Increasing Skirt Size Points to Postmenopausal Breast Cancer Risk

Change in skirt size signals postmenopausal breast cancer risk

medwireNews: Going up a skirt size in early adulthood is a good indicator of the increased risk of postmenopausal cancer associated with adiposity, say UK researchers who believe the measurement can act as a proxy for waist circumference.

Each increase in self-reported skirt size per decade between the age of 25 years and postmenopausal age was associated with a 33% increase in the risk of postmenopausal breast cancer, reports the team in BMJ Open.

This risk was calculated after adjusting for a raft of confounding factors, including age at menarche and menopause, history of hormone use, family history of breast and ovarian cancer, education, alcohol consumption and smoking habits.

Conversely, the data from 92,834 participants of the UK Collaborative Trial of Ovarian Cancer Screening indicate that each reduction in self-reported skirt size per decade conferred a 33% reduction in the risk of postmenopausal breast cancer, although skirt size increased for 76% of participants over the study period.

“These findings may provide women with a simple and easy to understand message given that [skirt size] has been found to be a reliable measure for changes in waist circumference and one that women may relate and understand better in comparison to other adiposity measures such as [body mass index]”, write Usha Menon, from University College London, and co-authors.

Change in skirt size continued to predict postmenopausal breast cancer risk after adjusting for other measures of adiposity such as body mass index or skirt size on entry to the study.

In all, 1.2% of women in the study developed postmenopausal breast cancer over a median of 3.19 years of follow-up. The researchers calculated that a unit increase in skirt size per decade was associated with an increase in the 5-year absolute risk of postmenopausal breast cancer from 1.63% to 2.14%.

Usha Menon and co-authors admit that the study may be limited by recall bias of skirt size at age 25 but say that such an error would lead researchers to underestimate the strength of the relationship between change in skirt size and breast cancer risk.

“Although the exact mechanism of these relationships need[s] to be better understood, there is a suggestion that body fat around the waist is more metabolically active than adipose tissue elsewhere”, the team concludes.

“Obesity is known to increase oestrogen levels as a result of aromatisation of androstenedione in adipose tissue as well as affect insulin resistance and chronic inflammation, well known factors shown to increase breast cancer risk.”


Fourkala E-O, BGurnell M, Cox C, et al. Association of skirt size and postmenopausal breast cancer risk in older women: a cohort study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). BMJ Open 2014;4:e005400. doi:10.1136/bmjopen-2014- 005400

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