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. 2020 Nov 23;20(1):1138.
doi: 10.1186/s12885-020-07648-w.

The impact of lifecourse socio-economic position and individual social mobility on breast cancer risk

Eloïse Berger  1 , Noële Maitre  2   3 , Francesca Romana Mancini  2   3 , Laura Baglietto  2   3   4 , Vittorio Perduca  2   3   5 , Hélène Colineaux  6   7 , Sabina Sieri  8 , Salvatore Panico  9 , Carlotta Sacerdote  10 , Rosario Tumino  11 , Paolo Vineis  12   13 , Marie-Christine Boutron-Ruault  2   3 , Gianluca Severi  2   3   14 , Raphaële Castagné  6 , Cyrille Delpierre  6
Affiliations

The impact of lifecourse socio-economic position and individual social mobility on breast cancer risk

Eloïse Berger et al. BMC Cancer. .

Abstract

Background: Women with an advantaged socioeconomic position (SEP) have a higher risk of developing breast cancer (BC). The reasons for this association do not seem to be limited to reproductive factors and remain to be understood. We aimed to investigate the impact of lifecourse SEP from childhood and social mobility on the risk of BC considering a broad set of potential mediators.

Methods: We used a discovery-replication strategy in two European prospective cohorts, E3N (N = 83,436) and EPIC-Italy (N = 20,530). In E3N, 7877 women were diagnosed with BC during a median 24.4 years of follow-up, while in EPIC-Italy, 893 BC cases were diagnosed within 15.1 years. Hazard ratios (HR) were estimated using Cox proportional hazard models on imputed data.

Results: In E3N, women with higher education had a higher risk of BC (HR [95%CI] = 1.21 [1.12, 1.30]). This association was attenuated by adjusting for reproductive factors, in particular age at first childbirth (HR[95%CI] = 1.13 [1.04, 1.22]). Health behaviours, anthropometric variables, and BC screening had a weaker effect on the association. Women who remained in a stable advantaged SEP had a higher risk of BC (HR [95%CI] = 1.24 [1.07; 1.43]) attenuated after adjustment for potential mediators (HR [95%CI] = 1.13 [0.98; 1.31]). These results were replicated in EPIC-Italy.

Conclusions: These results confirm the important role of reproductive factors in the social gradient in BC risk, which does not appear to be fully explained by the large set of potential mediators, including cancer screening, suggesting that further research is needed to identify additional mechanisms.

Keywords: Breast cancer; Lifecourse socio-economic position; Prospective cohorts; Social mobility.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Fig. 1
Fig. 1
Overview of selected data among both cohorts and proportion of available data from the study population % represents proportion of women with available data for each covariate in the population before imputation; * Sub-dataset including women with all available data among selected covariates in each cohort
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References

    1. Hvidtfeldt UA. Mechanisms underlying social inequality in post-menopausal breast cancer. Dan Med J. 2014;61(10):B4922. - PubMed
    1. Lundqvist A, Andersson E, Ahlberg I, Nilbert M, Gerdtham U. Socioeconomic inequalities in breast cancer incidence and mortality in Europe-a systematic review and meta-analysis. Eur J Pub Health. 2016;26(5):804–813. doi: 10.1093/eurpub/ckw070. - DOI - PMC - PubMed
    1. dos Santos Silva I, Beral V. Socioeconomic differences in reproductive behaviour. IARC Sci Publ. 1997;(138):285–308. - PubMed
    1. Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grötvedt L, Helmert U, et al. Persistent variations in average height between countries and between socio-economic groups: an overview of 10 European countries. Ann Hum Biol. 2000;27(4):407–421. doi: 10.1080/03014460050044883. - DOI - PubMed
    1. Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr. 2015;15:129. doi: 10.1186/s12887-015-0443-3. - DOI - PMC - PubMed