Epidemiologic risk factors for breast cancer related to menopausal status in Indonesia

Vol 4, No

j, July

- September 1995

Menopausal

Status

169

Epidemiologic Risk Factors for Breast Cancer Related to Menopausal Status
in Indonesia

i,""iï:ï.'JIj|,:_l;*,1,:Xôffi],",",',,îffilïii",'#îil:ffJi:ïi.',',';,ffïllffir:'i"::ï::h?rîiË:''
Esti Soetrisno+, Eudang Sri Roostini*
Abstrak
Untuk meneliti faktor risiko kanker payudara yang berkairan dengan status menopause, dilakukan
penelitian
sakit di Indonesia' Pada 300 kasus dan 600 kontrol yang berpasantan menurut umur dan keadaan

kasus kontrol pada rumah
sosial ekonomi dilalatkan
wareancard' Kasus dan kontrol dikelompokkan berdasarkan slatus menopausenya dan dianalisis
terpisah. Diperoleh lemuan-temuan
bermakna berikut ini. Di antara penderita kanker payudara pra menopauie ditemukan peningkatan
risiko pada yang mengalami trauma
payudara (RR:2,62; 95vo IK: 1,09-6,31), menggunakan kontrasepsi oral (4,96; 1,51-rc:24,
mengkinsumsi susu (1,g1; 1,01-3,35
konsumsi
minggu)'
penuruna
iap hari)'
Di antara
15 tahun
atau lebih
g,6l
g4; 2,92-11,66, konsumsi tiap hari
versus nir konsumsi). Penurunan risiko ditemulan pada wanita yang
5g), jumlah melahirkan hidup atau

bayi yang disusuinya tinggi (0,32; 0,13-0,76), menyusui 6 atau lebih

Abstract
a hospital-based case-control study was

ls were selected, matching for age and

tus and analyzed separately. Following
s detected in women with breast trauma
1-16.24), milk consumption (1.g1; j.0l-3.35, daily intake vs

with cooked-veserabte intake (0.34;0.1s-0.77, dairy inrake vs not daity

t"i:;:l:;*';::P;"â::::îï:::Ï::::::tî:::,'::.:i::r

was founcl in women having menarche at the age of 15 years or over (2.25;
1.35-3.76), regular menstruation after thirty years old (4.61;
umption (5'84; 2.92-11.66, daily intake vs no intake), and a decreaseâ risk inwomenwhowere
divorced orwidowed

2'45-B
(0'33;

d whose number of live birth or breast-fed children was high (0.32; 0.i3-0.76,
six or more breast-fed children vs

no bre

Keywords i case'conlrol

sludy, premenopausal women, post menopausal women, breast cancer, risk
factors

Deparlment of Preventive Medicine, School of Medicine Nagoya
Llniversity, Nagoya 466, Jupan
_
|

[)epartment of Commrmitl,Med.icine, Focttlty of Medicitrc, UttiversiA

_ oflnd.onesia, Jakarla 10320, Indonesia
+ Departmeil
of Analomic Pathologt, Faculty of Medicine, Iltriversity

oflndonesia,Jaka

s. Research Center,
,,J t ka rla I

a

ine, IJniversily of Indortesin,

01 30, I ndot rcsia

tlDeportmetil of Public
Health, Medical School, Nagoyt City lltriversity,
Nagoya 467, Japatt
.

' Deparlment

of Surgery, Faculry of Medicine, IJtiversity of Indotresia,
rta I 01 j0, I ndoncsia
**Jaka
Departmcnt of Surgery, Catrcer Iustihtle Hospiral, Tol P > 0.01,

Table 3. Distribution of Risk Factors in Premenopausal Group
Factors

Cases

Breast trauma
Never
Ever

120

Controls

300

R.R.

