Exposure to Severn Malnutrition Associated with Increased Breast Cancer Risk
Behind the Cancer Headlines®
April 12, 2004
Women who experienced a short but severe decrease in their food intake during the 1944–1945 Dutch famine have an increased risk of breast cancer compared with women whose caloric intake was not as greatly affected, according to a study published in the Journal of the National Cancer Institute.
Several animal studies have found that reducing caloric intake by one-third to one-half for the animals' lifetime prevents various types of cancer, but the implications of short-term caloric restriction are largely unknown. However, reproducing these types of studies in humans raises ethical and practical issues.
During World War II, a famine in the western part of The Netherlands resulted from a food embargo imposed by German authorities. Between 1983 and 1986, about 15,000 women participating in a Dutch breast cancer screening program who were between ages 2 and 33 during the 1944–1945 famine responded to a questionnaire about their famine experience. Sjoerd G. Elias, Ph.D., of the Julius Center for Health Sciences and Primary Care at the University Medical Center Utrecht, The Netherlands, and colleagues used data gathered from these women to study the effects of the famine on subsequent breast cancer risk.
Women were given a famine exposure score—absent, moderate, or severe exposure to famine—based on information about hunger, cold, and weight loss. The risk of breast cancer increased with increasing severity of famine exposure. For example, women who experienced severe exposure to famine had a 48% increased risk of breast cancer compared with women who were not affected by the famine.
The association between famine exposure and breast cancer risk was highest among women who were between ages 2 and 9 during the famine compared with women exposed at older ages. The risk was also stronger among women who never gave birth compared with women who had children.
Although a mechanism for the increased breast cancer risk among women exposed to short-term famine is unknown, the authors suggest that several endocrine systems may adapt to the extreme conditions of the famine, particularly while such systems are developing in young children, and are consequently inadequately developed to respond to a much higher caloric intake later on in life.
"Although the 1944–1945 famine is a black page in Dutch history, it provides a unique situation in which to study the long-term consequences of a short but severe famine in humans," the authors write.
Journal of the National Cancer Institute, April 7, 2004