Healthy eating index and breast cancer risk among Malaysian women

• Published in: European journal of cancer prevention 2013-07, Vol.22 (4), p.342-347
• Main Authors: Shahril, Mohd Razif, Sulaiman, Suhaina, Shaharudin, Soraya Hanie, Akmal, Sharifah Noor
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Breast Neoplasms - etiology; Diet; Female; Humans; Malaysia; Medical sciences; Middle Aged; Miscellaneous; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk; Short paper; Tumors
• ISSN: 0959-8278; 1473-5709
• DOI: 10.1097/cej.0b013e32835b37f9

Healthy Eating Index-2005 (HEI-2005), an index-based dietary pattern, has been shown to predict the risk of chronic diseases among Americans. This study aims to examine the ability of HEI-2005 in predicting the probability for risk of premenopausal and postmenopausal breast cancer among Malaysian women. Data from a case–control nutritional epidemiology study among 764 participants including 382 breast cancer cases and 382 healthy women were extracted and scored. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to evaluate the relationship between the risk of breast cancer and quartiles (Q) of HEI-2005 total scores and its component, whereas the risk prediction ability of HEI-2005 was investigated using diagnostics analysis. The results of this study showed that there is a significant reduction in the risk of breast cancer, with a higher HEI-2005 total score among premenopausal women (OR Q1 vs. Q4 = 0.34, 95% CI; 0.15–0.76) and postmenopausal women (OR Q1 vs. Q4 = 0.20, 95% CI; 0.06–0.63). However, HEI-2005 has a sensitivity of 56–60%, a specificity of 55–60%, and a positive predictive value and negative predictive value of 57–58%, which indicates a moderate ability to predict the risk of breast cancer according to menopausal status. The breast cancer incidence observed poorly agrees with risk outcomes from HEI-2005 as shown by low κ statistics (κ = 0.15). In conclusion, although the total HEI-2005 scores were associated with a risk of breast cancer among Malaysian women, the ability of HEI-2005 to predict risk is poor as indicated by the diagnostic analysis. A local index-based dietary pattern, which is disease specific, is required to predict the risk of breast cancer among Malaysian women for early prevention.