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Table 3.

Dietary and/or supplemental intake of calcium and breast cancer risk

First author (ref.), year, study placeYears of data collectionStudy designNo. cases/controls (cohort)Comparison*RR (95% CL)Variables adjusted for
Katsouyanni (54), 1988, Greece 1983-1984 Hospital-based case-control study 120/120 Dietary calcium (centiles), C90 vs C10 0.56 (0.27, 1.16) Age, education, and interviewer 
Zaridze (52), 1991, Russia 1987-1989 Hospital-based case-control study 139/139 Dietary calcium (quartiles)  Energy intake, age at menarche, and education 
    Premenopausal No association  
    Postmenopausal, Q4 vs Q1 0.20 (0.05, 0.84)  
Van't Veer (55), 1991, Netherlands § 1985-1987 Population-based case-control study 133/289 Dairy calcium/fiber  Age and fat intake 
    ≤464.4/≤26.2 1.0 (ref.)  
    >464.4/>26.2 0.58 (0.32, 1.05)  
Landa (53), 1994, Spain 1987-1988 Hospital-based case-control study 100/100 Dietary calcium (tertiles), Q3 vs Q1 0.4 (0.2, 0.9) Energy intake 
Negri (51), 1996, Italy 1991-1994 Hospital-based case-control study 2,569/2,588 Dietary calcium (quintiles), Q5 vs Q1 0.80 (0.7, 1.0) Age, center, education, parity, energy, and alcohol intake 
Knekt (57), 1996, Finland 1966/1972- Cohort study 88/4,697 Dietary calcium (tertiles), T3 vs T1 0.44 (0.24, 0.80) Not stated 
Witte (39), 1997, United States and Canada 1989 Familial matched case-control study 140/222 Not stated No association Not stated 
Levi (37), 2001, Swiss 1993-1999 Hospital-based case-control study 289/442 Dietary calcium (tertiles), T3 vs T1 0.73 (0.44, 1.22) Age, education, parity, menopausal status, BMI, total energy intake, and alcohol drinking 
Shin (40), 2002, United States 1980-1996 Cohort study 3,172/88,691 Total calcium (mg/d)  Age, period, physical activity, BBD, family history of breast cancer, height, weight change since age 18, BMI at age 18, age at menarche, parity, age at first birth, alcohol intake, energy, glycemic index, β-carotene, and vitamin E 
    Premenopausal, >1,000-1250 vs ≤500 0.75 (0.57, 0.99)  
    Postmenopausal, >1,000-1250 vs ≤500 0.90 (0.76, 1.07)  
Adzersen (50), 2003, Germany 1998-2000 Hospital-based case-control study 310/353 Dietary calcium (mg/d), 870-1,180 vs <558 0.42 (0.23, 0.75) Age, energy, age at menarche, age at first birth, age at menopause, mother/sister with breast cancer, current smoking, history of BBD or operation, BMI, alcohol, and HRT 
Boyapati (56), 2003, China 1996-1998 Population-based case-control study 1,459/1,556 Dietary calcium (deciles)  Age, energy, menopausal status (for all subjects only), family history among first-degree relatives, history of fibroadenoma, age at first live birth, BMI, education, income, protein, fruits, and vegetables 
    Postmenopausal, D10 vs D1 0.72 (0.38, 1.37)  
    Premenopausal, D10 vs D1 0.72 (0.38, 1.37)  
McCullough (13), 2005, United States** 1992-2001 Cohort study 2,855/68,567 Postmenopausal  Age, energy, history of breast cyst, family history of breast cancer, height, weight gain since age 18, alcohol use, race, age at menopause, age at first birth and no. live births, education, mammography history, and HRT 
    Dietary and supplemental (mg/d), >1,500 to ≤1,750 vs ≤500 0.76 (0.63, 0.92)  
    Dietary calcium (mg/d), >1,250 vs ≤500 0.80 (0.67, 0.95)  
    Supplemental calcium (mg/d), >1,000 vs none 0.98 (0.86, 1.12)  
First author (ref.), year, study placeYears of data collectionStudy designNo. cases/controls (cohort)Comparison*RR (95% CL)Variables adjusted for
Katsouyanni (54), 1988, Greece 1983-1984 Hospital-based case-control study 120/120 Dietary calcium (centiles), C90 vs C10 0.56 (0.27, 1.16) Age, education, and interviewer 
