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PURPOSE: Prior studies of menopausal hormone therapy (MHT) and ovarian cancer survival have been limited by lack of hormone regimen detail and insufficient sample sizes. To address these limitations, a comprehensive analysis of 6419 post-menopausal women with pathologically confirmed ovarian carcinoma was conducted to examine the association between MHT use prior to diagnosis and survival. METHODS: Data from 15 studies in the Ovarian Cancer Association Consortium were included. MHT use was examined by type (estrogen-only (ET) or estrogen+progestin (EPT)), duration, and recency of use relative to diagnosis. Cox proportional hazards models were used to estimate the association between hormone therapy use and survival. Logistic regression and mediation analysis was used to explore the relationship between MHT use and residual disease following debulking surgery. RESULTS: Use of ET or EPT for at least five years prior to diagnosis was associated with better ovarian cancer survival (hazard ratio, 0.80; 95% CI, 0.74 to 0.87). Among women with advanced stage, high-grade serous carcinoma, those who used MHT were less likely to have any macroscopic residual disease at the time of primary debulking surgery (p for trend

Background Menopausal estrogen-alone therapy is a risk factor for endometrial and ovarian cancers. When a progestin is included with the estrogen daily (continuous estrogen-progestin combined therapy), there is no increased risk of endometrial cancer. However, the effect of continuous estrogen-progestin combined therapy on risk of ovarian cancer is less clear. Methods We pooled primary data from five population-based case-control studies in the Ovarian Cancer Association Consortium, including 1509 postmenopausal ovarian cancer cases and 2295 postmenopausal controls. Information on previous menopausal hormonal therapy use, as well as ovarian cancer risk factors, was collected using in-person interviews. Logistic regression was used to assess the association between use of continuous estrogen-progestin combined therapy and risk of ovarian cancer by duration and recency of use and disease histotype. Results Ever postmenopausal use of continuous estrogen-progestin combined therapy was not associated with increased risk of ovarian cancer overall (OR = 0.85, 95% CI = 0.72, 1.0). A decreased risk was observed for mucinous ovarian cancer (OR = 0.40, 95% CI = 0.18, 0.91). The other main ovarian cancer histotypes did not show an association (endometrioid: OR = 0.86, 95% CI = 0.57, 1.3, clear cell: OR = 0.68, 95% CI = 0.40, 1.2; serous: OR = 0.98, 95% CI = 0.80, 1.2). Conclusions Given that estrogen-alone therapy has been shown to be associated with increased risk of ovarian cancer, these findings are consistent with the hypothesis that adding a progestin each day ameliorates the carcinogenic effects of estrogen on the cells of origin for all histotypes of ovarian cancer.

Background: Previous studies on the association between reproductive factors and ovarian cancer survival are equivocal, possibly due to small sample sizes. Methods: Using data on 11,175 people diagnosed with primary invasive epithelial ovarian, fallopian tube, or primary peritoneal cancer (ovarian cancer) from 16 studies in the Ovarian Cancer Association Consortium (OCAC), we examined the associations between survival and age at menarche, combined oral contraceptive use, parity, breastfeeding, age at last pregnancy, and menopausal status using Cox proportional hazard models. The models were adjusted for age at diagnosis, race/ethnicity, education level, and OCAC study and stratified on stage and histotype. Results: During the mean follow-up of 6.34 years (SD = 4.80), 6,418 patients passed away (57.4%). There was no evidence of associations between the reproductive factors and survival among patients with ovarian cancer overall or by histotype. Conclusions: This study found no association between reproductive factors and survival after an ovarian cancer diagnosis. Impact: Reproductive factors are well-established risk factors for ovarian cancer, but they are not associated with survival after a diagnosis of ovarian cancer.

