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Breast cancer hypothesis: a single cause for the majority of cases.

Abstract：

STUDY OBJECTIVE:The main cause of breast cancer remains unknown. Numerous causal factors or predisposing conditions have been proposed, but account for only a small percentage of the total disease. The current search for multiple causes is unavailing. This report explores whether any single aetiological agent may be responsible for the majority of cases, and attempts to define its properties. METHODS:Examination of all relevant epidemiological and biological evidence. MAIN RESULTS:Genetic inheritance is not the main cause of breast cancer because most cases are sporadic, there is a low prevalence of family history, and genetically similar women have differing rates after migration. Environmental exposure, such as pollution by industrialisation, is not a major cause, as deduced from a spectrum of epidemiological data. The possibility of infection as cause is not persuasive as there is no direct biological evidence and no epidemiological support. Oestrogen status is closely related to breast cancer risk, but there are numerous inconsistencies and paradoxes. It is suggested that oestrogens are not the proximate agent but are promoters acting in concert with the causal agent. Dietary factors, and especially fat, are associated with the aetiology of breast cancer as shown by intervention and ecological correlation studies, but the evidence from case-control and cohort studies is inconsistent and contradictory. CONCLUSIONS:The hypothesis that best fits the epidemiological data is that dietary fat is not itself the causal agent, but produces depletion of an essential factor that is normally protective against the development of breast cancer. Many of the observed inconsistencies in the epidemiology are explainable if deficiency of this agent is permissive for breast cancer to develop. Some properties of the putative agent are outlined, and research investigations proposed.

journal_name

J Epidemiol Community Health

journal_title

Journal of epidemiology and community health

authors

Wiseman RA

doi

10.1136/jech.54.11.851

keywords:

subject

Has Abstract

pub_date

2000-11-01 00:00:00

pages

851-8

issue

eissn

0143-005X

issn

1470-2738

journal_volume

pub_type

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Breast cancer hypothesis: a single cause for the majority of cases.