Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort
Background Women with higher educational attainment have a higher risk of developing breast cancer (BC). Despite the acknowledged impact of reproductive and lifestyle factors, some excess risks remain unexplained. Many studies support the hypothesis that education has a distinctive effect on physiol...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e087537.full |
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| author | Cyrille Delpierre Raphaële Castagné Eloïse Berger Gianluca Severi Marie-Christine Boutron-Ruault Laura Baglietto Laure Dossus Amandine Gelot Richard Dudouet |
| author_facet | Cyrille Delpierre Raphaële Castagné Eloïse Berger Gianluca Severi Marie-Christine Boutron-Ruault Laura Baglietto Laure Dossus Amandine Gelot Richard Dudouet |
| author_sort | Cyrille Delpierre |
| collection | DOAJ |
| description | Background Women with higher educational attainment have a higher risk of developing breast cancer (BC). Despite the acknowledged impact of reproductive and lifestyle factors, some excess risks remain unexplained. Many studies support the hypothesis that education has a distinctive effect on physiological processes associated with health, independently of known risk factors.Objectives In this study, we aimed to determine whether the biological embodiment of education could be part of the observed social inequalities in BC risk. We focused on biomarkers from several physiological systems examined individually, and jointly through a biological health score (BHS).Design Prospective cohort study.Setting This study, based on a subsample of the French E3N cohort, included women with biological data from four nested case–control studies.Participants The study included 3048 postmenopausal women (17% BC).Main outcome measures We first evaluated the association between educational attainment and each biomarker, separately (N=11) and by combining them into a BHS, indicative of an augmented biological health hazard when elevated. Finally, we explored the relationships between the socially patterned biomarkers and BHS, and risk of incident BC.Results Women with higher educational attainment exhibited a lower BHS in comparison to those with lower educational attainment (βhigh education=−0.21 (95% CI −0.42; 0.01), model 2). Specific biomarkers associated with the cardiovascular (systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), high-density lipoprotein (HDL)), inflammatory (C reactive protein (CRP)) and hormonal systems (sex hormone-binding globulin (SHBG) and oestradiol) were found socially distributed (OR CRP-high=0.70 (95% CI 0.54; 0.91), OR TG-high=0.79 (95% CI 0.61; 1.04), OR DBP-high=0.69 (95% CI 0.53; 0.90), OR SBP-high=0.57 (95% CI 0.44; 0.74), OR HDL-high=0.79 (95% CI 0.60; 1.03), (OR SHBG-high=0.67 (95% CI 0.52; 0.88), OR oestradiol-high=1.34 (95% CI 1.00; 1.79); model 1). Associations persisted after adjustment for cofounders and a large set of potential mediators for two of the investigated cardiovascular markers (OR DBP-high=0.75 (95% CI 0.57; 1.00), OR SBP-high=0.61 (95% CI 0.46; 0.81); model 2). No associations were found between the socially stratified biomarkers and BHS with risk of BC.Conclusion Educational attainment has a direct impact on biological processes suggesting that the biological embodiment of the social environment could be a potential pathway that mediates the association between educational attainment and health. Further studies are needed to specifically investigate the relationships between socially stratified biomarkers and BC risk. |
| format | Article |
| id | doaj-art-944d77b69d844b5d8f99b6104f8ae13a |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-944d77b69d844b5d8f99b6104f8ae13a2025-02-07T07:15:12ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-087537Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohortCyrille Delpierre0Raphaële Castagné1Eloïse Berger2Gianluca Severi3Marie-Christine Boutron-Ruault4Laura Baglietto5Laure Dossus6Amandine Gelot7Richard Dudouet81 EQUITY team, INSERM-UMR 1295, CERPOP, Toulouse, France1 EQUITY team, INSERM-UMR 1295, CERPOP, Toulouse, France1 EQUITY team, INSERM-UMR 1295, CERPOP, Toulouse, France3 Paris Saclay University, INSERM, Gustave Roussy, `Exposome and Heredity` Team, CESP, UVSQ, Villejuif, France3 Paris Saclay University, INSERM, Gustave Roussy, `Exposome and Heredity` Team, CESP, UVSQ, Villejuif, France3 Paris Saclay University, INSERM, Gustave Roussy, `Exposome and Heredity` Team, CESP, UVSQ, Villejuif, France2 International Agency for Research on Cancer, Lyon, France3 Paris Saclay University, INSERM, Gustave Roussy, `Exposome and Heredity` Team, CESP, UVSQ, Villejuif, France1 EQUITY team, INSERM-UMR 1295, CERPOP, Toulouse, FranceBackground Women with higher educational attainment have a higher risk of developing breast cancer (BC). Despite the acknowledged impact of reproductive and lifestyle factors, some excess risks remain unexplained. Many studies support the hypothesis that education has a distinctive effect on physiological processes associated with health, independently of known risk factors.Objectives In this study, we aimed to determine whether the biological embodiment of education could be part of the observed social inequalities in BC risk. We focused on biomarkers from several physiological systems examined individually, and jointly through a biological health score (BHS).Design Prospective cohort study.Setting This study, based on a subsample of the French E3N cohort, included women with biological data from four nested case–control studies.Participants The study included 3048 postmenopausal women (17% BC).Main outcome measures We first evaluated the association between educational attainment and each biomarker, separately (N=11) and by combining them into a BHS, indicative of an augmented biological health hazard when elevated. Finally, we explored the relationships between the socially patterned biomarkers and BHS, and risk of incident BC.Results Women with higher educational attainment exhibited a lower BHS in comparison to those with lower educational attainment (βhigh education=−0.21 (95% CI −0.42; 0.01), model 2). Specific biomarkers associated with the cardiovascular (systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), high-density lipoprotein (HDL)), inflammatory (C reactive protein (CRP)) and hormonal systems (sex hormone-binding globulin (SHBG) and oestradiol) were found socially distributed (OR CRP-high=0.70 (95% CI 0.54; 0.91), OR TG-high=0.79 (95% CI 0.61; 1.04), OR DBP-high=0.69 (95% CI 0.53; 0.90), OR SBP-high=0.57 (95% CI 0.44; 0.74), OR HDL-high=0.79 (95% CI 0.60; 1.03), (OR SHBG-high=0.67 (95% CI 0.52; 0.88), OR oestradiol-high=1.34 (95% CI 1.00; 1.79); model 1). Associations persisted after adjustment for cofounders and a large set of potential mediators for two of the investigated cardiovascular markers (OR DBP-high=0.75 (95% CI 0.57; 1.00), OR SBP-high=0.61 (95% CI 0.46; 0.81); model 2). No associations were found between the socially stratified biomarkers and BHS with risk of BC.Conclusion Educational attainment has a direct impact on biological processes suggesting that the biological embodiment of the social environment could be a potential pathway that mediates the association between educational attainment and health. Further studies are needed to specifically investigate the relationships between socially stratified biomarkers and BC risk.https://bmjopen.bmj.com/content/15/2/e087537.full |
| spellingShingle | Cyrille Delpierre Raphaële Castagné Eloïse Berger Gianluca Severi Marie-Christine Boutron-Ruault Laura Baglietto Laure Dossus Amandine Gelot Richard Dudouet Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort BMJ Open |
| title | Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort |
| title_full | Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort |
| title_fullStr | Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort |
| title_full_unstemmed | Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort |
| title_short | Biological embodiment of educational attainment and future risk of breast cancer: findings from a French prospective cohort |
| title_sort | biological embodiment of educational attainment and future risk of breast cancer findings from a french prospective cohort |
| url | https://bmjopen.bmj.com/content/15/2/e087537.full |
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