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Table 2 Epidemiologic studies investigating cadmium exposure in relation to breast cancer risk according to the menopause window of susceptibility (WOS)

From: Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research

First author (year) Exposure Population Sample size Risk estimate 95% CI Notes
Cadmium exposure stratified by menopausal status
 McElroy (2006) [165] Urinary cadmium Women aged 20–69 years 246 cases and 254 controls All ages OR 2.29
20–56 years OR 2.34
57–69 years OR 1.36
1.3–4.2
1.1–5.0
0.5–3.4
Highest (≥ 0.58) vs lowest (< 0.263 μg/g) quartile
 Gallagher (2010) [166] Urinary cadmium Long Island (LI), NY and NHANES women aged ≥ 30 years LI 100 cases and 98 controls
NHANES 99 cases and 3120 non-cases
All ages OR 2.81
n.s. difference by age
All ages OR 2.32
30–54 years OR n.s.
≥ 55 years OR 7.25
1.11–7.13
0.92–5.84
n.s.
1.04–50.7
Highest (≥ 0.60) vs lowest (< 0.22 μg/g creatinine) quartile
 Itoh (2014) [157] Dietary cadmium Japanese women aged 20–74 years 212 cases and 253 controls All cases OR 1.04
Premeno. OR 1.01
Postmeno. OR 1.06 Post. ER+ OR 1.08
Post. ER− OR 0.99
1.00–1.08
0.96–1.07
1.06–1.11
1.03–1.14
0.92–1.06
Continuous cadmium intake (μg/day)
 Amadou (2019) [160] Long-term airborne exposure to cadmium E3N French cohort aged 40–65 years 4059 cases and 4059 controls Overall OR 0.98
Premeno OR 0.72
Postmeno. OR 1.06
ER+ OR 1.00
ER− OR 0.63
0.84–1.14
0.45–1.15
0.89–1.27
0.82–1.22
0.41–0.95
Highest (> 5.47) vs lowest (≤ 0.033 mg/m2) quintile
 Grioni (2019) [156] Dietary cadmium Italian cohort aged 34–70 years 8924 total in cohort with 481 cases Overall HR 1.54
Premeno HR 1.73
Postmeno HR 1.29
ER+ HR 1.64
ER− HR 1.30
1.06–2.22
1.10–2.71
0.68–2.44
1.06–2.54
0.60–2.83
Highest (≥ 8.82) vs lowest (< 6.73 μg/day) quintile
 O’Brien (2019) [167] Cadmium from toenail clippings Sister and two-sister studies aged < 50 years 1217 sister-pairs of cases and controls OR 1.15 0.82–1.60 Highest (> 0.011) vs lowest (< 0.003 μg/g) quartile
 White (2019)
[161]
Residential census tract airborne exposure to cadmium at baseline Sister study aged 35–74 years 50,884 total in cohort with 2587 cases Overall HR 1.1
Premeno 1.0
Postmeno 1.1
0.96– 1.3
0.78– 1.4
0.96– 1.3
Highest vs lowest quintile
Postmenopausal women only
 Julin (2012) [158] Dietary cadmium Swedish postmenopausal women 55,987 total in cohort with 2112 cases All cases RR 1.21
ER+ cases RR 1.19
ER− cases RR 1.33
1.07–1.36
1.03–1.36
0.95–1.87
Highest (> 16) vs lowest (< 13 μg/day) tertile
 Adams (2012) [153] Dietary cadmium Postmenopausal women in VITamines And Lifestyle cohort 30,543 total in cohort with 899 cases HR 1.00
n.s. difference by ER status (p = 0.11)
0.72–1.41 Highest (> 13.3) vs lowest (< 7.48 μg/day) quartile
 Eriksen (2014) [155] Dietary cadmium Danish postmenopausal women 23,815 total in cohort with 1390 breast cancer cases All cases IRR 0.99
ER+ IRR 1.00
ER− IRR 0.88
0.87–1.13
0.85–1.15
0.62–1.22
Per 10 μg/day increase in intake
 Adams (2014) [154] Dietary cadmium Postmenopausal women aged 50–79 years 155,069 total in cohort with 6658 cases HR 0.90
n.s. difference by ER status
0.81–1.00 Highest (> 14.21) vs lowest (< 7.10 μg/day) quintile
 Adams (2016) [162] Urinary cadmium Postmenopausal women ages ≥ 50 years in Women’s Health Initiative 12,701 total in cohort with 508 cases and 1050 controls All HR 0.80
ER+ HR 0.98
ER−/PR- HR 0.88
0.56–1.14
0.87–1.07
0.70–1.11
Highest (> 0.748) vs lowest (< 0.325 μg/g creatinine) quartile
All ages
 Sawada (2012) [159] Dietary cadmium Japanese women aged 45–74 years 48,351 females total in cohort with 402 breast cancer cases HR 0.87 0.61–1.23 Highest (median 32.3) vs lowest (median 19.2 μg/day) tertile
 Nagata (2013) [164] Urinary cadmium Japanese women ages ≥ 25 years 153 cases from one hospital and 431 controls invited for breast cancer screening OR 6.05 2.90–12.62 Highest (> 2.620) vs lowest (< 1.674 μg/g creatinine) tertile
 Gaudet (2018) [163] Blood cadmium Cancer Prevention Study II women 47–85 years of age 816 cases and 816 controls All RR 1.01
ER+ RR 0.89
ER− RR 0.96
0.76–1.34
0.62–1.27
0.44–2.09
Continuous per μg/L
Italian women aged 35–70 years 292 cases and 294 controls RR 0.80 0.61–1.03 Continuous per μg/L
Swedish women aged 30–61 years 325 cases and 325 controls RR 0.73 0.54–0.97 Continuous per μg/L
Combined 3 nested case-cohort studies 1433 cases and 1435 controls RR 0.84 0.69–1.01 Continuous per μg/L
  1. Abbreviations: BCSC Breast Cancer Surveillance Consortium, CI confidence interval, EPA Environmental Protection Agency, ER estrogen receptor, HR hazard ratio, IRR incidence rate ratio, NHANES National Health and Nutrition Examination Survey, n.s. not statistically significant, OR odds ratio, RR relative risk