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Sleep duration and breast cancer risk among black and white women.

ABSTRACT: BACKGROUND:Sleep has been suggested to influence breast cancer risk; however, the evidence is mixed. Black women have a higher prevalence of both short (<6?h) and long (?9?h) sleep duration and are more likely to develop more aggressive, hormone receptor-negative breast cancer. No study has examined the relationship between sleep and breast cancer in blacks. We focused on race-specific associations among the blacks. METHODS:In the Southern Community Cohort Study (SCCS), a prospective study of which two-thirds of the population were black, we prospectively investigated self-reported sleep duration in relation to overall breast cancer risk by estrogen (ER) and progesterone receptor (PR) status in all women and in black women alone. RESULTS:Sleep duration was not associated with risk of total or hormone receptor-positive breast cancer. However, we found an inverse relationship between sleep duration and risk of ER- and PR- breast cancer among all women and in black women alone. Compared to the reference group (8?h), black women who reported shorter sleep duration had an increased risk of ER-?PR-?breast cancer (odds ratios; ORs (95% confidence intervals; CIs): 2.13 (1.15, 3.93), 1.66 (0.92, 3.02), and 2.22 (1.19, 4.12) for <6, 6, and 7?h, respectively, (p for trend, 0.04). CONCLUSIONS:Short sleep duration may be a risk factor for hormone receptor-negative breast cancer among black women.

SUBMITTER: Xiao Q

PROVIDER: S-EPMC4913026 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Sleep duration and breast cancer risk among black and white women.

Xiao Qian Q Signorello Lisa B LB Brinton Louise A LA Cohen Sarah S SS Blot William J WJ Matthews Charles E CE

Sleep medicine 20151209

<h4>Background</h4>Sleep has been suggested to influence breast cancer risk; however, the evidence is mixed. Black women have a higher prevalence of both short (<6 h) and long (≥9 h) sleep duration and are more likely to develop more aggressive, hormone receptor-negative breast cancer. No study has examined the relationship between sleep and breast cancer in blacks. We focused on race-specific associations among the blacks.<h4>Methods</h4>In the Southern Community Cohort Study (SCCS), a prospect ...[more]

PMID: 27318222

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Project description:INTRODUCTION:Although breast cancer incidence is higher among white women, black women are more likely to have aggressive tumors with less favorable histology, and to have a worse prognosis. Obesity and alcohol consumption have been identified as two modifiable risk factors for breast cancer, while physical activity may offer protection. Little however is known about the association of these factors with race on the severity of breast cancer. METHODS:Data collected as part of a large prospective study looking at insulin resistance and race among women with breast cancer was queried for patient characteristics, lifestyle factors and tumor characteristics. The association with Nottingham Prognostic Index (NPI) was assessed with different models using univariate and multivariate linear regression. RESULTS:Among 746 women in our cohort, 82% (n?=?615) were white and 18% (n?=?131) were black, mean age 58 years. Black patients were more likely to have high BMI (31.0 vs. 26.7, p?<?0.0001), comorbidities (69% vs 55%, p?=?0.01), self-reported poor diet (70% vs 42%, p?<?0.001), be sedentary (56% vs 46%, p?=?0.03) and were less likely to consume alcohol (8% vs 32%, p?<?0.0001) compared to white patients. Overall, 137 (18%) of the patients had poorer prognosis (NPI?>?4.4), which was significantly associated with younger age (55.6 vs 58.5 years, p?=?0.02), black race (27% vs 15%, p?=?0.001), triple negative cancer (15% vs 6%, p?=?0.003), and poor diet (54% vs 45%, p?=?0.046) compared to patients with better prognosis (NPI???4.4). On multivariate analysis, (model R2?=?0.12; p?<?0.001), age (??=?-0.011 per year, p?=?0.002), healthy diet (??=?-0.195, p?=?0.02), and exercise (??=?-0.004, p?=?0.02) were associated with better prognosis, while black race (??=?0.247, p?=?0.02) and triple negative cancer (??=?0.908, p?<?0.0001) were associated with poor prognosis. Neither alcohol use nor BMI was significantly associated with NPI. CONCLUSION:Among modifiable risk factors, diet and exercise are associated with NPI. Unmodifiable factors including race and biologic subtype remain the most important determinants of prognosis.

Project description:Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004-2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02-1.08)) and women (PR = 1.07 (95% CI: 1.04-1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21-1.30)) and women (PR = 1.24 (95% CI: 1.20-1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race-sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities.

Dataset Information

Sleep duration and breast cancer risk among black and white women.

Publications

Sleep duration and breast cancer risk among black and white women.

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