The association of infectious mononucleosis and breast cancer in The Health of Women (HOW) Study®
Bibliographic record
Abstract
Abstract Background The link between Epstein-Barr Virus (EBV) and breast cancer (BC) remains unclear. Infectious mononucleosis (IM) is a clinical manifestation of delayed onset of EBV infection in early adulthood. We utilized the Health of Women (HOW) Study® to understand the association between IM and BC risk. Subjects and methods The HOW Study® was a web-based survey of BC risk factors with >40,000 participants who answered seven modules between 2012 and 2015; 3,654 women had IM between the ages of 10 and 22 years (16.8%) and 17,026 never developed IM (78.5%). Of these 20,680 women, 1,997 (9.7%) had Stages I-III BC and 13,515 (65.4%) were cancer-free. Multivariable binary logistic regression ascertained the association between IM and BC risk by controlling for ethnicity, family history, age at menarche, oral contraceptive use, tobacco use, birthplace, parity, age at first birth, body mass index, and breast biopsy. Secondary analyses stratified cancer cases into those who had BC at <50 or ≥50 years old and by estrogen receptor (ER) subtype. Results Participants were mostly white, middle-aged women born in the United States or Canada. Women who had IM were less likely to develop BC than those who did not develop IM (adjusted odds ratio (OR)=0.83, 95% confidence interval (CI) 0.71-0.96). Findings were similar when stratifying women into <50 or ≥50 years old at BC diagnosis (<50 years old, adjusted OR=0.82, 95% CI 0.67-0.998; ≥50 years old, adjusted OR=0.83, 95% CI 0.69-1.00). Women who had IM were less likely to develop ER positive BC (adjusted OR=0.84, 95% CI 0.71-0.997); there was no association between IM and ER negative BC (adjusted OR=0.88, 95% CI 0.65-1.16). Conclusion In the HOW Study®, women diagnosed with IM between the ages of 10 and 22 had lower breast cancer risk compared to women who never developed IM.
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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) | 0.000 | 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 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".