Objective Although a high proportion of women with advanced stage ovarian cancer die within five years, approximately 30% will survive longer than this. The factors contributing to exceptional survival are currently poorly understood. The viewpoints of ovarian cancer survivors were qualitatively explored to determine the factors they felt have influenced their exceptional ovarian cancer survival. Methods Four focus groups, one each in Los Angeles (California), Ann Arbor (Michigan), New York (New York) and Edmonton (Alberta, Canada), were conducted with women who had survived at least five years. Physical activity, diet, meditation, prayer, treatment, complementary medicine, and side effects were explored in semi-structured discussions. The audiotaped sessions were transcribed and coded and then analyzed using Dedoose Version 8.0.35, a qualitative analysis software. Results Of the 26 women who participated, 23 had advanced stage disease. Three overarching themes emerged: (a) survivors had improved their ‘lifestyles’, including but not limited to fitness and diet; (b) survivors were able to draw on strong support systems, which included family, friends, support groups, faith communities, and healthcare workers; and (c) survivors had a strong life purpose, which manifested as positivity, taking charge of their lives, and advocating for themselves. Conclusions Long-term survivors have varying experiences with their cancer, but identified lifestyle modification, motivation and persistence, strong life purpose, and strong support systems as key elements in their better survival. These preliminary findings indicate the need for further prospective studies to determine whether meaningful differences exist between short term and long term survivors on these characteristics.

Author(s): Lee, Alice W; Rosenzweig, Stacey; Wiensch, Ashley; Australian Ovarian Cancer Study Group; Ramus, Susan J; Menon, Usha; Gentry-Maharaj, Aleksandra; Ziogas, Argyrios; Anton-Culver, Hoda; Whittemore, Alice S; Sieh, Weiva; Rothstein, Joseph H; McGuire, Valerie; Wentzensen, Nicolas; Bandera, Elisa V; Qin, Bo; Terry, Kathryn L; Cramer, Daniel W; Titus, Linda; Schildkraut, Joellen M; Berchuck, Andrew; Goode, Ellen L; Kjaer, Susanne K; Jensen, Allan; Jordan, Susan J; Ness, Roberta B; Modugno, Francesmary; Moysich, Kirsten; Thompson, Pamela J; Goodman, Marc T; Carney, Michael E; Chang-Claude, Jenny; Rossing, Mary Anne; Harris, Holly R; Doherty, Jennifer Anne; Risch, Harvey A; Khoja, Lilah; Alimujiang, Aliya; Phung, Minh Tung; Brieger, Katharine; Mukherjee, Bhramar; Pharoah, Paul DP; Wu, Anna H; Pike, Malcolm C; Webb, Penelope M; Pearce, Celeste Leigh | Abstract: BackgroundParity is associated with decreased risk of invasive ovarian cancer; however, the relationship between incomplete pregnancies and invasive ovarian cancer risk is unclear. This relationship was examined using 15 case-control studies from the Ovarian Cancer Association Consortium (OCAC). Histotype-specific associations, which have not been examined previously with large sample sizes, were also evaluated.MethodsA pooled analysis of 10 470 invasive epithelial ovarian cancer cases and 16 942 controls was conducted. Odds ratios (ORs) and 95% confidence intervals (CIs) for the association between incomplete pregnancies and invasive epithelial ovarian cancer were estimated using logistic regression. All models were conditioned on OCAC study, race and ethnicity, age, and education level and adjusted for number of complete pregnancies, oral contraceptive use, and history of breastfeeding. The same approach was used for histotype-specific analyses.ResultsEver having an incomplete pregnancy was associated with a 16% reduction in ovarian cancer risk (OR = 0.84, 95% CI = 0.79 to 0.89). There was a trend of decreasing risk with increasing number of incomplete pregnancies (2-sided Ptrend l .001). An inverse association was observed for all major histotypes; it was strongest for clear cell ovarian cancer.ConclusionsIncomplete pregnancies are associated with a reduced risk of invasive epithelial ovarian cancer. Pregnancy, including incomplete pregnancy, was associated with a greater reduction in risk of clear cell ovarian cancer, but the result was broadly consistent across histotypes. Future work should focus on understanding the mechanisms underlying this reduced risk.

