A comparison of prospective and retrospective assessments of diet in the study of breast cancer
Abstract
Fat intake was examined in relation to risk of breast cancer using dietary questionnaires administered both before and after the diagnosis of breast cancer. Among the Nurses' Health Study cohort members who completed a food frequency questionnaire and were free of cancer in 1986, 398 were diagnosed with breast cancer during 2 years of follow-up. These cases and 798 age-matched controls (cohort members who also completed a dietary questionnaire in 1986 but did not develop breast cancer) were sent another food frequency questionnaire in 1989 inquiring about their diet in 1985. Three hundred cases and 602 controls responded to the second questionnaire. The age-adjusted analysis using the prospective (1986) questionnaire demonstrated no appreciable associations between breast cancer incidence and intakes of total fat (odds ratio (OR) between highest and lowest quintiles = 0.87; 95% confidence interval (CI) 0.54-1.40) and saturated fat (OR = 0.97; CI 0.64-1.46). The age-adjusted analysis using the retrospective (1989) questionnaire suggested positive associations between breast cancer incidence and intakes of total fat (OR = 1.43; 95% CI 0.90-2.27) and saturated fat (OR = 1.38; 95% CI 0.89-2.13). When nutrients were adjusted for total energy intake, the direction and magnitude of the differences between the prospective and retrospective analyses were similar to the analyses unadjusted for energy intake. These results suggest that case-control studies of diet and breast cancer may yield biased associations between fat intake and the risk of breast cancer.
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Data from cohort studies have shown the existence of recall bias when intake of other beverages such as alcohol is assessed retrospectively in relation to the onset of disease.
“Data from cohort studies have shown the existence of recall bias when intake of other beverages (such as alcohol) are assessed retro- spectively in relation to the onset of disease.5'”
From Does coffee drinking increase the risk of coronary heart disease? Results from a meta‐analysis (1994) · cites this paper as [51]
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- Authors
- Giovannucci, E., stampfer, M. J., Colditz, G. A., Manson, J. E., Rosner, B. A., Longnecker, M., Speizer, F. E., & Willett, W. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- University of California, Los Angeles (US)
- Corresponding author
- Giovannucci, Edward
- ORCID
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1993-03-01
- Volume
- 137
- Issue
- 5
- Pages
- 502-511
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2261270094
- Cited by
- 207
- References
- 0
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 1 · 2023: 4 · 2021: 1 · 2020: 3 · 2018: 3 · 2017: 6 · 2016: 1 · 2015: 6 · 2014: 1 · 2013: 1 · 2012: 6
- FWCI
- 24.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ca040935-02)
- National Cancer Institute (CA-40935, CA-55075)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- breast cancer, dietary fat intake, saturated fat, food frequency questionnaire, case-control bias, Nurses' Health Study, cancer risk
- MeSH terms
- Adult, Breast Neoplasms, Energy Intake, Diet, Dietary Fats, Epidemiologic Methods, Female, Humans, Middle Aged, Prospective Studies, Surveys and Questionnaires, Retrospective Studies, Risk Factors, Cohort Studies, Bias, Selection Bias, Incidence, Odds Ratio, Case-Control Studies
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