Theory, methods, and operational results of the Young Women’s Health History Study: a study of young-onset breast cancer incidence in Black and White women

Ellen M. Velie, Lydia R. Marcus, Dorothy R. Pathak, Ann S. Hamilton, Ralph DiGaetano, Ron Klinger, Bibi Gollapudi, Richard Houang, Nicole Carnegie, L. Karl Olson, Amani Allen, Zhenzhen Zhang, Denise Modjesk, Gwendolyn Norman, Darek R. Lucas, Sapna Gupta, Hallgeir Rui, Kendra Schwartz

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: The etiology of young-onset breast cancer (BC) is poorly understood, despite its greater likelihood of being hormone receptor-negative with a worse prognosis and persistent racial and socioeconomic inequities. We conducted a population-based case–control study of BC among young Black and White women and here discuss the theory that informed our study, exposures collected, study methods, and operational results. Methods: Cases were non-Hispanic Black (NHB) and White (NHW) women age 20–49 years with invasive BC in metropolitan Detroit and Los Angeles County SEER registries 2010–2015. Controls were identified through area-based sampling from the U.S. census and frequency matched to cases on study site, race, and age. An eco-social theory of health informed life-course exposures collected from in-person interviews, including socioeconomic, reproductive, and energy balance factors. Measured anthropometry, blood (or saliva), and among cases SEER tumor characteristics and tumor tissue (from a subset of cases) were also collected. Results: Of 5,309 identified potentially eligible cases, 2,720 sampled participants were screened and 1,812 completed interviews (682 NHB, 1140 NHW; response rate (RR): 60%). Of 24,612 sampled control households 18,612 were rostered, 2,716 participants were sampled and screened, and 1,381 completed interviews (665 NHB, 716 NHW; RR: 53%). Ninety-nine% of participants completed the main interview, 82% provided blood or saliva (75% blood only), and SEER tumor characteristics (including ER, PR and HER2 status) were obtained from 96% of cases. Conclusions: Results from the successfully established YWHHS should expand our understanding of young-onset BC etiology overall and by tumor type and identify sources of racial and socioeconomic inequities in BC.

Original languageEnglish (US)
Pages (from-to)1129-1148
Number of pages20
JournalCancer Causes and Control
Issue number10
StatePublished - Oct 2021


  • Breast cancer
  • Epidemiology
  • Health status disparities
  • Life-course
  • Premenopause
  • Young-onset breast cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Theory, methods, and operational results of the Young Women’s Health History Study: a study of young-onset breast cancer incidence in Black and White women'. Together they form a unique fingerprint.

Cite this