Occupational exposure to solvents and risk of breast cancer.

BACKGROUND: Occupational exposure to some organic solvents may increase risk of breast cancer. METHODS: In a population-based case-control study, 1,205 women diagnosed with primary breast cancer between 2009 and 2011 were drawn from the Western Australian Cancer Registry and matched to 1,789 controls from the electoral roll. Exposure to solvents was determined through telephone interviews using OccIDEAS. RESULTS: About a third of women were occupationally exposed to solvents. Age adjusted breast cancer risks were elevated for women who had been exposed to aliphatic solvents odds ratio (OR) 1.21 (95%CI 0.99-1.48) and aromatic solvents OR 1.21 (95%CI 0.97-1.52). For most solvents the ORs were higher for those diagnosed before menopause. CONCLUSIONS: This study suggests that there may be an association between occupational exposure to aliphatic and aromatic solvents and the risk of breast cancer at the low levels of exposure experienced by women in this study.

Beliefs and perceptions about the causes of breast cancer: a case-control study.

BACKGROUND: Attributions of causality are common for many diseases, including breast cancer. The risk of developing breast cancer can be reduced by modifications to lifestyle and behaviours to minimise exposure to specific risk factors, such as obesity. However, these modifications will only occur if women believe that certain behaviours/lifestyle factors have an impact on the development of breast cancer. METHOD: The Breast Cancer, Environment and Employment Study is a case-control study of breast cancer conducted in Western Australia between 2009 and 2011. As part of the study 1109 women with breast cancer and 1633 women without the disease completed a Risk Perception Questionnaire in which they were asked in an open-ended question for specific cause/s to the development of breast cancer in themselves or in others. The study identified specific causal beliefs, and assessed differences in the beliefs between women with and without breast cancer. RESULTS: The most common attributions in women without breast cancer were to familial or inherited factors (77.6%), followed by lifestyle factors, such as poor diet and smoking (47.1%), and environmental factors, such as food additives (45.4%). The most common attributions in women with breast cancer were to mental or emotional factors (46.3%), especially stress, followed by lifestyle factors (38.6%) and physiological factors (37.5%), particularly relating to hormonal history. CONCLUSIONS: While the majority of participants in this study provided one or more causal attributions for breast cancer, many of the reported risk factors do not correspond to those generally accepted by the scientific community. These misperceptions could be having a significant impact on the success of prevention and early detection programs that seek to minimise the pain and suffering caused by this disease. In particular, women who have no family history of the disease may not work to minimise their exposure to the modifiable risk factors.

Including questionnaires with the invitation package appeared to increase the response fraction among women.

OBJECTIVE: The Breast Cancer Environment and Employment Study (BCEES) is a case--control study that began in 2009. The study experienced a lower than expected response fraction, a trend that appears to be occurring internationally. A 32-page questionnaire was included in the initial invitation to participate, and previous research suggests that long questionnaires decrease response fractions. The aim of this study was to test whether removal of the questionnaire from the invitation package increased participation. STUDY DESIGN AND SETTING: A randomized controlled trial was undertaken among the BCEES controls from June to August 2010. One group of 250 received the questionnaire in the initial invitation package, and the other group of 250 received only the invitation package and was sent the questionnaire after their consent was received. The proportion of responses for the two groups was compared using contingency tables and chi-square statistics. RESULTS: Those who received the questionnaire with the invitation package were more likely to consent to participate than those who did not (40.8% and 33.2%, respectively). However, this difference was not statistically significant (P=0.078). CONCLUSION: To improve response fractions and reduce time in following up nonresponses, questionnaires should be included in the invitation package.