Background: Ovarian cancer is a devastating disease with a five-year survival rate of less than 50%. Identifying strategies to improve survival is imperative. Ovarian cancer survivors with higher quality of life (QoL) have better prognosis based on results from GOG-0218. Life purpose, defined as the meaning or direction a person has in life, emerged as an important theme in recent focus groups conducted among women who have lived five or more years with ovarian cancer. The participants felt that strong life purpose is a major contributor to their exceptional survival. Further, among people without cancer, strong life purpose has been shown to lead to improved QoL and longer survival. The Purposeful eHealth application (app) has been developed to improve life purpose. Preliminary data from non-cancer patients suggest that use of the app leads to increased life purpose. We hypothesized that among ovarian cancer survivors, greater life purpose is associated with higher QoL scores, and we initiated a clinical trial to test the feasibility and acceptability of ovarian cancer patients using the Purposeful app. Secondary outcomes include evaluation of whether use of this eHealth app improves life purpose and QoL. The app has potential as an accessible hands-on support system for ovarian cancer survivors to increase life purpose, QoL, and potentially survival if positive results are observed from the trial. Methods: In this single-arm interventional study (NCT04458168), eligible patients are age 18 or older, have ovarian cancer, and are under treatment through the University of Michigan Rogel Cancer Center Gynecologic Oncology clinic. As of January 2022, we have enrolled 45 women. We innovatively designed the study to enroll 25 women in each of three groups based on disease status to identify an optimal intervention period: Group 1: just completed treatment, Group 2: have not experienced a recurrence after one year since the initial diagnosis, Group 3: have experienced a recurrence after primary treatment. After providing informed consent, participants are provided with the Purposeful app and asked to fill out seven questionnaires in-person or remotely: 1) Demographics; 2) Life Purpose; 3) QoL; 4) Well-Being; 5) Fatigue; 6) Meaning in Life; and 7) Self-Care Assessment and Integrative Medicine Use. Participants’ CA125 measures and disease status are also collected from medical records. Participants are followed up at months 1, 3, and 6; at each visit, participants complete questionnaires 2-7 and the Acceptability questionnaire. Participants are asked to use the app daily until the end of 6 months. At the end of the study, overall and group-specific feasibility and acceptability will be assessed. Additionally, we will examine the associations between app usage, life purpose, and QoL through generalized linear/additive mixed models. Citation Format: Aliya Alimujiang, Bhramar Mukherjee, Maureen Metzger, R. Kevin Reynolds, Lisa Spratke, Shitanshu Uppal, Jean H. Siedel, Christine Willacker, Victor J. Strecher, Celeste Leigh Pearce, Karen McLean. Feasibility, acceptability, and evaluation of a self-care app to enhance purposeful living among ovarian cancer patients (NCT04458168) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT208.

PURPOSE: To begin to explore the possible roles of childhood diet and growth in prostate cancer (PCa) development, we investigated these exposures in relation to two known/suspected PCa risk factors, earlier pubertal timing and greater attained height, in the Longitudinal Studies of Child Health and Development. METHODS: We used biannual/annual height, weight, and dietary history data to investigate childhood diet, body mass index (BMI), birth length, and childhood height in relation to PCa risk factors (age at peak height velocity (APHV), height at age 13, and adult height) for 64 Caucasian-American boys. RESULTS: In adjusted models, childhood fat and animal protein intake was positively associated with height at age 13 and adult height (P

Mammographic breast density is a strong risk factor for breast cancer. We comprehensively investigated the associations of body mass index (BMI) change from ages 10, 18, and 30 to age at mammogram with mammographic breast density in postmenopausal women. We used multivariable linear regression models, adjusted for confounders, to investigate the associations of BMI change with volumetric percent density, dense volume, and nondense volume, assessed using Volpara in 367 women. At the time of mammogram, the mean age was 57.9 years. Compared with women who had a BMI gain of 0.1–5 kg/m2 from age 10, women who had a BMI gain of 5.1–10 kg/m2 had a 24.4% decrease [95% confidence interval (CI), 6.0%–39.2%] in volumetric percent density; women who had a BMI gain of 10.1–15 kg/m2 had a 46.1% decrease (95% CI, 33.0%–56.7%) in volumetric percent density; and women who had a BMI gain of >15 kg/m2 had a 56.5% decrease (95% CI, 46.0%–65.0%) in volumetric percent density. Similar, but slightly attenuated associations were observed for BMI gain from ages 18 and 30 to age at mammogram and volumetric percent density. BMI gain over the life course was positively associated with nondense volume, but not dense volume. We observed strong associations between BMI change over the life course and mammographic breast density. The inverse associations between early-life adiposity change and volumetric percent density suggest that childhood adiposity may confer long-term protection against postmenopausal breast cancer via its effect of mammographic breast density.

