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Dietary patterns and the risk of female breast cancer among participants of the Canadian National Enhanced Cancer Surveillance System

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Abstract

OBJECTIVES: The role of diet in the etiology of breast cancer is not well understood despite extensive research. In the majority of this work, a single nutrientbased approach has been used which does not take into account combinations of food that are consumed. An alternative to the single nutrient approach is to identify patterns in the dietary intake information and relate these patterns to disease incidence. This investigation characterized dietary patterns among participants of a Canadian case-control study and related these dietary patterns to the incidence of breast cancer.

METHODS: Dietary and other risk factor data from cases and controls of the Canadian National Enhanced Cancer Surveillance System were collected using self-administered questionnaires. Principal component factor analysis was used to classify individuals based on their dietary patterns. The relationship between these dietary patterns and breast cancer was evaluated using logistic regression. The derived odds ratios and their 95% confidence limits were adjusted for several factors, such as smoking, alcohol intake, environmental tobacco smoke exposure and obesity.

RESULTS: In the 2,009 cases and 2,086 controls, three dietary patterns were identified: western, healthy and vitamin. The highest quartile of the “healthy” dietary pattern was related to a 22% decrease in breast cancer risk (95% CI: 0.61–1.00), relative to the lowest quartile. The fourth quartile of the “vitamin” dietary pattern was associated with a 14% decrease in breast cancer risk (95% CI: 0.70–1.04) relative to the first. No statistically significant associations between the “western” dietary pattern and breast cancer were found. These associations were neither confounded nor modified by menopausal status.

CONCLUSION: Our analyses reveal that individual dietary items tend to cluster together in such a way that there are three distinct dietary patterns in this sample of Canadian women. Some of these patterns, in turn, were associated with the risk of breast cancer.

Résumé

OBJECTIFS: On connaît mal le rôle du régime dans l’étiologie du cancer du sein malgré le grand nombre d’études sur le sujet. Dans la majorité de ces études, on utilise une démarche axée sur un nutriment particulier, ce qui ne tient pas compte des combinaisons d’aliments qui sont consommées. Une option de rechange à la démarche axée sur un seul nutriment consiste à repérer les grandes tendances de l’information sur les apports alimentaires et à les lier aux structures d’incidence des maladies. Notre enquête a caractérisé les schémas alimentaires des participantes d’une étude castémoins canadienne et les ont liés à l’incidence du cancer du sein.

MÉTHODE: Des données sur le régime alimentaire et d’autres facteurs de risque provenant de cas et de témoins du Système national de surveillance accrue du cancer ont été recueillies à l’aide de questionnaires à remplir soimême. Nous avons utilisé l’analyse factorielle en composantes principales pour classifier les répondantes d’après leurs habitudes alimentaires. Nous avons évalué la relation entre ces schémas alimentaires et le cancer du sein au moyen d’analyses de régression logistique. Les rapports de cotes dérivés et leurs intervalles de confiance de 95 % ont été ajustés selon plusieurs facteurs, dont le tabagisme, la consommation d’alcool, l’exposition à la fumée secondaire du tabac et l’obésité.

RÉSULTATS: Chez les 2 009 cas et les 2 086 témoins, nous avons défini trois schémas alimentaires: occidental, sain et vitaminé. Le quartile supérieur du schéma alimentaire «sain» était lié à une réduction de 22 % du risque de cancer du sein (IC de 95 %: 0,61–1,00), comparativement au quartile inférieur. Le quatrième quartile du schéma alimentaire «vitaminé» était associé à une réduction de 14 % du risque de cancer du sein (IC de 95 %: 0,70–1,04) comparativement au premier. Nous n’avons trouvé aucune association significative entre le schéma alimentaire «occidental» et le cancer du sein. Ces associations n’étaient ni faussées, ni modifiées par le statut ménopausique.

CONCLUSION: Nos analyses révèlent que les choix alimentaires individuels ont tendance à former des grappes qui dessinent trois schémas alimentaires distincts dans cet échantillon de Canadiennes. Certains de ces schémas étaient à leur tour associés au risque de cancer du sein.

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Authors and Affiliations

  1. Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada

    Keith Van Ryswyk BSc & Paul J. Villeneuve PhD

  2. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada

    Kenneth C. Johnson PhD

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  1. Keith Van Ryswyk BSc
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  2. Paul J. Villeneuve PhD
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The Canadian Cancer Registries Epidemiology Research Group

Corresponding author

Correspondence to Paul J. Villeneuve PhD.

Additional information

The Canadian Cancer Registries Epidemiology Research Group comprised a principal investigator from some of the provincial cancer registries involved in the National Enhanced Cancer Surveillance System: Farah McCrate, Eastern Health, Newfoundland; Ron Dewar, Nova Scotia Cancer Registry; Nancy Kreiger, Cancer Care Ontario; Donna Turner, Cancer Care Manitoba

Acknowledgements: The National Enhanced Cancer Surveillance System was conducted with funding and collaborations among Health Canada, the Public Health Agency of Canada and the provincial cancer registries.

Conflict of Interest: None to declare

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Van Ryswyk, K., Villeneuve, P.J., Johnson, K.C. et al. Dietary patterns and the risk of female breast cancer among participants of the Canadian National Enhanced Cancer Surveillance System. Can J Public Health 107, e49–e55 (2016). https://doi.org/10.17269/cjph.107.5230

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