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Morra A, Jung AY, Behrens S, et al. Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium. Cancer Epidemiol Biomarkers Prev. 2021;30(4):623-642doi: 10.1158/1055-9965.EPI-20-0924.
Morra, A., Jung, A. Y., Behrens, S., Keeman, R., Ahearn, T. U., Anton-Culver, H., Arndt, V., Augustinsson, A., Auvinen, P. K., Beane Freeman, L. E., Becher, H., Beckmann, M. W., Blomqvist, C., Bojesen, S. E., Bolla, M. K., Brenner, H., Briceno, I., Brucker, S. Y., Camp, N. J., Campa, D., Canzian, F., Castelao, J. E., Chanock, S. J., Choi, J. Y., Clarke, C. L., Couch, F. J., Cox, A., Cross, S. S., Czene, K., Dörk, T., Dunning, A. M., Dwek, M., Easton, D. F., Eccles, D. M., Egan, K. M., Evans, D. G., Fasching, P. A., Flyger, H., Gago-Dominguez, M., Gapstur, S. M., García-Sáenz, J. A., Gaudet, M. M., Giles, G. G., Grip, M., Guénel, P., Haiman, C. A., Håkansson, N., Hall, P., Hamann, U., Han, S. N., Hart, S. N., Hartman, M., Heyworth, J. S., Hoppe, R., Hopper, J. L., Hunter, D. J., Ito, H., Jager, A., Jakimovska, M., Jakubowska, A., Janni, W., Kaaks, R., Kang, D., Kapoor, P. M., Kitahara, C. M., Koutros, S., Kraft, P., Kristensen, V. N., Lacey, J. V., Lambrechts, D., Le Marchand, L., Li, J., Lindblom, A., Lubiński, J., Lush, M., Mannermaa, A., Manoochehri, M., Margolin, S., Mariapun, S., Matsuo, K., Mavroudis, D., Milne, R. L., Muranen, T. A., Newman, W. G., Noh, D. Y., Nordestgaard, B. G., Obi, N., Olshan, A. F., Olsson, H., Park-Simon, T. W., Petridis, C., Pharoah, P. D. P., Plaseska-Karanfilska, D., Presneau, N., Rashid, M. U., Rennert, G., Rennert, H. S., Rhenius, V., Romero, A., Saloustros, E., Sawyer, E. J., Schneeweiss, A., Schwentner, L., Scott, C., Shah, M., Shen, C. Y., Shu, X. O., Southey, M. C., Stram, D. O., Tamimi, R. M., Tapper, W., Tollenaar, R. A. E. M., Tomlinson, I., Torres, D., Troester, M. A., Truong, T., Vachon, C. M., Wang, Q., Wang, S. S., Williams, J. A., Winqvist, R., Wolk, A., Wu, A. H., Yoo, K. Y., Yu, J. C., Zheng, W., Ziogas, A., Yang, X. R., Eliassen, A. H., Holmes, M. D., García-Closas, M., Teo, S. H., Schmidt, M. K., Chang-Claude, J. (2021). Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 30(4), 623-642. https://doi.org/10.1158/1055-9965.EPI-20-0924
Morra, Anna, et al. "Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium." Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology vol. 30,4 (2021): 623-642. doi: https://doi.org/10.1158/1055-9965.EPI-20-0924
Morra A, Jung AY, Behrens S, Keeman R, Ahearn TU, Anton-Culver H, Arndt V, Augustinsson A, Auvinen PK, Beane Freeman LE, Becher H, Beckmann MW, Blomqvist C, Bojesen SE, Bolla MK, Brenner H, Briceno I, Brucker SY, Camp NJ, Campa D, Canzian F, Castelao JE, Chanock SJ, Choi JY, Clarke CL, Couch FJ, Cox A, Cross SS, Czene K, Dörk T, Dunning AM, Dwek M, Easton DF, Eccles DM, Egan KM, Evans DG, Fasching PA, Flyger H, Gago-Dominguez M, Gapstur SM, García-Sáenz JA, Gaudet MM, Giles GG, Grip M, Guénel P, Haiman CA, Håkansson N, Hall P, Hamann U, Han SN, Hart SN, Hartman M, Heyworth JS, Hoppe R, Hopper JL, Hunter DJ, Ito H, Jager A, Jakimovska M, Jakubowska A, Janni W, Kaaks R, Kang D, Kapoor PM, Kitahara CM, Koutros S, Kraft P, Kristensen VN, Lacey JV, Lambrechts D, Le Marchand L, Li J, Lindblom A, Lubiński J, Lush M, Mannermaa A, Manoochehri M, Margolin S, Mariapun S, Matsuo K, Mavroudis D, Milne RL, Muranen TA, Newman WG, Noh DY, Nordestgaard BG, Obi N, Olshan AF, Olsson H, Park-Simon TW, Petridis C, Pharoah PDP, Plaseska-Karanfilska D, Presneau N, Rashid MU, Rennert G, Rennert HS, Rhenius V, Romero A, Saloustros E, Sawyer EJ, Schneeweiss A, Schwentner L, Scott C, Shah M, Shen CY, Shu XO, Southey MC, Stram DO, Tamimi RM, Tapper W, Tollenaar RAEM, Tomlinson I, Torres D, Troester MA, Truong T, Vachon CM, Wang Q, Wang SS, Williams JA, Winqvist R, Wolk A, Wu AH, Yoo KY, Yu JC, Zheng W, Ziogas A, Yang XR, Eliassen AH, Holmes MD, García-Closas M, Teo SH, Schmidt MK, Chang-Claude J. Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium. Cancer Epidemiol Biomarkers Prev. 2021 Apr;30(4):623-642. doi: 10.1158/1055-9965.EPI-20-0924. Epub 2021 Jan 26. PMID: 33500318; PMCID: PMC8026532.
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Cancer Epidemiol Biomarkers Prev. 2021 Apr;30(4):623-642. doi: 10.1158/1055-9965.EPI-20-0924. Epub 2021 Jan 26.

Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

Anna Morra, Audrey Y Jung, Sabine Behrens, Renske Keeman, Thomas U Ahearn, Hoda Anton-Culver, Volker Arndt, Annelie Augustinsson, Päivi K Auvinen, Laura E Beane Freeman, Heiko Becher, Matthias W Beckmann, Carl Blomqvist, Stig E Bojesen, Manjeet K Bolla, Hermann Brenner, Ignacio Briceno, Sara Y Brucker, Nicola J Camp, Daniele Campa, Federico Canzian, Jose E Castelao, Stephen J Chanock, Ji-Yeob Choi, Christine L Clarke, Fergus J Couch, Angela Cox, Simon S Cross, Kamila Czene, Thilo Dörk, Alison M Dunning, Miriam Dwek, Douglas F Easton, Diana M Eccles, Kathleen M Egan, D Gareth Evans, Peter A Fasching, Henrik Flyger, Manuela Gago-Dominguez, Susan M Gapstur, José A García-Sáenz, Mia M Gaudet, Graham G Giles, Mervi Grip, Pascal Guénel, Christopher A Haiman, Niclas Håkansson, Per Hall, Ute Hamann, Sileny N Han, Steven N Hart, Mikael Hartman, Jane S Heyworth, Reiner Hoppe, John L Hopper, David J Hunter, Hidemi Ito, Agnes Jager, Milena Jakimovska, Anna Jakubowska, Wolfgang Janni, Rudolf Kaaks, Daehee Kang, Pooja Middha Kapoor, Cari M Kitahara, Stella Koutros, Peter Kraft, Vessela N Kristensen, James V Lacey, Diether Lambrechts, Loic Le Marchand, Jingmei Li, Annika Lindblom, Jan Lubiński, Michael Lush, Arto Mannermaa, Mehdi Manoochehri, Sara Margolin, Shivaani Mariapun, Keitaro Matsuo, Dimitrios Mavroudis, Roger L Milne, Taru A Muranen, William G Newman, Dong-Young Noh, Børge G Nordestgaard, Nadia Obi, Andrew F Olshan, Håkan Olsson, Tjoung-Won Park-Simon, Christos Petridis, Paul D P Pharoah, Dijana Plaseska-Karanfilska, Nadege Presneau, Muhammad U Rashid, Gad Rennert, Hedy S Rennert, Valerie Rhenius, Atocha Romero, Emmanouil Saloustros, Elinor J Sawyer, Andreas Schneeweiss, Lukas Schwentner, Christopher Scott, Mitul Shah, Chen-Yang Shen, Xiao-Ou Shu, Melissa C Southey, Daniel O Stram, Rulla M Tamimi, William Tapper, Rob A E M Tollenaar, Ian Tomlinson, Diana Torres, Melissa A Troester, Thérèse Truong, Celine M Vachon, Qin Wang, Sophia S Wang, Justin A Williams, Robert Winqvist, Alicja Wolk, Anna H Wu, Keun-Young Yoo, Jyh-Cherng Yu, Wei Zheng, Argyrios Ziogas, Xiaohong R Yang, A Heather Eliassen, Michelle D Holmes, Montserrat García-Closas, Soo Hwang Teo, Marjanka K Schmidt, Jenny Chang-Claude,

