| [Background]:Breast cancer is one of most common malignant tumors in the female of the world. Since 1980s, the incidence of breast cancer has showed an upward trend with annual increasing rate of 2%～3% in the world, especially rapidly increasing in developing countries. Currently, there are about 1.2 million new cases annually, about 500,000 women dying of breast cancer. Breast cancer has been threatening women's health and lives. Although China has a low incidence of breast cancer, the incidence of breast cancer has rapidly increased in recent years, which the number of new cases is from 3% to 4% annually increasing. Data have shown that the number of new cases of breast cancer has increased 38.5% while the death number of breast cancer has increased 37.1% from 2000 to 2005 in China. Breast cancer has become the first malignant tumor of women in Beijing, Shanghai and other cities. Therefore, it is very important to focus on its prevention. It's very important in prevention and intervention of breast cancer to clarify risk factors of breast cancer, establish model for screening high-risk population, and carry out special measures for these populations. This study is aimed to explore the major risk factors of breast cancer, analyze the distribution of risk factors, propose prevention measures and recommendations; build risk assessment score model for screening high-risk population of breast cancer based on the major risk factors.[Objective]:1. Clarifying the risk and protective factors of breast cancer and analyze the interaction between these factors.2. Initially establishing risk assessment score model for screening high-risk population of breast cancer based on risk factors analyzing, so that the model can provide some guideline for breast cancer prevention and clinical treatment.[Methods]:In this study, paired case-control study based on community was used to obtain risk factors of breast cancer. Reasonably scored risks of risk factors, risk assessment score screening model would be achieved for high-risk population of breast cancer. ROC was used to get suitable value for distinguishing high or low risk population.[Results]1. Characteristics of cases of breast cancerThere were 123 cases of breast cancer which had been diagnosed in recent two years. The age ranged from 25 to 70 whose mean and standard deviation (SD) were 49.91 and 9.35. There were 4.1% of 123 breast cancer cases with 25-34 age,27.6% with 35～44 age,35.8% with 45～54 age,26.0% with 55～64 age,6.5% with 65 and over age. For education level, there were 42.7% of 123 cases with elementary level or lower,29.3% with middle school level,19.5% with high school or secondary school, and 4.0% with college and above. For occupation, there were 68.3% of 123 cases with peasant,15.4% with worker,1.7% with teacher,2.4% with civil service,2.4% with individual business company,2.4% with company staff, and 1.7% with medical staff.2. Major risk factors of breast cancerSingle variate analysis showed that there were 13 factors related to breast cancer at a=0.05 which were number of family members, family annual income, body mass index (BMI), family history of breast cancer of first-level relative, times of abortion, regular or not of menstrual, history of breast benign tumor, eating garlic, current life satisfaction, general life satisfaction, economic status, and score of behavior prevention. Four factors were associated with breast cancer by multiple conditional Logistic regression model which were BMI (OR=1.522,95%CI:1.001～2.313), history of breast benign tumor (OR=10.235,95%CI: 1.138～92.052), family history of breast cancer (OR=7.587,95%CI:0.924～62.156), current life satisfaction (OR=3.196,95%CI:1.742～5.863). Attributable risk percents (ARPs) and population attributable risk percents (PARPs) of BMI, history of breast benign tumor, family history of breast cancer, and current life satisfaction were 34.3%,5.2%; 90.2%,6.9%; 86.8%,5.0%; and 68.7%,45.1% respectively.3. Analysis of interaction between risk factors of breast cancerThere were positive interactions between BMI and family history of breast cancer of first-level relative, BMI and current life satisfaction. 4. Risk assessment score screening modelY=10×age+67×history of breast benign tumor+91×history of diabetes mellitus+60×location+12×fertility agel+69×family history 2+34×current life satisfaction+11×BMI3+18×times of abortionl The ROC area of this model was 0.729. The model's specificity and Youden's index were 60～70% and the power of its prediction was middle.5. Comparing Gail model and this modelThe ROC area of Gail model was 0.564 with P>0.05 while the ROC area of this model was 0.729 with P<0.05 which showed that diagnostic performance of this model was relatively well and indicated Gail model might be not suitable for Chinese females or should be revised.[Conclusion]Prevention should be paid more attention to prevention and control of breast cancer. Risk factors should be combined with its positive and effective control measures. Family history of breast cancer, history of breast benign tumor, current life satisfaction and body mass index were major risk factors of breast cancer. Family history of breast cancer and history of breast benign tumor had relatively strong causal effect while current life satisfaction had relatively strong prevention effect. Healthy life style should be educated to females with family history of breast cancer or history of breast benign tumor. The risk assessment score model for screening high-risk population of breast cancer had certain practical value which might be used in the population prevention and intervention of breast cancer for screening high risk population. However, the source of data is some limited, extrapolating of this model has certain limitations which should be further verified and improved.
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