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Mendelian randomisation study of smoking exposure in relation to breast cancer risk

Mendelian randomisation study of smoking exposure in relation to breast cancer risk
Mendelian randomisation study of smoking exposure in relation to breast cancer risk

Background: Despite a modest association between tobacco smoking and breast cancer risk reported by recent epidemiological studies, it is still equivocal whether smoking is causally related to breast cancer risk.

 Methods: We applied Mendelian randomisation (MR) to evaluate a potential causal effect of cigarette smoking on breast cancer risk. Both individual-level data as well as summary statistics for 164 single-nucleotide polymorphisms (SNPs) reported in genome-wide association studies of lifetime smoking index (LSI) or cigarette per day (CPD) were used to obtain MR effect estimates. Data from 108,420 invasive breast cancer cases and 87,681 controls were used for the LSI analysis and for the CPD analysis conducted among ever-smokers from 26,147 cancer cases and 26,072 controls. Sensitivity analyses were conducted to address pleiotropy.

 Results: Genetically predicted LSI was associated with increased breast cancer risk (OR 1.18 per SD, 95% CI: 1.07–1.30, P = 0.11 × 10–2), but there was no evidence of association for genetically predicted CPD (OR 1.02, 95% CI: 0.78–1.19, P = 0.85). The sensitivity analyses yielded similar results and showed no strong evidence of pleiotropic effect.

 Conclusion: Our MR study provides supportive evidence for a potential causal association with breast cancer risk for lifetime smoking exposure but not cigarettes per day among smokers.

0007-0920
1135-1145
Park, Hanla A.
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Neumeyer, Sonja
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Michailidou, Kyriaki
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Bolla, Manjeet K.
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Wang, Qin
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Ahearn, Thomas U.
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Dennis, Joe
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Andrulis, Irene L.
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Anton-Culver, Hoda
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Antonenkova, Natalia N.
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Arndt, Volker
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Baten, Adinda
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Bogdanova, Natalia V.
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Bojesen, Stig E.
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Brauch, Hiltrud
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Brenner, Hermann
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Brucker, Sara Y.
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Burwinkel, Barbara
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Campa, Daniele
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Canzian, Federico
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Castelao, Jose E.
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Chanock, Stephen J.
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Chenevix-Trench, Georgia
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Clarke, Christine L.
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Børresen-Dale, Anne Lise
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Grenaker Alnæs, Grethe I.
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Sahlberg, Kristine K.
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Ottestad, Lars
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Kåresen, Rolf
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Schlichting, Ellen
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Holmen, Marit Muri
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Sauer, Toril
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Haakensen, Vilde
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Eccles, Diana M.
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Evans, D. Gareth
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He, Wei
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Campbell, Ian
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Fox, Stephen
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Scott, Clare
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Scott, Christopher
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Tapper, William J.
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Taylor, Jack A.
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NBCS Collaborators
ABCTB Investigators
KConFab Investigators
Park, Hanla A.
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Neumeyer, Sonja
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Michailidou, Kyriaki
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Bolla, Manjeet K.
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Wang, Qin
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Ahearn, Thomas U.
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Dennis, Joe
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Andrulis, Irene L.
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Anton-Culver, Hoda
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Antonenkova, Natalia N.
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Arndt, Volker
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Aronson, Kristan J.
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Augustinsson, Annelie
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Baten, Adinda
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Beane Freeman, Laura E.
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Becher, Heiko
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Beckmann, Matthias W.
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Behrens, Sabine
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Benitez, Javier
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Bermisheva, Marina
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Bogdanova, Natalia V.
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Bojesen, Stig E.
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Brauch, Hiltrud
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Brenner, Hermann
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Brucker, Sara Y.
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Burwinkel, Barbara
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Campa, Daniele
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Canzian, Federico
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Castelao, Jose E.
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Chanock, Stephen J.
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Clarke, Christine L.
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Børresen-Dale, Anne Lise
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Grenaker Alnæs, Grethe I.
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Sahlberg, Kristine K.
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Ottestad, Lars
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Kåresen, Rolf
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Schlichting, Ellen
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Holmen, Marit Muri
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Sauer, Toril
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Haakensen, Vilde
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Eccles, Diana M.
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Evans, D. Gareth
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He, Wei
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Campbell, Ian
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Fox, Stephen
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Scott, Clare
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Scott, Christopher
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Tapper, William J.
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Taylor, Jack A.
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Park, Hanla A., Neumeyer, Sonja, Michailidou, Kyriaki, Bolla, Manjeet K., Wang, Qin, Ahearn, Thomas U. and Dennis, Joe , NBCS Collaborators, ABCTB Investigators and KConFab Investigators (2021) Mendelian randomisation study of smoking exposure in relation to breast cancer risk. British Journal of Cancer, 125 (8), 1135-1145. (doi:10.1038/s41416-021-01432-8).