Zaridze (52), 1991, Russia 1987-1989 Hospital-based case-control study 139/139 Dietary calcium (quartiles)  Energy intake, age at menarche, and education 
    Premenopausal No association  
    Postmenopausal, Q4 vs Q1 0.20 (0.05, 0.84)  
Van't Veer (55), 1991, Netherlands § 1985-1987 Population-based case-control study 133/289 Dairy calcium/fiber  Age and fat intake 
    ≤464.4/≤26.2 1.0 (ref.)  
    >464.4/>26.2 0.58 (0.32, 1.05)  
Landa (53), 1994, Spain 1987-1988 Hospital-based case-control study 100/100 Dietary calcium (tertiles), Q3 vs Q1 0.4 (0.2, 0.9) Energy intake 
Negri (51), 1996, Italy 1991-1994 Hospital-based case-control study 2,569/2,588 Dietary calcium (quintiles), Q5 vs Q1 0.80 (0.7, 1.0) Age, center, education, parity, energy, and alcohol intake 
Knekt (57), 1996, Finland 1966/1972- Cohort study 88/4,697 Dietary calcium (tertiles), T3 vs T1 0.44 (0.24, 0.80) Not stated 
Witte (39), 1997, United States and Canada 1989 Familial matched case-control study 140/222 Not stated No association Not stated 
Levi (37), 2001, Swiss 1993-1999 Hospital-based case-control study 289/442 Dietary calcium (tertiles), T3 vs T1 0.73 (0.44, 1.22) Age, education, parity, menopausal status, BMI, total energy intake, and alcohol drinking 
Shin (40), 2002, United States 1980-1996 Cohort study 3,172/88,691 Total calcium (mg/d)  Age, period, physical activity, BBD, family history of breast cancer, height, weight change since age 18, BMI at age 18, age at menarche, parity, age at first birth, alcohol intake, energy, glycemic index, β-carotene, and vitamin E 
    Premenopausal, >1,000-1250 vs ≤500 0.75 (0.57, 0.99)  
    Postmenopausal, >1,000-1250 vs ≤500 0.90 (0.76, 1.07)  
Adzersen (50), 2003, Germany 1998-2000 Hospital-based case-control study 310/353 Dietary calcium (mg/d), 870-1,180 vs <558 0.42 (0.23, 0.75) Age, energy, age at menarche, age at first birth, age at menopause, mother/sister with breast cancer, current smoking, history of BBD or operation, BMI, alcohol, and HRT 
Boyapati (56), 2003, China 1996-1998 Population-based case-control study 1,459/1,556 Dietary calcium (deciles)  Age, energy, menopausal status (for all subjects only), family history among first-degree relatives, history of fibroadenoma, age at first live birth, BMI, education, income, protein, fruits, and vegetables 
    Postmenopausal, D10 vs D1 0.72 (0.38, 1.37)  
    Premenopausal, D10 vs D1 0.72 (0.38, 1.37)  
McCullough (13), 2005, United States** 1992-2001 Cohort study 2,855/68,567 Postmenopausal  Age, energy, history of breast cyst, family history of breast cancer, height, weight gain since age 18, alcohol use, race, age at menopause, age at first birth and no. live births, education, mammography history, and HRT 
    Dietary and supplemental (mg/d), >1,500 to ≤1,750 vs ≤500 0.76 (0.63, 0.92)  
    Dietary calcium (mg/d), >1,250 vs ≤500 0.80 (0.67, 0.95)  
    Supplemental calcium (mg/d), >1,000 vs none 0.98 (0.86, 1.12)  
*

The associations are presented by menopausal status whenever the studies reported them separately or the studies were restricted to either premenopausal or postmenopausal women. Otherwise, the associations for a combination of premenopausal and postmenopausal women are presented.

RR and 95% CL were estimated for consumption of calcium equal to the value of the 90th centile versus consumption equal to the value of the 10th centile.

Detailed estimates were not presented.

§

Joint effects of calcium and fiber were presented.

The cohort was recruited between 1966 and 1972 and followed up for 25 years.

The study was based on the Nurses' Health Study. Cumulative calcium intake was used in analyses.

**

This study, an analysis of postmenopausal women, was conducted in the Cancer Prevention Study II Nutrition Cohort.

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