.lastname: Peeters
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, Netherlands.
authors.forename: S G
authors.initials: SG
authors.lastname: Elias
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D017698:Postmenopause; D015995:Prevalence; D012306:Risk