Key Points Question Does an association exist between life purpose and all-cause or cause-specific mortality among people older than 50 years participating in the US Health and Retirement Study? Findings This cohort study of 6985 adults showed that life purpose was significantly associated with all-cause mortality. Meaning Life purpose is a modifiable risk factor and as such the role of interventions to improve life purpose should be evaluated for health outcomes, including mortality., Importance A growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical. Objective To evaluate whether an association exists between life purpose and all-cause or cause-specific mortality among older adults in the United States. Design, Setting, and Participants The Health and Retirement Study (HRS) is a national cohort study of US adults older than 50 years. Adults between the ages of 51 to 61 were enrolled in the HRS, and their spouses or partners were enrolled regardless of age. Initially, individuals born between 1931 and 1941 were enrolled starting in 1992, but subsequent cohort enrichment was carried out. The present prospective cohort study sample was drawn from 8419 HRS participants who were older than 50 years and who had filled out a psychological questionnaire during the HRS 2006 interview period. Of these, 1142 nonresponders with incomplete life purpose data, 163 respondents with missing sample weights, 81 participants lost to follow-up, 1 participant with an incorrect survival time, and 47 participants with missing information on covariates were excluded. The final sample for analysis was 6985 individuals. Data analyses were conducted between June 5, 2018, and April 22, 2019. Exposures Purpose in life was assessed for the 2006 interview period with a 7-item questionnaire from the modified Ryff and Keyes Scales of Psychological Well-being evaluation using a Likert scale ranging from 1 to 6, with higher scores indicating greater purpose in life; for all-cause and cause-specific mortality analyses, 5 categories of life purpose scores were used (1.00-2.99, 3.00-3.99, 4.00-4.99, 5.00-5.99, and 6.00). Main Outcomes and Measures All-cause and cause-specific mortality were assessed between 2006 and 2010. Weighted Cox proportional hazards models were used to evaluate life purpose and mortality. Results Of 6985 individuals included in the analysis, 4016 (57.5%) were women, the mean (SD) age of all participants was 68.6 (9.8) years, and the mean (SD) survival time for decedents was 31.21 (15.42) months (range, 1.00-71.00 months). Life purpose was significantly associated with all-cause mortality in the HRS (hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category). Some significant cause-specific mortality associations with life purpose were also observed (heart, circulatory, and blood conditions: hazard ratio, 2.66; 95% CI, 1.62-4.38). Conclusions and Relevance This study’s results indicated that stronger purpose in life was associated with decreased mortality. Purposeful living may have health benefits. Future research should focus on evaluating the association of life purpose interventions with health outcomes, including mortality. In addition, understanding potential biological mechanisms through which life purpose may influence health outcomes would be valuable., This cohort study assesses whether an association exists between life purpose and all-cause or cause-specific mortality among adults older than 50 years of age who participated in the US Health and Retirement Study.

Although childhood adiposity is inversely associated with breast cancer risk, the association of childhood adiposity with mammographic density in premenopausal women has not been adequately studied. We analyzed data from 365 premenopausal women who came in for screening mammography at Washington University (St. Louis, MO) from 2015 to 2016. Body size at age 10 was self-reported using somatotype pictogram. Body mass index (BMI) at age 10 was imputed using data from Growing Up Today Study. Volpara software was used to evaluate volumetric percent density (VPD), dense volume (DV), and nondense volume (NDV). Adjusted multivariable linear regression models were used to evaluate the associations between adiposity at age 10 and mammographic density measures. Adiposity at age 10 was inversely associated with VPD and positively associated with NDV. A 1 kg/m2 increase in BMI at age 10 was associated with a 6.4% decrease in VPD, and a 6.9% increase in NDV (P < 0.001). Compared with women whose age 10 body size was 1 or 2, women with body size 3 or 4 had a 16.8% decrease in VPD and a 26.6% increase in NDV, women with body size 5 had a 32.2% decrease in VPD and a 58.5% increase in NDV, and women with body sizes ≥6 had a 47.8% decrease in VPD and a 80.9% increase in NDV (P < 0.05). The associations were attenuated, but still significant after adjusting for current BMI. Mechanistic studies to understand how childhood adiposity influences breast development, mammographic density, and breast cancer in premenopausal women are needed. Cancer Prev Res; 11(5); 287–94. ©2018 AACR.