Affiliations

  1. Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
  2. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  3. National Cancer Institute, NIH, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland.
  4. Department of Epidemiology, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, California.
  5. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  6. Clinical Sciences, Department of Cancer Epidemiology, Lund University, Lund, Sweden.
  7. Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland.
  8. Oncology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
  9. Cancer Center, Department of Oncology, Kuopio University Hospital, Kuopio, Finland.
  10. Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  11. Institute of Biometry and Clinical Epidemiology, Charité -Universitätsmedizin Berlin, Berlin, Germany.
  12. Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
  13. Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
  14. Department of Oncology, Örebro University Hospital, Örebro, Sweden.
  15. Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark.
  16. Copenhagen University Hospital, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev, Denmark.
  17. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  18. Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom.
  19. Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.
  20. German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany.
  21. Medical Faculty, Universidad de La Sabana, Bogota, Colombia.
  22. Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany.
  23. Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
  24. Department of Biology, University of Pisa, Pisa, Italy.
  25. Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  26. Oncology and Genetics Unit, Xerencia de Xestion Integrada de Vigo-SERGAS, Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Vigo, Spain.
  27. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
  28. Cancer Research Institute, Seoul National University, Seoul, Korea.
  29. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
  30. Department of Oncology and Metabolism, Sheffield Institute for Nucleic Acids (SInFoNiA), University of Sheffield, Sheffield, United Kingdom.
  31. Department of Neuroscience, Academic Unit of Pathology, University of Sheffield, Sheffield, United Kingdom.
  32. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
  33. Gynaecology Research Unit, Hannover Medical School, Hannover, Germany.
  34. Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom.
  35. School of Life Sciences, University of Westminster, London, United Kingdom.
  36. Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
  37. Division of Population Sciences, Moffitt Cancer Center & Research Institute, Tampa, Florida.
  38. Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
  39. St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, United Kingdom.
  40. Division of Hematology and Oncology, Department of Medicine David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
  41. Copenhagen University Hospital, Department of Breast Surgery, Herlev and Gentofte Hospital, Herlev, Denmark.
  42. Galician Public Foundation of Genomic Medicine (FPGMX), Genomic Medicine Group, International Cancer Genetics and Epidemiology Group, Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.
  43. Moores Cancer Center, University of California San Diego, La Jolla, California.
  44. Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia.
  45. Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain.
  46. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
  47. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
  48. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
  49. Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland.
  50. Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, INSERM, University Paris-Saclay, Villejuif, France.
  51. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
  52. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
  53. Department of Oncology, Södersjukhuset, Stockholm, Sweden.
  54. German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany.
  55. Department of Gynaecological Oncology, Leuven Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
  56. Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
  57. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
  58. Department of Surgery, National University Health System, Singapore, Singapore.
  59. School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.
  60. Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.
  61. University of Tübingen, Tübingen, Germany.
  62. University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom.
  63. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  64. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
  65. Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  66. Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
  67. MASA, Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje, Republic of North Macedonia.
  68. Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
  69. Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland.
  70. Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
  71. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
  72. Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
  73. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
  74. Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  75. Department of Computational and Quantitative Medicine, City of Hope, Duarte, California.
  76. City of Hope Comprehensive Cancer Center, City of Hope, Duarte, California.
  77. VIB Center for Cancer Biology, Leuven, Belgium.
  78. Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium.
  79. Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
  80. Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore.
  81. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
  82. Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden.
  83. Pathology and Forensic Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
  84. Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.
  85. Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
  86. Breast Cancer Research Programme, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia.
  87. Department of Mathematical Sciences, Faculty of Science and Engineering, University of Nottingham Malaysia Campus, Semenyih, Selangor, Malaysia.
  88. Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece.
  89. Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
  90. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
  91. Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  92. Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
  93. Research Oncology, King's College London, Guy's Hospital, London, United Kingdom.
  94. Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan.
  95. Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel.
  96. Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  97. Department of Oncology, University Hospital of Larissa, Larissa, Greece.
  98. School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, King's College London, London, United Kingdom.
  99. National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany.
  100. Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany.
  101. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
  102. School of Public Health, China Medical University, Taichung, Taiwan.
  103. Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee.
  104. Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia.
  105. Department of Population Health Sciences, Weill Cornell Medicine, New York, New York.
  106. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
  107. Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.
  108. Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.
  109. Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia.
  110. Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, Minnesota.
  111. Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, Oulu, Finland.
  112. Laboratory of Cancer Genetics and Tumor Biology, Northern Finland Laboratory Centre Oulu, Oulu, Finland.
  113. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
  114. Seoul National University College of Medicine, Seoul, Korea.
  115. Armed Forces Capital Hospital, Seongnam, Korea.
  116. Department of Surgery, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
  117. Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
  118. Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  119. Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands. [email protected].
  120. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
  121. Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

PMID: 33500318 PMCID: PMC8026532 DOI: 10.1158/1055-9965.EPI-20-0924

Abstract

BACKGROUND: It is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype.

METHODS: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype.

RESULTS: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (

CONCLUSIONS: We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype.

IMPACT: Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.

©2021 American Association for Cancer Research.

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