Abstract P5-12-01: The joint effect of modifiable risk factors on risk of invasive breast cancer among Canadian women
Bibliographic record
Abstract
Abstract Background Although several studies have suggested that obesity and other modifiable factors influence breast carcinogenesis, there is limited evidence on the combined effect of these exposures on risk of breast cancer. Thus, to gain further insight into whether modifiable risk factors may operate collectively to alter risk of breast cancer, we assessed the association of a healthy lifestyle index (HLI) score (a combination of diet, physical activity, smoking, alcohol consumption and anthropometry) with risk of invasive breast cancer among women in the Canadian Study of Diet, Lifestyle, and Health (CSDLH). Method We performed a case-cohort study using a cohort of 39,532 female participants in the CSDLH who were recruited between 1995 and 1998. The study included an age-stratified subcohort of 3,027 women and 1,018 incident invasive breast cancer cases. Lifestyle and dietary information was collected at baseline using self-administered questionnaires. We estimated hazard ratios (HR) and 95 % confidence intervals (CI) for the association of the HLI score and the individual HLI components with risk of breast cancer using Cox proportional hazards regression modified for the case cohort design. Results: Every unit increase in the HLI score was associated with a 3% reduced risk of breast cancer (HR: 0.97; 95% CI: 0.95-1.00). When considering quintiles of the HLI score, those in the highest quintile had a 26% lower risk for breast cancer compared to those with HLI score in the lowest quintile (HRq5 vs q1: 0.74; 95% CI: 0.59-0.93). In analyses stratified by menopausal status, there was a similar inverse association between the HLI score and risk of breast cancer among postmenopausal women (HR: 0.97; 95% CI: 0.94-1.00) and a tendency towards an inverse association among premenopausal women (HR per unit increase in the HLI score: 0.98; 95% CI: 0.95-1.01). Among the individual components of the HLI score, there was some suggestion of a reduction in risk of breast cancer in association with a relatively high physical activity level in the overall study population (HRq5 vs. q1: 0.81: 95% CI: 0.63-1.04, p trend: 0.08), but consuming a healthy diet, smoking, having high alcohol consumption and being obese were not associated with altered risk of breast cancer. Conclusion: Our findings indicate that adherence to a healthy lifestyle may be associated with reduced risk of breast cancer. These findings suggest the need to further investigate how modifiable risk factors may act jointly to contribute to the development of breast cancer. Such knowledge may have important implications for the development of interventions designed to promote a healthy lifestyle to aid in the primary prevention of breast cancer. Citation Format: Arthur R, Kirsh V, Kreiger N, Rohan T. The joint effect of modifiable risk factors on risk of invasive breast cancer among Canadian women [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-12-01.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".