Background
Methods
Components of the Gail Models
Caucasian women (1983–1987) | Singaporean (Overall) | Singaporean (Chinese) | Singaporean (Malay) | Singaporean (Indian) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Age |
J
|
τ
j
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B
j
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c
j
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B
j
|
c
j
|
B
j
|
c
j
|
B
j
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c
j
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B
j
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c
j
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0 – 19 | 1 | 20 | 0 | 0 | 0.3 | 11.7 | 0.2 | 10.5 | 0.5 | 17.4 | 0.5 | 11.0 |
20 – 24 | 2 | 25 | 1 | 49.3 | 1.9 | 14.3 | 1.8 | 11.9 | 1.1 | 25.7 | 2.2 | 12.9 |
25 – 29 | 3 | 30 | 7.6 | 53.1 | 8.1 | 14.2 | 7.0 | 12.5 | 15.9 | 22.5 | 4.9 | 19.7 |
30 – 34 | 4 | 35 | 26.6 | 62.5 | 24.8 | 19.8 | 25.5 | 16.8 | 27.7 | 47.0 | 5.9 | 14.8 |
35 – 39 | 5 | 40 | 66.1 | 82.5 | 57.6 | 32.6 | 60.3 | 29.4 | 60.0 | 53.9 | 31.6 | 34.8 |
40 – 44 | 6 | 45 | 126.5 | 130.7 | 118.7 | 58.5 | 121.5 | 51.6 | 123.7 | 98.6 | 87.9 | 60.7 |
45 – 49 | 7 | 50 | 186.6 | 218.1 | 162.6 | 106.2 | 169.1 | 95.1 | 145.1 | 175.1 | 128.4 | 111.9 |
50 – 54 | 8 | 55 | 221.1 | 365.5 | 187.0 | 182.1 | 193.6 | 165.1 | 158.4 | 297.5 | 147.2 | 212.6 |
55 – 59 | 9 | 60 | 272.1 | 585.2 | 204.3 | 319.1 | 211.0 | 271.1 | 167.0 | 617.7 | 181.5 | 445.9 |
60 – 64 | 10 | 65 | 334.8 | 943.9 | 199.1 | 565.9 | 202.1 | 489.6 | 209.3 | 1093.0 | 157.6 | 853.3 |
65 – 69 | 11 | 70 | 392.3 | 1502.8 | 193.9 | 989.5 | 199.8 | 856.5 | 131.9 | 2040.3 | 219.5 | 1158.5 |
70 – 74 | 12 | 75 | 417.8 | 2383.9 | 166.5 | 1798.6 | 161.3 | 1624.3 | 199.1 | 3034.6 | 152.5 | 1932.2 |
75 – 79 | 13 | 80 | 443.9 | 3883.2 | 179.0 | 3285.3 | 180.9 | 3001.6 | 128.6 | 5678.6 | 197.2 | 3662.0 |
80 – 84 | 14 | 85 | 442.1 | 6682.8 | 189.8 | 5681.0 | 191.4 | 5388.2 | 188.4 | 8681.2 | 125.0 | 6093.8 |
>=85 | 15 | 90 | 410.9 | 14490.8 | 166.2 | 11425.5 | 164.5 | 11352.1 | 117.6 | 13323.5 | 375.0 | 11000.0 |
Data sources
SBSP
Nested case-control study
Follow-up and breast cancer ascertainment
Statistical analyses
Risk factor | Categories | BCDDP | GAIL-SBSP | GAIL-SBSP (FULL) | S-GAIL-SBSP | E-GAIL-SBSP | ||
---|---|---|---|---|---|---|---|---|
Code |
β
| Code |
β
|
β(CI) |
