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The ecologic approach generally finds that dietary fat is highly associated with breast carcinoma mortality, with fish intake and solar ultraviolet\u2010B (UV\u2010B) radiation, a source of vitamin D, inversely associated. Case\u2013control and cohort studies generally find a variety of chemical, nonfat dietary, environmental, genetic, lifestyle, and reproductive factors to be important.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>An ecologic study was conducted using breast carcinoma mortality rates (1989\u20131996), dietary supply data, and latitude (an index of solar UV\u2010B radiation) from 35 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The fraction of energy derived from animal products (risk) combined with that from vegetable products (risk reduction), followed by solar UV\u2010B radiation and, to a lesser extent, energy derived from alcohol (risk) and fish intake (risk reduction), were found to explain 80% of the variance of breast carcinoma mortality rates. Dietary fat contributed insignificantly in regressions involving the other factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>It is hypothesized that animal products are associated with risk for breast carcinoma because they are associated with greater amounts of insulin\u2010like growth factor\u20131and lifetime doses of estrogen. Vegetable products contain several risk reduction components including antioxidants and phytoestrogens. The association with latitude is very likely because of solar UV\u2010B radiation and vitamin D. Alcohol modulates estrogen's effects on breasts. Fish intake is associated with risk reduction through vitamin D and n\u20103 oils. These results are consistent with those of many case\u2013control and cohort studies but should be assessed in well designed cohort studies. Cancer 2002;94:272\u201381. \u00a9 2002 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.10196","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T18:14:37Z","timestamp":1030299277000},"page":"272-281","source":"Crossref","is-referenced-by-count":162,"title":["An ecologic study of dietary and solar ultraviolet\u2010B links to breast carcinoma mortality rates"],"prefix":"10.1002","volume":"94","author":[{"given":"William B.","family":"Grant","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2001,12,28]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910150411"},{"key":"e_1_2_7_3_2","first-page":"3374","article-title":"Experimental evidence of dietary factors and hormone\u2010dependent cancers","volume":"35","author":"Carroll KK","year":"1975","journal-title":"Cancer Res"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19861015)58:8 <1804::AID-CNCR2820581404>3.0.CO;2-N"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1993.1016"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.332"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/01635588909514002"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-7435(90)90058-R"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1999.tb08728.x"},{"key":"e_1_2_7_10_2","first-page":"96","article-title":"Acid haze air pollution and breast and colon cancer mortality in 20 Canadian cities","volume":"80","author":"Gorham ED","year":"1989","journal-title":"Can J Public Health"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/19.4.820"},{"key":"e_1_2_7_12_2","first-page":"377","volume-title":"Dietary fat and breast cancer","author":"Willett W","year":"1998"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2001.00822.x"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.10.914"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nutr.20.1.221"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008469-199407000-00003"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980099000385"},{"key":"e_1_2_7_18_2","first-page":"399","article-title":"Vitamin D and breast cancer risk: the NHANES I epidemiologic follow\u2010up study, 1971\u20131975 to 1992. 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