Record type: Article

Abstract

Background: Despite a modest association between tobacco smoking and breast cancer risk reported by recent epidemiological studies, it is still equivocal whether smoking is causally related to breast cancer risk.

 Methods: We applied Mendelian randomisation (MR) to evaluate a potential causal effect of cigarette smoking on breast cancer risk. Both individual-level data as well as summary statistics for 164 single-nucleotide polymorphisms (SNPs) reported in genome-wide association studies of lifetime smoking index (LSI) or cigarette per day (CPD) were used to obtain MR effect estimates. Data from 108,420 invasive breast cancer cases and 87,681 controls were used for the LSI analysis and for the CPD analysis conducted among ever-smokers from 26,147 cancer cases and 26,072 controls. Sensitivity analyses were conducted to address pleiotropy.

 Results: Genetically predicted LSI was associated with increased breast cancer risk (OR 1.18 per SD, 95% CI: 1.07–1.30, P = 0.11 × 10–2), but there was no evidence of association for genetically predicted CPD (OR 1.02, 95% CI: 0.78–1.19, P = 0.85). The sensitivity analyses yielded similar results and showed no strong evidence of pleiotropic effect.

 Conclusion: Our MR study provides supportive evidence for a potential causal association with breast cancer risk for lifetime smoking exposure but not cigarettes per day among smokers.