β(CI) |
β(CI) | ||
Main effects
| ||||||||
AGECAT (y) | <50 | 0 | 0.01081 | 0 | 0.01081 | 0.807 | – | – |
≥50 | 1 | 1 | (–0.73 to 2.35) | |||||
AGEMEN (y) | ≥14 | 0 | 0.09401 | 0 | 0.09401 | 0.240 | 0.238 | 0.204 |
12–13 | 1 | 1 | (0.05 to 0.43) | (0.05 to 0.43) | (0.01 to 0.39) | |||
<12 | 2 | 2 | ||||||
AGEFLB (y) | <20 | 0 | 0.21863 | 0 | 0.21863 | 0.185 | 0.183 | 0.170 |
20–24 | 1 | 1 | (0.016 to 0.31) | (0.06 to 0.31) | (0.03 to 0.31) | |||
25–29 or nulliparous | 2 | 2 | ||||||
≥30 | 3 | 3 | ||||||
NUMREL | 0 | 0 | 0.95830 | 0 | 0.95830 | 0.844 | 0.777 | 0.774 |
1 | 1 | 1 | (–0.17 to 1.86) | (0.30 to 1.26) | (0.29 to 1.26) | |||
≥2 | 2 | 2 | ||||||
NBIOPS | 0 | 0 | 0.52926 | 0 | 0.52926 | −15.877 | – | – |
1 | 1 | 1 | (–16.28 to –15.47) | |||||
≥2 | 2 | 1 | ||||||
ATYPICAL | No | 0 | 0.57405* | 99 | – | – | – | – |
Yes | 1 | 99 | ||||||
BMI (kg/m2) | < 23.0 | – | – | 0 | – | – | – | 0.380 |
23.0 – 27.4 | 1 | (0.22 to 0.54) | ||||||
≥ 27.5 | 2 | |||||||
PARITY | ≥ 3 | – | – | 0 | – | – | – | 0.203 |
1 – 2 | 1 | (0.03 to 0.38) | ||||||
0 | 2 | |||||||
Interaction terms
| ||||||||
NBIOPS x AGECAT | −0.28804 | −0.28804 | 16.138 | – | – | |||
(Not estimatable) | ||||||||
AGEFLB x NUMREL | −0.19081 | −0.19081 | −0.059 | – | – | |||
(–0.61 to 0.50) |
Results
GAIL-SBSP
Age at entry, (y) | No. of women followed | GAIL-SBSP | S-GAIL-SBSP | E-GAIL-SBSP | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
O
|
E
|
E/O(CI) |
P
|
E
|
E/O(CI) |
P
|
E
|
E/O(CI) |
P
| ||
Overall
| |||||||||||
45–49 | 109 | 0 | 0.95 | – | 0.092 | 0.97 | – | 0.111 | 0.96 | – | 0.006 |
50–59 | 13,911 | 144 | 124.11 | 0.86 (0.73 to 1.01) | 124.86 | 0.87 (0.74 to 1.02) | 149.12 | 1.04 (0.88 to 1.22) | |||
60–69 | 14,642 | 95 | 115.38 | 1.21 (0.99 to 1.49) | 114.57 | 1.21 (0.99 to 1.47) | 137.70 | 1.45 (1.19 to 1.77) | |||
70–74 | 221 | 2 | 1.40 | 0.70 (0.18 to 2.80) | 1.40 | 0.70 (0.17 to 2.80) | 1.69 | 0.85 (0.21 to 3.38) | |||
Total | 28,883 | 241 | 241.83 | 1.00 (0.88 to 1.14) | 0.957 | 241.80 | 1.00 (0.88 to 1.14) | 0.959 | 289.47 | 1.20 (1.06 to 1.36) | 0.004 |
Chinese
| |||||||||||
45–49 | 93 | 0 | 0.85 | – | 0.440 | 0.87 | – | 0.480 | 0.84 | – | 0.076 |
50–59 | 11,795 | 119 | 109.98 | 0.92 (0.77 to 1.11) | 109.64 | 0.92 (0.77 to 1.10) | 127.35 | 1.07 (0.89 to 1.28) | |||
60–69 | 12,256 | 87 | 99.85 | 1.15 (0.93 to 1.42) | 98.22 | 1.13 (0.91 to 1.39) | 115.12 | 1.32 (1.07 to 1.63) | |||
