Salads and breast cancer.

Breast cancer risk: Data about the relation with breast cancer risk was provided by a pooled analysis of 8 cohorts (15). No association was found.

Breast cancer mortality: Data about the relation with breast cancer mortality was provided by one cohort (8). No association was found.

Conclusion: No associations were found. No evidence was found for an association between salads and breast cancer.

Author	Cohort name	Subjects	Years of follow-up	Cases	End point	Consumption of	Relative Risk (RR)	Adjustments
15) Smith-Warner SA. (2001)	Pooled Analysis of 8 Cohort Studies.	331,596	5-10	6,354?	Invasive breast cancer risk	Lettuce, salad	INCLUSION CRITERIA: 1) A published prospective study with at least 200 incident breast cancer cases. 2) Assessment of usual dietary intake. 3) A validation study of the diet assessment method or a closely related instrument. INCLUDED STUDIES (Follow-up years/No. of breast cancer cases): The Adventist Health Study (1976-1982/160). Mills PK, Beeson WL, Phillips RL. Dietary habits and breast cancer incidence among Seventh-day Adventists. Cancer. 1989 Aug 1;64(3):582-90. Abstract The Canadian National Breast Screening Study (1982-1987/419). Rohan TE, Howe GR, Friedenreich CM, Jain M, Miller AB. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control. 1993 Jan;4(1):29-37. Abstract The Iowa Women's Health Study (1986-1995/1130). Kushi LH, Fee RM, Sellers TA, Zheng W, Folsom AR. Intake of vitamins A, C, and E and postmenopausal breast cancer. The Iowa Women's Health Study. Am J Epidemiol. 1996 Jul 15;144(2):165-74. Full text The Netherlands Cohort Study (1986-1992/937). Verhoeven DT, Assen N, Goldbohm RA, Dorant E, van 't Veer P, Sturmans F. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer. 1997;75(1):149-55. Abstract The New York State Cohort (1980-1987/367). Graham S, Zielezny M, Marshall J, Priore R, Freudenheim J, Brasure J. Diet in the epidemiology of postmenopausal breast cancer in the New York State Cohort. Am J Epidemiol. 1992 Dec 1;136(11):1327-37. Abstract The New York University Women's Health Study (1985-1994/386). Toniolo P, Riboli E, Shore RE, Pasternacks BS. Consumption of meat, animal products, protein, and fat and risk of breast cancer: a prospective cohort study in New York. Epidemiology. 1994 Jul;5(4):391-7. Abstract The Nurses' Health Study B (1986-1996/1638). Zhang S, Hunter DJ, Forman MR, Rosner BA, Speizer FE, Colditz GA. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst. 1999 Mar 17;91(6):547-56. Full text The Sweden Mammography Cohort (1987-1997/1318). Wolk A, Bergstrom R, Hunter D, Willet W, Ljung H, Holmberg L. A prospective study of association of monounsaturated fat and other types of fat with risk of breast cancer. Arch Intern Med. 1998 Jan 12;158(1):41-5. Full text RELATIVE RISK: No significant association: RR = 0.93 (0.84-1.02) per 100 g/day increment. P for heterogeneity in results across studies = 0.83. Menopausal status at follow-up did not modify the associations (no data shown).	Age at menarche, interaction between parity and age at birth of first child, oral contraceptive use (ever/never), history of benign breast disease, menopausal status at follow-up, postmenopausal hormone use, family history of breast cancer, smoking status (ever/never), education, BMI, BMI-menopausal status interaction, height, alcohol intake, and energy intake.
8) Appleby PN. (2002)	The Health Food Shoppers Study.	10,741 subjects, aged 16-89 (4,325 men, 6,416 women. 8,675 non-smokers). (UK)	1973-79 to 1997	90 (79 non-smokers)?	Female breast cancer mortality	Raw vegetable salads (not defined)	RR = 1.29 (0.81-2.07; No P-value) for daily consumption vs less frequent consumption.	Age at recruitment, sex, smoking, and each other food (fresh fruit, wholemeal bread, nuts/dried fruit, raw vegetable salads, and bran cereals).
8) Key TJ. (1996)	The Health Food Shoppers Study.	10.771 (4.336 men and 6.435 women) aged > or = 16, recruited through health food shops, vegeterian societies, and magazines. (UK)	16.8 (1973-79 to 1995)	0 men, 65? women	breast cancer mortality	raw salad (not defined)	RR = 1.15 (0.70-1.87; No P-value) for consumption at least daily vs < daily.	age, sex, and smoking

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

15) Smith-Warner SA. (2001)

Pooled Analysis of 8 Cohort Studies.

