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Dietary fat and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition^1,2,3

¹ From the Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (SS,VK, and VP); the IARC-WHO, Lyon, France (PF, SR, NS, SR, and MJ); the Etiological and Preventive Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy (FB); the National Cancer Institute, Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, NIH, DHHS, Bethesda, MD (ACMT); the Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark (ATj and AO); the Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, Denmark (KO and MUJ); INSERM ERI-20, Institut Gustave Roussy, Villejuif, France (FC-C and M-CB-R); CNRS FRE 2939, Institut Gustave Roussy, Villejuif, France (VC); the Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany (RK and JL); the Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany (HB and UN); the Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece (ATr, AN, and PLa); the Department of Clinical and Experimental Medicine, University of Naples, Naples, Italy (SP); the Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Florence, Italy (DP); the Imperial College, London, United Kingdom (PV); the University of Torino, Turin, Italy (PV); the Cancer Registry, MP Arezzo Civic Hospital, Ragusa, Italy (RT); the Institute of Community Medicine, University of Tromsø, Tromsø, Norway (EL, MK, and GS); the Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain (CAG); the Public Health Institute of Navarra, and El Centro de Investigación Biomédica en Red (CIBER) en Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain (EA; the Public Health Division of Gipuzkoa, Donostia-San Sebastian, Spain (PA); the Epidemiology Department, Murcia Health Council, Murcia, and CIBERESP, Murcia, Spain (MJT); the Andalusian School of Public Health and CIBERESP, Granada, Spain (CM-G); the Health Information Unit, Public Health and Health Planning Directorate, Asturias, Spain (JRQ); the Department of Clinical Sciences, Lund University, Malmö, Sweden (GB and BG); the Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden (GH); the Oncology Unit, Department of Radiation Sciences, Umeå University, Umeå, Sweden (PLe); the Center for Nutrition and Health, National Institute of Public Health and the Environment, Bilthoven, Netherlands (HBBdM and FJPvD); the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands (PHMP and CHvG); the Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom (TKK and FLC); the Dunn Human Nutrition Unit, Medical Research Council, Cambridge, United Kingdom (SB and KTK); and the Department of Epidemiology & Public Health, Imperial College, London, United Kingdom (TN and ER)

Background: Epidemiologic studies have produced conflicting results with respect to an association of dietary fat with breast cancer.

Objective: We aimed to investigate the association between fat consumption and breast cancer.

Design: We prospectively investigated fat consumption in a large (n = 319 826), geographically and culturally heterogeneous cohort of European women enrolled in the European Prospective Investigation into Cancer and Nutrition who completed a dietary questionnaire. After a mean of 8.8 y of follow-up, 7119 women developed breast cancer. Cox proportional hazard models, stratified by age and center and adjusted for energy intake and confounders, were used to estimate hazard ratios (HRs) for breast cancer.

Results: An association between high saturated fat intake and greater breast cancer risk was found [HR = 1.13 (95% CI: 1.00, 1.27; P for trend = 0.038) for the highest quintile of saturated fat intake compared with the lowest quintile: 1.02 (1.00, 1.04) for a 20% increase in saturated fat consumption (continuous variable)]. No significant association of breast cancer with total, monounsaturated, or polyunsaturated fat was found, although trends were for a direct association of risk with monounsaturated fat and an inverse association with polyunsaturated fat. In menopausal women, the positive association with saturated fat was confined to nonusers of hormone therapy at baseline [1.21 (0.99, 1.48) for the highest quintile compared with the lowest quintile; P for trend = 0.044; and 1.03 (1.00, 1.07) for a 20% increase in saturated fat as a continuous variable].

Conclusions: Evidence indicates a weak positive association between saturated fat intake and breast cancer risk. This association was more pronounced for postmenopausal women who never used hormone therapy.

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