70–74 | 195 | 2 | 1.21 | 0.60 (0.15 to 2.42) | 1.20 | 0.60 (0.15 to 2.40) | 1.44 | 0.72 (0.18 to 2.88) | |||
Total | 24,339 | 208 | 211.88 | 1.02 (0.89 to 1.17) | 0.790 | 209.93 | 1.01 (0.88 to 1.16) | 0.894 | 244.75 | 1.18 (1.03 to 1.35) | 0.019 |
Malay
| |||||||||||
45–49 | 7 | 0 | 0.05 | – | 0.652 | 0.06 | – | 0.591 | 0.05 | – | 0.209 |
50–59 | 711 | 4 | 4.91 | 1.23 (0.46 to 3.27) | 5.23 | 1.31 (0.49 to 3.48) | 7.27 | 1.82 (0.68 to 4.85) | |||
60–69 | 889 | 2 | 5.41 | 2.71 (0.68 to 10.82) | 5.67 | 2.84 (0.71 to 11.34) | 7.72 | 3.86 (0.97 to 15.43) | |||
70–74 | 12 | 0 | 0.08 | – | 0.08 | – | 0.11 | – | |||
Total | 1,619 | 6 | 10.46 | 1.74 (0.78 to 3.88) | 0.168 | 11.04 | 1.84 (0.83 to 4.09) | 0.130 | 15.15 | 2.53 (1.13 to 5.62) | 0.019 |
Indian
| |||||||||||
45–49 | 5 | 0 | 0.03 | – | <0.001 | 0.03 | – | <0.001 | 0.02 | – | 0.002 |
50–59 | 683 | 16 | 4.75 | 0.30 (0.18 to 0.48) | 5.08 | 0.32 (0.19 to 0.52) | 6.98 | 0.44 (0.27 to 0.71) | |||
60–69 | 727 | 1 | 5.34 | 5.34 (0.75 to 37.90) | 5.56 | 5.56 (0.78 to 39.49) | 7.58 | 7.58 (1.07 to 53.79) | |||
70–74 | 7 | 0 | 0.04 | – | 0.04 | – | 0.05 | – | |||
Total | 1,422 | 17 | 10.16 | 0.60 (0.37 to 0.96) | 0.032 | 10.71 | 0.63 (0.39 to 1.01) | 0.055 | 14.64 | 0.86 (0.54 to 1.38) | 0.537 |
Risk factors | No. of women followed | GAIL-SBSP | S-GAIL-SBSP | E-GAIL-SBSP | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
O
|
E
|
E/O(CI) |
P
|
E
|
E/O(CI) |
P
|
E
|
E/O(CI) |
P
| ||
AGEMEN (y) | |||||||||||
≥14 | 18,652 | 142 | 148.50 | 1.05 (0.89 to 1.23) | 0.890 | 139.32 | 0.98 (0.83 to 1.16) | 0.945 | 165.22 | 1.16 (0.99 to 1.37) | 0.035 |
12–13 | 9,279 | 89 | 83.81 | 0.94 (0.77 to 1.16) | 90.61 | 1.02 (0.83 to 1.25) | 109.59 | 1.23 (1.00 to 1.52) | |||
<12 | 952 | 10 | 9.53 | 0.95 (0.51 to 1.77) | 11.87 | 1.19 (0.64 to 2.21) | 14.66 | 1.47 (0.79 to 2.73) | |||
NBIOPS | |||||||||||
0 | 27,176 | 218 | 222.80 | 1.02 (0.89 to 1.17) | 0.629 | 226.43 | 1.04 (0.91 to 1.19) | 0.129 | 271.38 | 1.24 (1.09 to 1.42) | 0.003 |
1 | 1,707 | 23 | 19.04 | 0.83 (0.55 to 1.25) | 15.37 | 0.67 (0.44 to 1.01) | 18.09 | 0.79 (0.52 to 1.18) | |||
NUMREL | |||||||||||
0 | 28,143 | 225 | 229.50 | 1.02 (0.90 to 1.16) | 0.045 | 227.71 | 1.01 (0.89 to 1.15) | 0.109 | 272.98 | 1.21 (1.06 to 1.38) | 0.004 |
1 | 729 | 14 | 11.98 | 0.86 (0.51 to 1.44) | 13.67 | 0.98 (0.58 to 1.65) | 16.01 | 1.14 (0.68 to 1.93) | |||
