|
Résumé :
|
[BDSP. Notice produite par INIST-CNRS R0x8CCkp. Diffusion soumise à autorisation]. We investigated body size and survival by race/ethnicity in 11,351 breast cancer patients diagnosed from 1993 to 2007 with follow-up through 2009 by using data from questionnaires and the California Cancer Registry. We calculated hazard ratios and 95% confidence intervals from multivariable Cox proportional hazard model-estimated associations of body size (body mass index (BMI) (weight (kg)/height (m) 2) and waist-hip ratio (WHR)) with breast cancer-specific and all-cause mortality. Among 2,744 ascertained deaths, 1,445 were related to breast cancer. Being underweight (BMI<18.5) was associated with increased risk of breast cancer mortality compared with being normal weight in non-Latina whites (hazard ratio (HR)=1.91,95% confidence interval (CI) : 1.14,3.20), whereas morbid obesity (BMI>=40) was suggestive of increased risk (HR=1.43,95% CI : 0.84,2.43). In Latinas, only the morbidly obese were at high risk of death (HR=2.26,95% CI : 1.23,4.15). No BMI-mortality associations were apparent in African Americans and Asian Americans. High WHR (quartile 4 vs. quartile 1) was associated with breast cancer mortality in Asian Americans (HR=2.21,95% CI : 1.21,4.03 ; P for trend=0.01), whereas no associations were found in African Americans, Latinas, or non-Latina whites. For all-cause mortality, even stronger BMI and WHR associations were observed. The impact of obesity and body fat distribution on breast cancer patients'risk of death may vary across racial/ethnic groups.
|
