Migration History, Language Acculturation, and Mammographic Breast Density

Cancer Epidemiol Biomarkers Prev. 2018 May;27(5):566-574. doi: 10.1158/1055-9965.EPI-17-0885. Epub 2018 Feb 23.

Abstract

Background: Breast cancer incidence is lower in many U.S. ethnic minority and foreign-born population groups. Investigating whether migration and acculturation patterns in risk are reflected in disease biomarkers may help to elucidate the underlying mechanisms.Methods: We compared the distribution of breast cancer risk factors across U.S.-born white, African American and Hispanic women, and foreign-born Hispanic women (n = 477, ages 40-64 years, 287 born in Caribbean countries). We used linear regression models to examine the associations of migration history and linguistic acculturation with mammographic breast density (MBD), measured using computer-assisted methods as percent and area of dense breast tissue.Results: The distribution of most breast cancer risk factors varied by ethnicity, nativity, and age at migration. In age- and body mass index-adjusted models, U.S.-born women did not differ in average MBD according to ethnicity, but foreign-born Hispanic women had lower MBD [e.g., -4.50%; 95% confidence interval (CI), -7.12 to -1.89 lower percent density in foreign- vs. U.S.-born Hispanic women]. Lower linguistic acculturation and lower percent of life spent in the United States were also associated with lower MBD [e.g., monolingual Spanish and bilingual vs. monolingual English speakers, respectively, had 5.09% (95% CI, -8.33 to -1.85) and 3.34% (95% CI, -6.57 to -0.12) lower percent density]. Adjusting for risk factors (e.g., childhood body size, parity) attenuated some of these associations.Conclusions: Hispanic women predominantly born in Caribbean countries have lower MBD than U.S.-born women of diverse ethnic backgrounds, including U.S.-born Hispanic women of Caribbean heritage.Impact: MBD may provide insight into mechanisms driving geographic and migration variations in breast cancer risk. Cancer Epidemiol Biomarkers Prev; 27(5); 566-74. ©2018 AACR.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acculturation
  • Adult
  • Black or African American / statistics & numerical data*
  • Breast / diagnostic imaging
  • Breast Density / ethnology*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / ethnology*
  • Caribbean Region
  • Emigrants and Immigrants / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Incidence
  • Language
  • Mammography / statistics & numerical data
  • Middle Aged
  • Risk Factors
  • United States / epidemiology