≥2 | 11 | 2 | 0.36 | 0.18 (0.04 to 0.71) | 0.42 | 0.21 (0.05 to 0.83) | 0.48 | 0.24 (0.06 to 0.97) | |||
AGEFLB (y) | |||||||||||
<20 | 4,952 | 26 | 29.89 | 1.15 (0.78 to 1.69) | 0.900 | 31.58 | 1.21 (0.83 to 1.78) | 0.750 | 39.77 | 1.53 (1.04 to 2.25) | 0.038 |
20–24 | 10,840 | 77 | 80.61 | 1.05 (0.84 to 1.31) | 81.02 | 1.05 (0.84 to 1.32) | 94.41 | 1.23 (0.98 to 1.53) | |||
25–29 or nulliparous | 9,843 | 97 | 93.48 | 0.96 (0.79 to 1.18) | 92.61 | 0.95 (0.78 to 1.16) | 112.39 | 1.16 (0.95 to 1.41) | |||
≥30 | 3,248 | 41 | 37.85 | 0.92 (0.68 to 1.25) | 36.59 | 0.89 (0.66 to 1.21) | 42.90 | 1.05 (0.77 to 1.42) | |||
BMI (kg/m2) | |||||||||||
<23.0 | 10,237 | 68 | 89.31 | 1.31 (1.04 to 1.67) | 0.018 | 88.34 | 1.30 (1.02 to 1.65) | 0.028 | 75.94 | 1.12 (0.88 to 1.42) | 0.026 |
23.0–27.4 | 12,225 | 107 | 101.99 | 0.95 (0.79 to 1.15) | 102.09 | 0.95 (0.79 to 1.15) | 124.26 | 1.16 (0.96 to 1.40) | |||
≥27.5 | 6,411 | 66 | 50.45 | 0.76 (0.60 to 0.970 | 51.29 | 0.78 (0.61 to 0.99) | 89.21 | 1.35 (1.06 to 1.72) | |||
Parity | |||||||||||
≥3 | 20,197 | 147 | 156.72 | 1.07 (0.91 to 1.25) | 0.632 | 157.01 | 1.07 (0.91 to 1.26) | 0.615 | 178.11 | 1.21 (1.03 to 1.42) | 0.041 |
1–2 | 6,410 | 68 | 63.16 | 0.93 (0.73 to 1.18) | 62.80 | 0.92 (0.73 to 1.17) | 78.57 | 1.16 (0.91 to 1.47) | |||
0 | 2,276 | 26 | 21.95 | 0.84 (0.57 to 1.24) | 21.99 | 0.85 (0.58 to 1.24) | 32.78 | 1.26 (0.86 to 1.85) |
S-GAIL-SBSP
Characteristics | Categories | Cases (N=439) | Controls (N=1,198) | Adjusted OR (CI) |
P
|
---|---|---|---|---|---|
AGECAT (y) | < 50 | 2 | 11 | 1.00 (referent) | 0.317 |
≥ 50 | 437 | 1187 | 2.19 (0.47 to 10.13) | ||
AGEMEN (y) | ≥ 14 | 246 | 772 | 1.00 (referent) | 0.039 |
12 – 13 | 173 | 377 | 1.23 (1.01 to 1.49) | ||
< 12 | 20 | 49 | 1.51 (1.24 to 1.83) | ||
AGEFLB (y) | < 20 | 56 | 187 | 1.00 (referent) | 0.015 |
20 – 24 | 132 | 440 | 1.19 (1.04 to 1.37) | ||
25 – 29 or nulliparous | 185 | 425 | 1.42 (1.23 to 1.64) | ||
≥ 30 | 66 | 144 | 1.69 (1.47 to 1.95) | ||
NUMREL | 0 | 411 | 1162 | 1.00 (referent) | 0.002 |
1 | 25 | 36 | 2.15 (1.31 to 3.52) | ||
≥ 2 | 3 | 0 | 4.62 (2.82 to 7.56) | ||
NBIOPS | 0 | 398 | 1119 | 1.00 (referent) | 0.234 |
≥ 1 | 41 | 79 | 1.28 (0.85 to 1.94) | ||
ETHNICITY | Chinese | 377 | 1051 | 1.00 (referent) | |
Malay | 15 | 29 | 0.96 (0.58 to 1.59) | 0.868 | |