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More information

Accepted/In Press date: 28 April 2021
e-pub ahead of print date: 2 August 2021
Published date: 12 October 2021
Additional Information: Acknowledgements We thank all the individuals who took part in these studies and all the researchers, clinicians, technicians and administrative staff who have enabled this work to be carried out. The COGS study would not have been possible without the contributions of the following: Andrew Berchuck (OCAC), Rosalind A. Eeles, Ali Amin Al Olama, Zsofia Kote-Jarai, Sara Benlloch (PRACTICAL), Antonis Antoniou, and Lesley McGuffog (CIMBA), Andrew Lee, and Ed Dicks, Craig Luccarini and the staff of the Centre for Genetic Epidemiology Laboratory, Anna Gonzalez-Neira and the staff of the CNIO genotyping unit, and Daniel C. Tessier, Francois Bacot, Daniel Vincent, Sylvie LaBoissière and Frederic Robidoux and the staff of the McGill University and Génome Québec Innovation Centre, Sune F. Nielsen and the staff of the Copenhagen DNA laboratory, and Julie M. Cunningham, Sharon A. Windebank, Christopher A. Hilker, Jeffrey Meyer and the staff of Mayo Clinic Genotyping Core Facility. ABCFS thank Maggie Angelakos, Judi Maskiell, Gillian Dite. ABCS thanks the Blood bank Sanquin, The Netherlands. ABCTB Investigators: Christine Clarke, Rosemary Balleine, Robert Baxter, Stephen Braye, Jane Carpenter, Jane Dahlstrom, John Forbes, Soon Lee, Debbie Marsh, Adrienne Morey, Nirmala Pathmanathan, Rodney Scott, Allan Spigelman, Nicholas Wilcken, Desmond Yip. Samples are made available to researchers on a non-exclusive basis. BBCS thanks Eileen Williams, Elaine Ryder-Mills, Kara Sargus. BCEES thanks Allyson Thomson, Christobel Saunders, Terry Slevin, BreastScreen Western Australia, Elizabeth Wylie, Rachel Lloyd. The BCINIS study would not have been possible without the contributions of Dr. K. Landsman, Dr. N. Gronich, Dr. A. Flugelman, Dr. W. Saliba, Dr. E. Liani, Dr. I. Cohen, Dr. S. Kalet, Dr. V. Friedman, Dr. O. Barnet of the NICCC in Haifa, and all the contributing family medicine, surgery, pathology and oncology teams in all medical institutes in Northern Israel. BIGGS thanks Niall McInerney, Gabrielle Colleran, Andrew Rowan, Angela Jones. The BREOGAN study would not have been possible without the contributions of the following: Manuela Gago-Dominguez, Jose Esteban Castelao, Angel Carracedo, Victor Muñoz Garzón, Alejandro Novo Domínguez, Maria Elena Martinez, Sara Miranda Ponte, Carmen Redondo Marey, Maite Peña Fernández, Manuel Enguix Castelo, Maria Torres, Manuel Calaza (BREOGAN), José Antúnez, Máximo Fraga and the staff of the Department of Pathology and Biobank of the University Hospital Complex of Santiago-CHUS, Instituto de Investigación Sanitaria de Santiago, IDIS, Xerencia de Xestion Integrada de Santiago-SERGAS; Joaquín González-Carreró and the staff of the Department of Pathology and Biobank of University Hospital Complex of Vigo, Instituto de Investigacion Biomedica Galicia Sur, SERGAS, Vigo, Spain. BSUCH thanks Peter Bugert, Medical Faculty Mannheim. CBCS thanks study participants, co-investigators, collaborators and staff of the Canadian Breast Cancer Study, and project coordinators Agnes Lai and Celine Morissette. CCGP thanks Styliani Apostolaki, Anna Margiolaki, Georgios Nintos, Maria Perraki, Georgia Saloustrou, Georgia Sevastaki, Konstantinos Pompodakis. CGPS thanks staff and participants of the Copenhagen General Population Study. For the excellent technical assistance: Dorthe Uldall Andersen, Maria Birna Arnadottir, Anne Bank, Dorthe Kjeldgård Hansen. The Danish Cancer Biobank is acknowledged for providing infrastructure for the collection of blood samples for the cases. CNIO-BCS thanks Guillermo Pita, Charo Alonso, Nuria Álvarez, Pilar Zamora, Primitiva Menendez, the Human Genotyping-CEGEN Unit (CNIO). Investigators from the CPS-II cohort thank the participants and Study Management Group for their invaluable contributions to this research. They also acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention National Program of Cancer Registries, as well as cancer registries supported by the National Cancer Institute Surveillance Epidemiology and End Results program. The CTS Steering Committee includes Leslie Bernstein, Susan Neuhausen, Huiyan Ma, and Jessica Clague DeHart at the Beckman Research Institute of City of Hope, Dennis Deapen, Rich Pinder, and Eunjung Lee at the University of Southern California, Pam Horn-Ross, Peggy Reynolds, Christina Clarke Dur and David Nelson at the Cancer Prevention Institute of California, Hoda Anton-Culver, Argyrios Ziogas, and Hannah Park at the University of California Irvine, and Fred Schumacher at Case Western University. DIETCOMPLYF thanks the patients, nurses and clinical staff involved in the study. The DietCompLyf study was funded by the charity Against Breast Cancer (Registered Charity Number 1121258) and the NCRN. We thank the participants and the investigators of EPIC (European Prospective Investigation into Cancer and Nutrition). ESTHER thanks Hartwig Ziegler, Sonja Wolf, Volker Hermann, Christa Stegmaier, Katja Butterbach. FHRISK thanks NIHR for funding. GC-HBOC thanks Stefanie Engert, Heide Hellebrand, Sandra Kröber and LIFE-Leipzig Research Centre for Civilization Diseases (Markus Loeffler, Joachim Thiery, Matthias Nüchter, Ronny Baber). The GENICA Network: Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen, Germany [HB, WYL], German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ) Partner Site Tübingen (HB), gefördert durch die Deutsche Forschungsgemeinschaft (DFG) im Rahmen der Exzellenzstrategie des Bundes und der Länder—EXC 2180–390900677 (HB), Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany (Yon-Dschun Ko, Christian Baisch), Institute of