331,596

5-10

6,354?

Invasive breast cancer risk

Lettuce, salad

INCLUSION CRITERIA:

1) A published prospective study with at least 200 incident breast cancer cases.
2) Assessment of usual dietary intake.
3) A validation study of the diet assessment method or a closely related instrument.

INCLUDED STUDIES (Follow-up years/No. of breast cancer cases):

The Adventist Health Study (1976-1982/160).
Mills PK, Beeson WL, Phillips RL. Dietary habits and breast cancer incidence among Seventh-day Adventists. Cancer. 1989 Aug 1;64(3):582-90. Abstract
The Canadian National Breast Screening Study (1982-1987/419).
Rohan TE, Howe GR, Friedenreich CM, Jain M, Miller AB. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control. 1993 Jan;4(1):29-37. Abstract
The Iowa Women's Health Study (1986-1995/1130).
Kushi LH, Fee RM, Sellers TA, Zheng W, Folsom AR. Intake of vitamins A, C, and E and postmenopausal breast cancer. The Iowa Women's Health Study. Am J Epidemiol. 1996 Jul 15;144(2):165-74. Full text
The Netherlands Cohort Study (1986-1992/937).
Verhoeven DT, Assen N, Goldbohm RA, Dorant E, van 't Veer P, Sturmans F. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer. 1997;75(1):149-55. Abstract
The New York State Cohort (1980-1987/367).
Graham S, Zielezny M, Marshall J, Priore R, Freudenheim J, Brasure J. Diet in the epidemiology of postmenopausal breast cancer in the New York State Cohort. Am J Epidemiol. 1992 Dec 1;136(11):1327-37. Abstract
The New York University Women's Health Study (1985-1994/386).
Toniolo P, Riboli E, Shore RE, Pasternacks BS. Consumption of meat, animal products, protein, and fat and risk of breast cancer: a prospective cohort study in New York. Epidemiology. 1994 Jul;5(4):391-7. Abstract
The Nurses' Health Study B (1986-1996/1638).
Zhang S, Hunter DJ, Forman MR, Rosner BA, Speizer FE, Colditz GA. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst. 1999 Mar 17;91(6):547-56. Full text
The Sweden Mammography Cohort (1987-1997/1318).
Wolk A, Bergstrom R, Hunter D, Willet W, Ljung H, Holmberg L. A prospective study of association of monounsaturated fat and other types of fat with risk of breast cancer. Arch Intern Med. 1998 Jan 12;158(1):41-5. Full text

RELATIVE RISK:

No significant association: RR = 0.93 (0.84-1.02) per 100 g/day increment.

P for heterogeneity in results across studies = 0.83.

Menopausal status at follow-up did not modify the associations (no data shown).

Age at menarche, interaction between parity and age at birth of first child, oral contraceptive use (ever/never), history of benign breast disease, menopausal status at follow-up, postmenopausal hormone use, family history of breast cancer, smoking status (ever/never), education, BMI, BMI-menopausal status interaction, height, alcohol intake, and energy intake.

8) Appleby PN. (2002)

The Health Food Shoppers Study.

10,741 subjects, aged 16-89 (4,325 men, 6,416 women. 8,675 non-smokers).
(UK)

1973-79 to 1997

90 (79 non-smokers)?

Female breast cancer mortality

Raw vegetable salads (not defined)

RR = 1.29 (0.81-2.07; No P-value) for daily consumption vs less frequent consumption.

Age at recruitment, sex, smoking, and each other food (fresh fruit, wholemeal bread, nuts/dried fruit, raw vegetable salads, and bran cereals).

8) Key TJ. (1996)

The Health Food Shoppers Study.

10.771 (4.336 men and 6.435 women) aged > or = 16, recruited through health food shops, vegeterian societies, and magazines.
(UK)

16.8
(1973-79 to 1995)

0 men, 65? women

breast cancer mortality

raw salad (not defined)

RR = 1.15 (0.70-1.87; No P-value) for consumption at least daily vs < daily.

age, sex, and smoking

Cancer & Diet. A systematic review.

Literature review.

Relating various aspects of our diet
to breast cancer risk & mortality.

Salads and breast cancer.

Cancer & Diet. A systematic review.

Literature review.

Relating various aspects of our dietto breast cancer risk & mortality.

Salads and breast cancer.

Relating various aspects of our diet
to breast cancer risk & mortality.