Indian | 25 | 65 | 1.30 (0.67 to 2.50) | 0.434 | |
Others | 22 | 53 | 1.02 (0.60 to 1.74) | 0.936 | |
BMI (kg/m2) | < 23.0 | 126 | 476 | 1.00 (referent) | <0.001 |
23.0 – 27.4 | 207 | 497 | 1.43 (1.22 to 1.68) | ||
≥ 27.5 | 106 | 223 | 2.04 (1.73 to 2.39) | ||
PARITY | ≥ 3 | 263 | 801 | 1.00 (referent) | 0.031 |
1 – 2 | 112 | 276 | 1.22 (1.02 to 1.46) | ||
0 | 64 | 121 | 1.49 (1.24 to 1.79) | ||
OC | No | 278 | 743 | 1.00 (referent) | 0.894 |
Yes | 161 | 455 | 1.02 (0.80 to 1.29) | ||
HRT
| No | 364 | 1022 | 1.00 (referent) | 0.265 |
Yes | 75 | 173 | 1.19 (0.88 to 1.62) | ||
SMOKING
| No | 415 | 1126 | 1.00 (referent) | 0.831 |
Yes | 24 | 72 | 1.05 (0.98 to 1.72) | ||
WHR | ≤ 0.85 | 293 | 863 | 1.00 (referent) | 0.074 |
> 0.85 | 146 | 335 | 1.25 (0.98 to 1.60) |
Cases | Control | Total (%) |
RR
| ||||
---|---|---|---|---|---|---|---|
E-GAIL-SBSP | S-GAIL-SBSP | BCDDP | |||||
Women (
n
)
| 439 | 1,198 | 1,637 | 1,637 | 1,637 | 5,998 | |
AGEMEN (y) | |||||||
≥14 | 246 | 772 | 1,018 (62.19) | 1 | 1 | 1 | |
12–13 | 173 | 377 | 550 (33.60) | 1.23 | 1.27 | 1.10 | |
<12 | 20 | 49 | 69 (4.22) | 1.50 | 1.61 | 1.21 | |
AGECAT (y) | NBIOPS | ||||||
<50 | 0 | 2 | 10 | 12 (0.73) | – | – | 1 |
1 | 0 | 1 | 1 (0.06) | – | – | 1.70 | |
2 | – | – | – | – | – | 2.88 | |
≥50 | 0 | 396 | 1,109 | 1,505 (91.94) | – | – | 1 |
1 | 41 | 78 | 119 (7.27) | – | – | 1.27 | |
2 | – | – | – | – | – | 1.62 | |
AGEFLB (y) | NUMREL | ||||||
<20 | 0 | 54 | 182 | 236 (14.42) | 1 | 1 | 1 |
1 | 2 | 5 | 7 (0.43) | 2.17 | 2.17 | 2.61 | |
≥2 | – | – | – | 4.70 | 4.73 | 6.80 | |
20–24 | 0 | 123 | 431 | 554 (33.84) | 1.19 | 1.20 | 1.24 |
1 | 7 | 11 | 18 (1.10) | 2.57 | 2.61 | 2.68 | |
≥2 | 2 | 0 | 2 (0.12) | 5.57 | 5.68 | 5.78 | |
25–29 or nulliparous | 0 | 172 | 410 | 582 (35.55) | 1.40 | 1.44 | 1.55 |
1 | 13 | 15 | 28 (1.71) | 3.05 | 3.14 | 2.76 | |
≥2 | – | – | – | 6.60 | 6.83 | 4.91 | |
≥30 | 0 | 62 | 139 | 201 (12.28) | 1.66 | 1.73 | 1.93 |
1 | 3 | 5 | 8 (0.49) | 3.61 | 3.77 | 2.83 | |
≥2 | 1 | 0 | 1 (0.06) | 7.82 | 8.20 | 4.17 | |
BMI (kg/m2) | |||||||
< 23.0 | 126 | 476 | 602 (36.82) | 1 | – | – | |
23.0 – 27.4 | 207 | 497 | 704 (43.06) | 1.46 | – | – | |
≥ 27.5 | 106 | 223 | 329 (20.12) | 2.14 | – | – | |
PARITY | |||||||
≥3 | 263 | 801 | 1,064 (65.00) | 1 | – | – | |
1–2 | 112 | 276 | 388 (23.70) | 1.23 | – | – | |
0 | 64 | 121 | 185 (11.30) | 1.50 | – | – |