We investigated the associations of adolescent adiposity, changes in adiposity during adulthood, and attained adiposity with volumetric mammographic density measures.We recruited 383 premenopausal women who had a routine screening mammogram at the Breast Health Center, Washington University in St. Louis, MO from December 2015 to October 2016. Trained research personnel assessed current adiposity measures. Weight at ages 18 and 30 were self-reported. We evaluated mammographic density measures: volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV) using Volpara. Multivariable linear regression models were used to evaluate the associations of adiposity measures with volumetric mammographic density measures.All attained adiposity measures, BMI at age 18, age 30, and weight change were significantly inversely associated with VPD, and positively associated with DV and NDV. One unit increase in body fat % was associated with a 4.9% decrease in VPD and a 6.5% increase in NDV (p-values0.001). For each kilogram increase in weight change from age 18 to attained, VPD decreased by 16.3%, 47.1%, and 58.8% for women who gained 5.1-15, 15.1-25 and25 kg, respectively, compared to women who gained less than 5 kg during this time period (p-values0.001). Irrespective of BMI at age 18, VPD significantly decreased and NDV increased among women who were currently obese.There is a need for mechanistic studies focusing on early adulthood to provide a better understanding of how adiposity in early life relates to mammographic density, and possibly breast cancer development in premenopausal women.

Introduction Although most women with high-grade serous ovarian cancer (HGSC) die within five years, approximately 15% will survive for 10 or more years. The factors contributing to this exceptional survival are currently unknown, but are thought to be a complex interaction between clinical, genetic, immunologic, and lifestyle factors. The purpose of this study is to qualitatively explore factors that may influence exceptional ovarian cancer survival. Methodological Approach Four focus groups, one each in Los Angeles (California), Ann Arbor (Michigan), New York (New York) and Edmonton (Alberta, Canada), were conducted. Women previously diagnosed with HGSC who have survived 5 or more years were invited to participate. Physical activity, diet, meditation, prayer, treatment, integrative medicine, and side effects were explored in the semi-structured focus group interviews. All four sessions were audiotaped and transcribed. The transcriptions were coded by two individuals using grounded theory. The coded transcripts were analyzed using Dedoose. Findings Of the 26 women who participated, 24 were diagnosed with HGSC. Two women, one with a stage III, low-grade mucinous tumor and another with a MMMT carcinosarcoma, did not meet our inclusion criteria, but were not asked to leave. Among the 24 women with HGSC, 19 have survived 10 or more years, two 8-9 years and three 5-7 years; all but one woman had stage III or IV disease. Three overarching themes were uncovered: (a) Survivors were highly motivated to improve lifestyle factors, including but not limited to fitness and diet, and had, in fact, done so; (b) Survivors had a strong life purpose, which manifested as positivity, taking charge, and self-advocacy; and (c) Survivors were able to draw on strong support systems, which included family, friends, support groups, faith, and healthcare workers. Conclusion HGSC long-term survivors have varying experiences with their cancer, but share motivation and persistence, strong life purpose, and strong support systems. This study sheds light on how the specific behaviors and attitudes of patients may contribute to their long-term survival with HGSC. Focus groups are preparatory to further prospective studies that will determine whether short term and long term survivors differ on these characteristics. Our results highlight the need for more research to gain better understanding of the role that life purpose and support systems play in survival with HGSC. Citation Format: Aliya Alimujiang, Lilah Khoja, Ashley Wiensch, Malcolm C. Pike, Penelope Webb, Anne Chase, Jean Richardson, Celeste Leigh Pearce. Ovarian cancer survivors' views of factors that influenced their exceptional survival: A qualitative study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3288.