Pathology, University of Bonn, Germany (Hans-Peter Fischer), Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany (Ute Hamann), Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany (Thomas Brüning, Beate Pesch, Sylvia Rabstein, Anne Lotz); and Institute of Occupational Medicine and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Germany (Volker Harth). GLACIER thanks Kelly Kohut, Patricia Gorman, Maria Troy. HABCS thanks Michael Bremer and Peter Hillemanns. HEBCS thanks Sofia Khan, Johanna Kiiski, Carl Blomqvist, Kristiina Aittomäki, Rainer Fagerholm, and Kirsimari Aaltonen. HMBCS thanks Hans Christiansen and Johann H. Karstens. HUBCS thanks Shamil Gantsev. ICICLE thanks Kelly Kohut, Michele Caneppele, Maria Troy. KARMA and SASBAC thank the Swedish Medical Research Counsel. KBCP thanks Eija Myöhänen, Helena Kemiläinen. kConFab/AOCS wish to thank Heather Thorne, Eveline Niedermayr, all the kConFab research nurses and staff, the heads and staff of the Family Cancer Clinics, and the Clinical Follow Up Study (which has received funding from the NHMRC, the National Breast Cancer Foundation, Cancer Australia, and the National Institute of Health (USA)) for their contributions to this resource, and the many families who contribute to kConFab. LMBC thanks Gilian Peuteman, Thomas Van Brussel, EvyVanderheyden and Kathleen Corthouts. MABCS thanks Milena Jakimovska (RCGEB “Georgi D. Efremov”), Snezhana Smichkoska, Emilija Lazarova (University Clinic of Radiotherapy and Oncology), Dzengis Jasar, Mitko Karadjozov (Adzibadem-Sistina Hospital), Andrej Arsovski and Liljana Stojanovska (Re-Medika Hospital) for their contributions and commitment to this study. MARIE thanks Petra Seibold, Dieter Flesch-Janys, Judith Heinz, Nadia Obi, Alina Vrieling, Sabine Behrens, Ursula Eilber, Muhabbet Celik, Til Olchers and Stefan Nickels. MBCSG (Milan Breast Cancer Study Group):, Siranoush Manoukian, Bernard Peissel, Jacopo Azzollini, Dario Zimbalatti, Daniela Zaffaroni, Bernardo Bonanni, Irene Feroce, Mariarosaria Calvello, Aliana Guerrieri Gonzaga, Monica Marabelli, Davide Bondavalli and the personnel of the Cogentech Cancer Genetic Test Laboratory The MCCS was made possible by the contribution of many people, including the original investigators, the teams that recruited the participants and continue working on follow-up, and the many thousands of Melbourne residents who continue to participate in the study. We thank the coordinators, the research staff and especially the MMHS participants for their continued collaboration on research studies in breast cancer. MSKCC thanks Marina Corines, Lauren Jacobs. MTLGEBCS would like to thank Martine Tranchant (CHU de Québec—Université Laval Research Center), Marie-France Valois, Annie Turgeon and Lea Heguy (McGill University Health Center, Royal Victoria Hospital; McGill University) for DNA extraction, sample management and skilful technical assistance. J.S. is Chair holder of the Canada Research Chair in Oncogenetics. The following are NBCS Collaborators: Kristine K. Sahlberg (PhD), Lars Ottestad (MD), Rolf Kåresen (Prof. Em.), Dr. Ellen Schlichting (MD), Marit Muri Holmen (MD), Toril Sauer (MD), Vilde Haakensen (MD), Olav Engebråten (MD), Bjørn Naume (MD), Alexander Fosså (MD), Cecile E. Kiserud (MD), Kristin V. Reinertsen (MD), Åslaug Helland (MD), Margit Riis (MD), Jürgen Geisler (MD), Anne-Lise Børresen-Dale (Prof. Em.), OSBREAC and Grethe I. Grenaker Alnæs (MSc). NBHS thank study participants and research staff for their contributions and commitment to the studies. For NHS and NHS2 the study protocol was approved by the institutional review boards of the Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, and those of participating registries as required. We would like to thank the participants and staff of the NHS and NHS2 for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA and WY. The authors assume full responsibility for analyses and interpretation of these data. OBCS thanks Arja Jukkola-Vuorinen, Mervi Grip, Saila Kauppila, Meeri Otsukka, Leena Keskitalo and Kari Mononen for their contributions to this study. The OFBCR thanks Teresa Selander, Nayana Weerasooriya and Steve Gallinger. ORIGO thanks E. Krol-Warmerdam, and J. Blom for patient accrual, administering questionnaires, and managing clinical information. PBCS thanks Louise Brinton, Mark Sherman, Neonila Szeszenia-Dabrowska, Beata Peplonska, Witold Zatonski, Pei Chao, Michael Stagner. The ethical approval for the POSH study is MREC /00/6/69, UKCRN ID: 1137. PREFACE thanks Sonja Oeser and Silke Landrith. PROCAS thanks NIHR for funding. The RBCS thanks Corine M. Beaufort, Jannet Blom, Renée Broeren-Foekens, Saskia Pelders, Wendy J.C. Prager-van der Smissen, Kirsten Ruigrok-Ritstier, Anita M.A.C. Trapman-Jansen, Michelle van der Vlugt-Daane, Vanja de Weerd, and the Erasmus MC Family Cancer Clinic. SBCS thanks Sue Higham, Helen Cramp, Dan Connley, Ian Brock, Sabapathy Balasubramanian and Malcolm W.R. Reed. We thank the SEARCH and EPIC teams. SKKDKFZS thanks all study participants, clinicians, family doctors, researchers and technicians for their contributions and commitment to this study. We thank the SUCCESS Study teams in Munich, Duessldorf, Erlangen and Ulm. SZBCS thanks Ewa Putresza. UCIBCS thanks Irene Masunaka. UKBGS thanks Breast Cancer Now and the Institute of Cancer Research for support and funding of the Breakthrough Generations Study, and the study participants, study staff, and the doctors, nurses and other health care providers and health information sources who have contributed to the study. We acknowledge NHS funding to the Royal Marsden/ICR NIHR Biomedical Research Centre. We thank the UKOPS participants who donated their samples and data and all the researchers, especially Andy Ryan, Simon Gayther and Ian Jacobs.

