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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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The Heritability of Breast Cancer among Women in the Nordic Twin Study of Cancer

Sören Möller, Lorelei A. Mucci, Jennifer R. Harris, Thomas Scheike, Klaus Holst, Ulrich Halekoh, Hans-Olov Adami, Kamila Czene, Kaare Christensen, Niels V. Holm, Eero Pukkala, Axel Skytthe, Jaakko Kaprio and Jacob B. Hjelmborg
Sören Möller
1Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark.
2The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.
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  • For correspondence: moeller@health.sdu.dk
Lorelei A. Mucci
3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
4Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
5Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.
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Jennifer R. Harris
6Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway.
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Thomas Scheike
7Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
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Klaus Holst
7Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
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Ulrich Halekoh
1Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark.
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Hans-Olov Adami
3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
8Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Kamila Czene
8Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Kaare Christensen
1Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark.
2The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.
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Niels V. Holm
2The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.
9Department of Oncology, Odense University Hospital, Odense, Denmark.
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Eero Pukkala
10Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
11School of Health Sciences, University of Tampere, Tampere, Finland.
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Axel Skytthe
1Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark.
2The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.
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Jaakko Kaprio
12Department of Public Health & Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland.
13Department of Health, National Institute for Health & Welfare, Helsinki, Finland.
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Jacob B. Hjelmborg
1Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark.
2The Danish Twin Registry, University of Southern Denmark, Odense, Denmark.
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DOI: 10.1158/1055-9965.EPI-15-0913 Published January 2016
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    Figure 1.

    Casewise concordance of breast cancer risk by age at diagnosis for MZ pairs and DZ pairs, and the marginal risk of breast cancer. The risks are adjusted for censoring and competing risk of death. Transparent areas show 95% confidence interval.

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    Figure 2.

    Additive genetic and common environment component of liability to breast cancer by age at diagnosis. Bias correction due to censoring and competing risk of death by the inverse probability weighting technique. Transparent areas show 95% confidence interval.

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    Figure 3.

    Pattern of cumulative breast cancer hazard in monozygotic (left) and dizygotic (right) twins with respect to age of diagnosis of the co-twin. Bias correcting due to censoring and competing risk.

Tables

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  • Table 1.

    Description of female twins from same-sexed pairs in the Nordic Twin Studies of Cancer (NorTwinCan) cohorts

    DenmarkFinlandNorwaySwedenTotal
    Birth cohorts1870–20041880–19571895–19791886–2008
    Cancer registration since1943195319531958
    Initiation of follow-up1943197519641961
    End of follow-up2009–12-312010–12-312008–12-312009–12-31
    N female twins33,33912,50712,82445,869104,539
    N MZ/DZ complete pairs6,235/10,4302,026/4,1792,935/3,4399,859/12,89221,055/30,940
    N MZ/DZ complete uncensored pairs1,251/2,332403/792195/2321,781/3,2383,630/6,594
    N breast cancer cases1,2296353581,7113,933
    N breast cancer in complete pairs1,2296303521,7003,911
    N breast cancer in complete uncensored pairs695221919071,914
    N concordant uncensored MZ/DZ pairs44/4815/2313/552/65124/141
    N discordant uncensored MZ/DZ pairs170/34139/10618/37243/430470/914
    N unaffected uncensored MZ/DZ pairs1,037/1,943349/663164/1901,486/2,7433,036/5,539
  • Table 2.

    Cumulative risk, casewise concordance risk, and heritability of liability to breast cancer diagnosis in the NorTwinCan database; bias correction due to censoring by the inverse probability weighting technique; lifetime risk for premenopausal cancer is up to 50 years, although lifetime risk for postmenopausal cancer is conditional on survival to age 53 years

    Casewise concordance and 95% CIEstimates and 95% CIs from twin modeling
    Age at diagnosisLifetime risk and 95% CIMZDZCommon env. c2Heritability h2
    Any ages8.1% (7.8%–8.5%)28% (23%–33%)20% (17%–24%)16% (10%–32%)31% (10%–52%)
    <50 years1.5% (1.2%–1.7%)10% (5%–17%)6% (3%–10%)12% (0%–39%)27% (0%–62%)
    ≥53 years7.2% (6.6%–7.8%)21% (16%–27%)16% (13%–20%)16% (0%–34%)22% (0%–46%)
  • Table 3.

    Relative recurrence risk and multilocus index of breast cancer by decades of age of diagnosis of breast cancer for female MZ and DZ pairs; bias correction due to censoring and competing risk of death

    AgeRelative recurrence risk for MZRelative recurrence risk for DZMultilocus index
    (95% CI)(95% CI)(95% CI)
    All2.16 (1.77–2.55)1.70 (1.41–1.99)1.64 (0.78–2.50)
    −505.91 (1.75–10.07)3.51 (1.02–6.00)1.96 (−0.59–4.51)
    50–604.93 (3.36–6.50)2.77 (1.83–3.71)2.21 (0.74–3.68)
    60–702.98 (2.27–3.69)2.24 (1.73–2.75)1.60 (0.74–2.46)
    70–802.50 (2.01–2.99)1.80 (1.45–2.15)1.87 (0.87–2.87)
    80–902.15 (1.76–2.54)1.67 (1.38–1.96)1.71 (0.77–2.65)
    90+2.04 (1.65–2.43)1.68 (1.39–1.97)1.53 (0.65–2.41)
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Cancer Epidemiology Biomarkers & Prevention: 25 (1)
January 2016
Volume 25, Issue 1
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The Heritability of Breast Cancer among Women in the Nordic Twin Study of Cancer
Sören Möller, Lorelei A. Mucci, Jennifer R. Harris, Thomas Scheike, Klaus Holst, Ulrich Halekoh, Hans-Olov Adami, Kamila Czene, Kaare Christensen, Niels V. Holm, Eero Pukkala, Axel Skytthe, Jaakko Kaprio and Jacob B. Hjelmborg
Cancer Epidemiol Biomarkers Prev January 1 2016 (25) (1) 145-150; DOI: 10.1158/1055-9965.EPI-15-0913

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The Heritability of Breast Cancer among Women in the Nordic Twin Study of Cancer
Sören Möller, Lorelei A. Mucci, Jennifer R. Harris, Thomas Scheike, Klaus Holst, Ulrich Halekoh, Hans-Olov Adami, Kamila Czene, Kaare Christensen, Niels V. Holm, Eero Pukkala, Axel Skytthe, Jaakko Kaprio and Jacob B. Hjelmborg
Cancer Epidemiol Biomarkers Prev January 1 2016 (25) (1) 145-150; DOI: 10.1158/1055-9965.EPI-15-0913
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