The Great Chinese Famine afflicted almost all Chinese people between 1959 and 1961. No study has explicitly assessed the association between an exposure to Chinese Famine and risk of overall breast cancer and tumor subtype. We evaluated the unique historical environmental influences of famine exposure on breast cancer subtypes. 16,469 Chinese women who were diagnosed with invasive breast cancer in the Fudan University Shanghai Cancer Center (FUSCC) from 1999 to 2014 were analyzed. Four tumor subtypes were defined by both estrogen-receptor (ER) and progesterone-receptor (PR) status. Multinomial logistic regression models were used to estimate the odds ratios (ORs) of ER−PR−, ER+PR−, and ER−PR+ relative to ER+PR+ breast cancer for exposure to famine and age at the exposure. Compared with cases not exposed to the Famine, exposed cases were more likely to be diagnosed with ER−PR− (OR 1.60, 95 % CI 1.43–1.81), ER−PR+ (OR 4.85, 95 % CI 3.80–6.19), and ER+PR− (OR 1.99, 95 % CI 1.67–2.37) than ER+PR+ breast cancer after controlling for established breast cancer risk factors. Women exposed to Famine after first birth had a higher risk of EP−PR− (OR 1.66, 95 % CI 1.28–2.15), ER−PR+ (OR 9.75, 95 % CI 5.85–16.25), and ER+PR− (OR 2.35, 95 % CI 1.69–3.26) compared to those with ER+PR+ breast cancer. Women exposed to the Famine, particularly those exposed after first birth, were more likely to be diagnosed with ER−PR−, ER−PR+, and ER+PR− breast cancer. This retrospective analysis suggests that famine, malnutrition, or the associated lack of fruit and vegetable consumption in adulthood may be related to epidemiological heterogeneity within breast cancer subtypes.

Background: Higher mammographic breast density is a strong risk factor for breast cancer. Early-life factors may influence breast development and subsequent breast density in adulthood. Although childhood adiposity is inversely associated with breast cancer risk, the association of childhood adiposity with mammographic breast density in premenopausal women has not been adequately studied. This knowledge could provide insight into pathways linking mammographic density and breast cancer risk. We investigated the associations between adiposity at age 10 and mammographic density. Methods: We collected data from 370 premenopausal women during their routine screening mammograms at Washington University in St. Louis, MO from December 2015 to October 2016. Body size at age 10 was self-reported using the Stunkard 9-figure Somatotype pictogram. For these analyses, the Stunkard pictogram was collapsed into 4 groups: (i) body size 1 or 2, (ii) body size 3 or 4, (iii) body size 5, (iv) body size 6 or higher. Body mass index (BMI) at age 10 was imputed using BMI and Stunkard data from the Growing Up Today Study. Trained personnel collected womens' height and weight, which were used to calculate current BMI. We used the Volpara software to evaluate the following volumetric mammographic density measures: volumetric percent density (VPD), dense volume (DV) and non-dense volume (NDV). Age-adjusted Pearson correlations and multivariable linear regression models (adjusted for age, age at each given birth, family history, race, education, oral contraceptive use, and breast feeding history) were used to evaluate the associations between adiposity at age 10 and volumetric mammographic density measures. Results: The mean age at the time of screening mammogram was 47.1 years. The majority of the women (43.8%) reported having body size 1 or 2, followed by body size 3 or 4 (34.9%), body size 5 (13.8%) and body size 6 (7.6%) at age 10. We observed a negative correlation between BMI at age 10 (r= -0.28, p-value Conclusions: Our findings of an inverse association between adiposity at age 10 and percent density suggest that adiposity at age 10 could impact breast cancer development via its effect on mammographic density. Mechanistic studies to understand how childhood adiposity reduces mammographic density and breast cancer development in premenopausal women are needed. Citation Format: Alimujiang A, Imm KR, Appleton CM, Colditz GA, Berkey CS, Toriola AT. Adiposity at age 10 and mammographic density among premenopausal women [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-01-01.

