title: Urinary Cadmium and Risk of Invasive Breast Cancer in the Women's Health Initiative.
abstract: Cadmium is a widespread heavy metal pollutant that may act as an exogenous estrogenic hormone. Environmental cadmium exposure has been associated with risk of breast cancer in retrospective studies. We prospectively assessed the relationship between cadmium exposure, evaluated by creatinine-normalized urinary cadmium concentration, and invasive breast cancer among 12,701 postmenopausal women aged ≥50 years in a Women's Health Initiative study of bone mineral density. After a median of 13.2 years of follow-up (1993-2010), 508 cases of invasive breast cancer and 1,050 comparison women were identified for a case-cohort analysis. Multivariable Cox regression was used to calculate hazard ratios and 95% confidence intervals. Risk of breast cancer was not associated with urinary cadmium parameterized either in quartiles (comparing highest quartile with lowest, hazard ratio = 0.80, 95% confidence interval: 0.56, 1.14; P for trend = 0.20) or as a log-transformed continuous variable (per 2-fold higher urinary cadmium concentration, hazard ratio = 0.94, 95% confidence interval: 0.86, 1.03). We did not observe an association between urinary cadmium and breast cancer risk in any subgroup examined, including never smokers and women with body mass index (weight (kg)/height (m)(2)) less than 25. Results were consistent in both estrogen receptor-positive and estrogen receptor-negative tumors. Our results do not support the hypothesis that environmental cadmium exposure is associated with risk of postmenopausal breast cancer.
authors.forename: Scott V
authors.initials: SV
authors.lastname: Adams
authors.forename: Martin M
authors.initials: MM
authors.lastname: Shafer
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Bonner
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Jaymie R
authors.initials: JR
authors.lastname: Meliker
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Polly A
authors.initials: PA
authors.lastname: Newcomb
mesh_terms: D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000652:urine; D002104:Cadmium / Q000652:urine*; D004781:Environmental Exposure / Q000032:analysis*; D004785:Environmental Pollutants / Q000032:analysis; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D016387:Women's Health
chemical_list: D004785:Environmental Pollutants; D002104:Cadmium
keywords: breast cancer; cadmium; case-cohort studies; environmental carcinogens; postmenopause; women's health