Annals of Oncology Advance Access originally published online on October 7, 2008
Annals of Oncology 2009 20(3):581-590; doi:10.1093/annonc/mdn594
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epidemiology |
Clustering dietary habits and the risk of breast and ovarian cancers
1 Department of Medicine and Surgery, "G. A. Maccacaro" Institute of Medical Statistics and Biometry of the University of Milan
2 Department of Epidemiology, The Mario Negri Institute for Pharmacological Research
3 The National Institute of Tumors IRCSS Foundation, Milan, Italy
4 The International Agency for Research on Cancer (IARC), Lyon, France
5 Department of Epidemiology and Biostatistics, Aviano Cancer Center, Aviano
6 Department of Medicine, Surgery and Dentistry, University of Milan, Milan, Italy
* Correspondence to: Dr V. Edefonti, Istituto di Statistica Medica e Biometria ‘Giulio A. Maccacaro’, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, via Venezian 1, 20133 Milan, Italy. Tel: +390250320873; Fax: +390250320866; E-mail: valeria.edefonti{at}unimi.it
Background: Limited information is available on the relationship between dietary patterns and breast and ovarian cancers.
Patients and methods: Cases were 2569 breast cancers and 1031 ovarian cancers hospitalized in four Italian areas from 1991 to 1999. Controls were 3413 women in hospital for acute non-neoplastic diseases. Dietary habits were investigated through a validated food-frequency questionnaire. Dietary patterns were obtained from a K-means clustering on factor scores from factor analysis. Odds ratios (ORs) for both cancers were estimated using unconditional multiple logistic regression models on clusters of patients. Floating absolute risk method was used for reporting 95% floating confidence intervals (FCIs).
Results: We identified five groups of subjects. The G3 cluster, including subjects with the lowest intakes of any food group, was used as reference. The G5 cluster, including subjects mainly consuming bread and pasta, was unfavorable for both cancers (OR = 1.23, 95% FCI = 1.08–1.38 for breast cancer, OR = 1.21, 95% FCI = 1.03–1.42 for ovarian cancer). The G1 group, including subjects mainly consuming fruits and vegetables, was protective against ovarian cancer (OR = 0.81, 95% FCI = 0.67–0.98).
Conclusions: A diet mainly based on bread and pasta is unfavorable for breast and ovarian cancers; a diet rich in fruits and vegetables may be associated with a reduced risk of ovarian cancer.
Key words: breast cancer, clustering, cluster analysis, dietary patterns, factor analysis, ovarian cancer
Received for publication February 12, 2008. Revision received July 21, 2008. Accepted for publication July 25, 2008.
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