Identifiers

Local EPrints ID: 451012
URI: http://eprints.soton.ac.uk/id/eprint/451012
ISSN: 0007-0920
PURE UUID: 8891ad4b-adf9-449e-9107-a8ad128c2fdc
ORCID for Diana M. Eccles: ORCID iD orcid.org/0000-0002-9935-3169
ORCID for William J. Tapper: ORCID iD orcid.org/0000-0002-5896-1889

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Date deposited: 01 Sep 2021 16:33
Last modified: 17 Mar 2024 02:49

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Contributors

Author: Hanla A. Park
Author: Sonja Neumeyer
Author: Kyriaki Michailidou
Author: Manjeet K. Bolla
Author: Qin Wang
Author: Thomas U. Ahearn
Author: Joe Dennis
Author: Irene L. Andrulis
Author: Hoda Anton-Culver
Author: Natalia N. Antonenkova
Author: Volker Arndt
Author: Kristan J. Aronson
Author: Annelie Augustinsson
Author: Adinda Baten
Author: Laura E. Beane Freeman
Author: Heiko Becher
Author: Matthias W. Beckmann
Author: Sabine Behrens
Author: Javier Benitez
Author: Marina Bermisheva
Author: Natalia V. Bogdanova
Author: Stig E. Bojesen
Author: Hiltrud Brauch
Author: Hermann Brenner
Author: Sara Y. Brucker
Author: Barbara Burwinkel
Author: Daniele Campa
Author: Federico Canzian
Author: Jose E. Castelao
Author: Stephen J. Chanock
Author: Georgia Chenevix-Trench
Author: Christine L. Clarke
Author: Anne Lise Børresen-Dale
Author: Grethe I. Grenaker Alnæs
Author: Kristine K. Sahlberg
Author: Lars Ottestad
Author: Rolf Kåresen
Author: Ellen Schlichting
Author: Marit Muri Holmen
Author: Toril Sauer
Author: Vilde Haakensen
Author: Diana M. Eccles ORCID iD
Author: D. Gareth Evans
Author: Wei He
Author: Ian Campbell
Author: Stephen Fox
Author: Clare Scott
Author: Christopher Scott
Author: Jack A. Taylor
Corporate Author: NBCS Collaborators
Corporate Author: ABCTB Investigators
Corporate Author: KConFab Investigators

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