Background: Although accumulating evidence from different disciplines supports an early-life contribution to prostate cancer (PCa) risk, few studies have focused on this life stage. One major reason for this dearth of research is the decades-long span of time between early-life exposures and PCa onset, making traditional epidemiologic study designs challenging. To overcome this challenge, we took advantage of several well-supported or recently observed PCa risk factors - age at peak height velocity (APHV), height at age 13, and adult height - to shorten the time required to study early-life exposures and to improve exposure classification by using these risk factors as markers of future PCa risk. We focused our analysis on childhood diet because it influenced APHV in a similar study of girls, and because of its strongly suspected role in PCa development. Methods: We analyzed data from the Longitudinal Studies of Child Health and Development, which followed 67 Caucasian boys from Boston from birth through adolescence in the 1930-40s. At each biannual (or annual) visit, study staff measured participants’ height and weight, and assessed their diet by dietary history interviews. We used these data to estimate age- and energy-adjusted nutrient intake, diet scores (combining information on fat and animal protein from ages 1-10 years into a Western diet score, and information on vegetable protein from ages 1-10 into a healthy diet score), age-specific height-z-scores, body mass index, peak height velocity (PHV), and APHV. We investigated crude associations between dietary and anthropometric measures by Pearson correlation coefficients, and multivariable-adjusted associations by linear regression. Results: Childhood consumption of a Western diet (as measured by our fat-animal protein score) was positively associated with height at age 13 (beta coefficient (ß)=0.08, P Conclusions: Our findings suggest that consumption of a Western diet during childhood (1-10 years of age) is associated with greater height at age 13, a possible marker of both earlier onset of puberty and greater height. As this measure was recently associated with later PCa risk/mortality in a large Danish cohort study, our findings may point towards an early dietary contribution to PCa risk. Future studies should explore this possible association further for its potential to inform primary PCa prevention strategies. Note: This abstract was not presented at the meeting. Citation Format: ALIYA ALIMUJIANG, Graham A. Colditz, Catherine S. Berkey, Siobhan Sutcliffe. The relation of childhood diet to the timing of puberty in boys: Results from the Longitudinal Studies of Child Health and Development [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4259. doi:10.1158/1538-7445.AM2017-4259

Background: Body mass index (BMI) is inversely associated with mammographic density among postmenopausal women, but few studies have evaluated this in premenopausal women. Further, there is limited data on the associations of weight change during adulthood with mammographic density. To address these, we investigated the associations of current adiposity measures, BMI at ages 18, 30, and changes in BMI at these age periods with volumetric mammographic density measures in 314 premenopausal women who underwent screening mammogram at the Breast Health Center, Washington University in St. Louis, MO. Methods: Study participants completed a questionnaire with information on breast cancer risk factors. Weight at ages 18 and 30 were self-reported. Current weight, height, waist, and body fat percent (%), were assessed by trained research personnel. BMIs were calculated as weight at each age/current height squared (kg/m2). We calculated weight change from; (i) age 18 to 30, (ii) age 18 to current age, (iii) age 30 to current age. Volpara was used to determine volumetric mammographic density measures. We investigated age-adjusted correlations between adiposity measures and mammographic density measures using Pearson correlation coefficients. We used multivariable linear regression models (adjusted for age, age at menarche, parity, age at each birth, family history of breast cancer, race, and education) to evaluate the associations of adiposity measures with mammographic density measures. Results: All adiposity and weight change measures were significantly inversely associated with percent density (PD), and positively associated with breast volume (BV). The strongest inverse correlations with PD were observed for body fat % (r= -0.68, P25kg to those who had stable weight (gained between 0-5kg) during this period. Conclusions: Weight gain in early adulthood is associated with reductions in PD and increases in BV in premenopausal women. Our findings highlight the need for mechanistic studies focusing on early adulthood to provide a better understanding of how adiposity relates to mammographic density, and possibly breast cancer development in premenopausal women. Citation Format: Aliya Alimujiang, Graham Colditz, Catherine Appleton, Adetunji T. Toriola. Adiposity, change in adiposity during adulthood and mammographic density in premenopausal women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4248. doi:10.1158/1538-7445.AM2017-4248