95Vo

C.l.

l3

1.00

Reference

2.88

(1.37

126

324

9

5

1.00
4.63

Reference
(1.67
12.84)

to'l
l9

290
2't

1.00

Reference
(1.03
3.54)

98

Less than once/week

38
26

r.00

Once-twice/week
3-4 times/week

2l
l2

87
59
32
53

0.77
0.92
0.97

1.00
1.03

7t

86
47
40

2.62

156

1.70

l8

14

1.00

Re[erence

315

o.29

(0.14

Pill

l5

use

No
Yes

Malignancy among relatives
No
Yes

Milk

Never

Daily
Fresh fruits
Never - less than once /weél(
Once-twiceÂveek
3.4 tintes/week

Daily

(looked vegetable

Not daily
Daily

0.05>P>0.0t

38
23

l3
28

tt7

1.91

1.85

Trend

-6.07)
-

-

Relerence
(o.43
t.37)
- l.7l)
(0.4e
(0.45

(1.06 -2.07)

-3.23)

Reference
(0.48
(1.36 -2.23)
5.05)
(1.0o - 2.sl)

-

-

0.s8)

4.83

I

172

Suzaki et al.

Med J Indones

Table 4. Distribution of Risk Factors in Postmenopausal Group

Factors

Controls

Cases

Marital status
Manied

86

Separated or widowed

68.

Unmarried

9

R.R.

9s% c.r.

Trend

95

1.00

Reference

173

0.43

3

3.3r

(0.2e
(0.e3

-

0.6s)
11.84)

Height (cm)
160

-

Waist / hip ratio
< 0.70

28

65

1.00

Reference

o;lo - 0.79

57

101

l.3l

0.80 - 0.89

53

84

r.46

(0.76
(0.84

19

2.69

(r.27

))

È 0.90

Menarche

< 15 years old
> 15 years old

-

-

7L

92

r.00

Reference

175

95

2.36

(1.60

Regularity of menstruation over 30 years

-

Irregular

33

105

1.00

Reference

Regular

130

r65

2.5r

(t.60

r44
t9

263

1.00

Reference

8

4.34

(r.e1

None

25

22

r.00

Re[erence

(0.s4
(0.17

Menopausal process
Natural
Induced
Number of live birth

-

-

r,2

44

35

t.1l

3-5

55

150

0.32

>6

36

62

o.52

None

29

27

1.00

Reference

r,2

45

33

t.27

3-5

56

153

0.34

3l

57

0.51

(0.64
(0.1e
(0.26

148

259

1.00

Reference

l5

12

2.t9

(r.oo

Never

54

138

1.00

Reference

Less than once / week

24

63

o.97

(O.ss

Once-twice / week
3-4 times, week

20

27

1.89

l5

9

4.26

Almost daily

50

33

3.87

(o.ee
(1.8s
(2.2e

Number of lactation

:6

(o.zs
-

Smoking habit
Nonsmoker
Current ex-smoker

Mitk

'0.05 >P>().01, 0.01

>P>

0.001,10.001

=P>

0.0001

-

-

4.30
1.4s)
O.ez)
5.53

2.27)
2.s6)

s.67)
18.317

3.s0)
18.51I

3.92)

e.s7)
26.07

Ï

2.28)
0.61)
1.03)
28.83

1

2.s3)
0.62)
1.00)

4.72)
32.201

r.7r)
3.63)

e.8r)
6.ss)

Vol 4, No 3, July - September 1995

Menopausal

Status

173

Table 4 summarizes the risk factors for postmenopausal women detected by univariate analysis.

children 0.34 (0.19-0.64) and 6 or more children 0.51

of 5.22 (95o/o CI

RR of 0.97 (0.55-1.71), once to twice per week 1.89
(0.99-3.63), 3-4 times per week 4.26 (1.85-9.81), almost daily 3.87 (2.29-6.55), when compared to non-

Compared to married women, separated or widowed
women were at a smaller risk, but unmarried wolnen
were at a greater risk. When the marital status was
dichotomized into unmarried and ever married, then

unmarried women showed a RR

1.58-17.21). Height was inversely associated with BC

(P