Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature

Animal experiments and human ecological studies suggest that dietary fat intake is associated with a risk of breast cancer, but individual-based studies have given contradictory results. We have carried out a meta-analysis of this association to include all papers published up to July 2003. Case–control and cohort studies that examined the association of dietary fat, or fat-containing foods, with risk of breast cancer were identified. A total of 45 risk estimates for total fat intake were obtained. Descriptive data from each study were extracted with an estimate of relative risk and its associated 95% confidence interval (CI), and were analysed using the random effects model of DerSimonian and Laird. The summary relative risk, comparing the highest and lowest levels of intake of total fat, was 1.13 (95% CI: 1.03–1.25). Cohort studies (N=14) had a summary relative risk of 1.11 (95% CI: 0.99–1.25) and case–control studies (N=31) had a relative risk of 1.14 (95% CI 0.99–1.32). Significant summary relative risks were also found for saturated fat (RR, 1.19; 95% CI: 1.06–1.35) and meat intake (RR, 1.17; 95% CI 1.06–1.29). Combined estimates of risk for total and saturated fat intake, and for meat intake, all indicate an association between higher intakes and an increased risk of breast cancer. Case–control and cohort studies gave similar results.