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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2012

Open Access 01-12-2012 | Epidemiology

Collaborative modeling of the impact of obesity on race-specific breast cancer incidence and mortality

Authors: Yaojen Chang, Clyde B. Schechter, Nicolien T. van Ravesteyn, Aimee M. Near, Eveline A. M. Heijnsdijk, Lucile Adams-Campbell, David Levy, Harry J. de Koning, Jeanne S. Mandelblatt

Published in: Breast Cancer Research and Treatment | Issue 3/2012

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Abstract

Obesity affects multiple points along the breast cancer control continuum from prevention to screening and treatment, often in opposing directions. Obesity is also more prevalent in Blacks than Whites at most ages so it might contribute to observed racial disparities in mortality. We use two established simulation models from the Cancer Intervention and Surveillance Modeling Network (CISNET) to evaluate the impact of obesity on race-specific breast cancer outcomes. The models use common national data to inform parameters for the multiple US birth cohorts of Black and White women, including age- and race-specific incidence, competing mortality, mammography characteristics, and treatment effectiveness. Parameters are modified by obesity (BMI of ≥30 kg/m2) in conjunction with its age-, race-, cohort- and time-period-specific prevalence. We measure age-standardized breast cancer incidence and mortality and cases and deaths attributable to obesity. Obesity is more prevalent among Blacks than Whites until age 74; after age 74 it is more prevalent in Whites. The models estimate that the fraction of the US breast cancer cases attributable to obesity is 3.9–4.5 % (range across models) for Whites and 2.5–3.6 % for Blacks. Given the protective effects of obesity on risk among women <50 years, elimination of obesity in this age group could increase cases for both the races, but decrease cases for women ≥50 years. Overall, obesity accounts for 4.4–9.2 % and 3.1–8.4 % of the total number of breast cancer deaths in Whites and Blacks, respectively, across models. However, variations in obesity prevalence have no net effect on race disparities in breast cancer mortality because of the opposing effects of age on risk and patterns of age- and race-specific prevalence. Despite its modest impact on breast cancer control and race disparities, obesity remains one of the few known modifiable risks for cancer and other diseases, underlining its relevance as a public health target.
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Metadata
Title
Collaborative modeling of the impact of obesity on race-specific breast cancer incidence and mortality
Authors
Yaojen Chang
Clyde B. Schechter
Nicolien T. van Ravesteyn
Aimee M. Near
Eveline A. M. Heijnsdijk
Lucile Adams-Campbell
David Levy
Harry J. de Koning
Jeanne S. Mandelblatt
Publication date
01-12-2012
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2012
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-012-2274-3

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