Incidence Trends of Early-onset Breast Cancer by Lifestyle Risk Factors

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2025 Feb 21

PMID 39984883

Authors

Jasmiina Rantala

Karri Seppa

Johan Eriksson

Sirpa Heinavaara

Tommi Harkanen

Pekka Jousilahti

Paul Knekt

Satu Mannisto

Ossi Rahkonen

Nea Malila

Eetu Makinen

Heidi Ryynanen

Maarit Laaksonen

Sanna Heikkinen

Janne Pitkaniemi

Affiliations

Soon will be listed here.

Abstract

Background: The incidence of early-onset breast cancer (< 50 years) has been increasing over the past decades with the role of modifiable, lifestyle-related risk factors remaining mostly unidentified.

Methods: To investigate the role of key lifestyle factors in the incidence trends of early-onset breast cancer (EOBC), we pooled data from six health studies in Finland in 1972-2015 and combined them with breast cancer data from the Finnish Cancer Registry. The cohort consisted of 56,253 women with 397 EOBCs. The effects of risk factors (hazard ratios) on EOBC and average annual percent change (AAPC) of incidence were estimated using Poisson regression models.

Results: The highest annual increase in age-standardized incidence was observed among women aged 40-49 who were overweight (AAPC 4.0%, 95% CI 0.5-7.7%), currently smoking (AAPC 3.3%, 95% CI 0.1-6.6%) or moderately physically active (AAPC 2.9%, 95% CI 0.3-5.6%).

Conclusions: The increase in early-onset breast cancer incidence was highest among women aged 40-49 who were overweight, currently smoking, or moderately physically active, while no change by risk factors was found in women under 40 years of age. Our findings suggest a different type of cancer process in young adults and highlight the importance of lifestyle risk factors in the incidence of EOBC.

References

Paffenbarger Jr R, Kampert J, Chang H . Characteristics that predict risk of breast cancer before and after the menopause. Am J Epidemiol. 1980; 112(2):258-68. DOI: 10.1093/oxfordjournals.aje.a112992. View

Eliassen A, Colditz G, Rosner B, Willett W, Hankinson S . Adult weight change and risk of postmenopausal breast cancer. JAMA. 2006; 296(2):193-201. DOI: 10.1001/jama.296.2.193. View

. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019; 394(10204):1159-1168. PMC: 6891893. DOI: 10.1016/S0140-6736(19)31709-X. View

Althuis M, Brogan D, Coates R, Daling J, Gammon M, Malone K . Hormonal content and potency of oral contraceptives and breast cancer risk among young women. Br J Cancer. 2003; 88(1):50-7. PMC: 2376784. DOI: 10.1038/sj.bjc.6600691. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Macacu A, Autier P, Boniol M, Boyle P . Active and passive smoking and risk of breast cancer: a meta-analysis. Breast Cancer Res Treat. 2015; 154(2):213-24. DOI: 10.1007/s10549-015-3628-4. View

Soini T, Hurskainen R, Grenman S, Maenpaa J, Paavonen J, Pukkala E . Cancer risk in women using the levonorgestrel-releasing intrauterine system in Finland. Obstet Gynecol. 2014; 124(2 Pt 1):292-299. DOI: 10.1097/AOG.0000000000000356. View

Heer E, Harper A, Escandor N, Sung H, McCormack V, Fidler-Benaoudia M . Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. Lancet Glob Health. 2020; 8(8):e1027-e1037. DOI: 10.1016/S2214-109X(20)30215-1. View

Northcote J, Livingston M . Accuracy of self-reported drinking: observational verification of 'last occasion' drink estimates of young adults. Alcohol Alcohol. 2011; 46(6):709-13. DOI: 10.1093/alcalc/agr138. View

10.

Nelson H, Zakher B, Cantor A, Fu R, Griffin J, OMeara E . Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis. Ann Intern Med. 2012; 156(9):635-48. PMC: 3561467. DOI: 10.7326/0003-4819-156-9-201205010-00006. View

11.

. The alpha-tocopherol, beta-carotene lung cancer prevention study: design, methods, participant characteristics, and compliance. The ATBC Cancer Prevention Study Group. Ann Epidemiol. 1994; 4(1):1-10. DOI: 10.1016/1047-2797(94)90036-1. View

12.

Knekt P, Rissanen H, Jarvinen R, Heliovaara M . Cohort Profile: The Finnish Mobile Clinic Health Surveys FMC, FMCF and MFS. Int J Epidemiol. 2017; 46(6):1760-1761i. DOI: 10.1093/ije/dyx092. View

13.

. Pharmaceuticals. IARC Monogr Eval Carcinog Risks Hum. 2012; 100(Pt A):1-401. PMC: 4781347. View

14.

Hussain S, Altieri A, Sundquist J, Hemminki K . Influence of education level on breast cancer risk and survival in Sweden between 1990 and 2004. Int J Cancer. 2007; 122(1):165-9. DOI: 10.1002/ijc.23007. View

15.

Pakarinen M, Raitanen J, Kaaja R, Luoto R . Secular trend in the menopausal age in Finland 1997-2007 and correlation with socioeconomic, reproductive and lifestyle factors. Maturitas. 2010; 66(4):417-22. DOI: 10.1016/j.maturitas.2010.04.005. View

16.

Berkey C, Frazier A, Gardner J, Colditz G . Adolescence and breast carcinoma risk. Cancer. 1999; 85(11):2400-9. DOI: 10.1002/(sici)1097-0142(19990601)85:11<2400::aid-cncr15>3.0.co;2-o. View

17.

Baer H, Tworoger S, Hankinson S, Willett W . Body fatness at young ages and risk of breast cancer throughout life. Am J Epidemiol. 2010; 171(11):1183-94. PMC: 2915489. DOI: 10.1093/aje/kwq045. View

18.

Schoemaker M, Nichols H, Wright L, Brook M, Jones M, OBrien K . Association of Body Mass Index and Age With Subsequent Breast Cancer Risk in Premenopausal Women. JAMA Oncol. 2018; 4(11):e181771. PMC: 6248078. DOI: 10.1001/jamaoncol.2018.1771. View

19.

Jousilahti P, Helakorpi S . Prevalence of exposure to environmental tobacco smoke at work and at home--15-year trends in Finland. Scand J Work Environ Health. 2002; 28 Suppl 2:16-20. View

20.

Kumle M, Weiderpass E, Braaten T, Persson I, Adami H, Lund E . Use of oral contraceptives and breast cancer risk: The Norwegian-Swedish Women's Lifestyle and Health Cohort Study. Cancer Epidemiol Biomarkers Prev. 2002; 11(11):1375-81. View