Publications from the current and previous year are listed below; articles are listed chronologically within each year from the most to the least recent.

Most research articles have a link to the published abstract (a detailed summary) through the US. National Library of Medicine.

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BWHS_Printer friendly publication list, March 2016(articles listed from most to least recent)

Last Updated: March 7, 2016


Previous studies have found that a woman’s personal socioeconomic status (e.g., income and education) is related to her risk of developing asthma, with higher risk among women with fewer socioeconomic resources. It is possible that neighborhood socioeconomic status could also contribute to risk of developing asthma, for example in neighborhoods with more older buildings with higher levels of allergens. In a study in the BWHS that included 1520 women who developed asthma during follow-up, individual and neighborhood socioeconomic status were both assessed in relation to asthma incidence. Lower personal socioeconomic status was associated with increased asthma risk, as has been seen in other studies, whereas there was no association of neighborhood with risk.  link to online article

We assessed a genetic pathways that might be involved in breast cancer occurrence, namely the fibroblast growth factor receptor (FGFR) signaling pathway. We compared genetic variants in this pathway among women with and without breast cancer in a collaborative study of the BWHS with three other studies of African American women. We found an association of the FGFR2 gene with estrogen receptor positive breast cancer, and an association of the FGFR1 gene with estrogen receptor negative breast cancer. Thus, different genes in the same pathway may be associated with different breast cancer subtypes.  link to online article

A woman’s family history of various cancers may be related to her chance of developing breast cancer, but evidence has been conflicting. We assessed the relation of a woman’s first-degree family history (in her mother, father, sisters, brothers, or children) of breast cancer and several other cancers (e.g., prostate, lung, colon, cervix) to her risk of developing breast cancer. This was a collaborative study of the BWHS with three other studies that included African American women.  First degree family history of breast cancer was associated with a 70% increase in a woman’s own risk of developing breast cancer, whereas having a family history of both breast cancer and prostate cancer was associated with an increase three times that great. These findings suggest that greater surveillance and screening for breast cancer may be needed for women with a family history of both breast and prostate cancer.  link to online article

Vitamin D deficiency is more common among African Americans than among other racial groups. We assessed whether vitamin D-related genetic pathways are involved in breast cancer risk in the BWHS and three other studies of African American women. To do so, we compared genetic variants in vitamin-D related pathways among women with and without breast cancer.  Several genetic variants were related to breast cancer risk, and one in particular was related to estrogen receptor negative breast cancer, a subtype that occurs more commonly among African American women. These results support a possible role for vitamin D in the occurrence of breast cancer subtypes.  link to online article

Estrogen receptor negative (ER-) breast cancer is a subtype of breast cancer that occurs more commonly in black women than white women. Because ER- cancer includes “triple negative” breast cancer, a subtype that has a poorer prognosis than other subtypes, there has been a search for genetic variants that may be associated with higher or reduced risk of ER- cancer. In the present collaborative study that involved BWHS and three other studies of African American women, we assessed genetic variants in a pathway, mTOR that might play a role in the development of breast cancer. Several variants were found to be related to risk of ER- breast cancer. If confirmed, these findings suggest a mechanism that might help to explain the occurrence of ER- breast cancer in black women.  link to online article

Inflammation may be a pathway involved in the development of endometrial cancer (cancer of the lining of the womb). Fatty fish contain a substance, a “fatty acid”, that is thought to reduce inflammation. If this is so, fish consumption might lower risk of developing endometrial cancer.  We assessed this possibility in the BWHS and found that fish intake was related only weakly to the overall incidence of endometrial cancer.  There was a hint of a lower risk for fish consumption among leaner women, but assessment of this possibility will require larger numbers.  link to online article

Exposure to a component of air pollution called fine particulate matter (PM2.5) has been linked to increases in insulin resistance and blood pressure, raising the possibility that PM2.5 could increase the incidence of diabetes and hypertension. In a study of BWHS participants living in 56 metropolitan areas across the US, we first estimated PM2.5 levels and then assessed whether levels were related to the occurrence of type 2 diabetes or hypertension. Our analysis suggested that PM2.5 dose not increase the incidence of either condition.  link to online article

Cancer of the endometrium (the lining of the womb) occurs more commonly among white women who are overweight or obese or have type 2 diabetes, but whether this is the case among African American women has received little study.  In an assessment of these issues within the BWHS, we found that the incidence of endometrial cancer increased as body mass index increased.  There was also an increased risk of this cancer among women who had diabetes.  Thus, overweight and diabetes appear to have similar effects on endometrial cancer incidence in black and white women.  link to online article


Genes contributing to breast cancer risk are poorly understood. We investigated over 140,000 genetic variants  in hormone pathways in relation to risk of breast cancer in Black women based on the four large studies in the African American Breast Cancer Epidemiology and Risk (AMBER) Consortium, which includes the BWHS. Our assessments identified eight genes in hormone pathways that might be associated with  breast cancer in Black women. These will be assessed in further studies with additional data.  link to online article

Uterine leiomyomata (uterine fibroids), which are benign tumors of the wall of the uterus, are influenced by sex steroid hormones. We prospectively assessed the relationship between UL and incidence of breast cancer, a hormonally responsive cancer, in the Black Women’s Health Study.  Based on 2,276 incident breast cancer cases ascertained during follow-up, the incidence rate ratio for the association between history of UL and breast cancer incidence was close to 1.00 for breast cancer overall and for estrogen receptor positive and estrogen receptor negative breast cancer. There were some small elevations in risk, mostly nonsignificant, for associations with diagnosis of UL before age 30. The results suggest that history of UL diagnosis overall is unrelated to incidence of breast cancer.  link to online article

African American women experience higher rates of ER- (estrogen receptor-negative) breast cancer, an aggressive type of breast cancer, than white women. African American women also, on average, have an earlier age at menarche (first period) than other U.S. women. Causes of ER- breast cancer have not been clearly established. Data from the BWHS and three other  studies with large numbers of African American women (the AMBER Consortium) were used to assess the relationship of age at menarche with risk of ER- and ER+ breast cancer. Risk of ER+ breast cancer was increased among women with longer intervals between menarche and the birth of the first child, whereas later menarche was associated with lower risk of ER- breast cancer regardless of childbearing. These differences suggest that the biologic pathways influencing risk of ER- and ER+ breast cancer may differ.  link to online article

Data from the BWHS and three other studies were used to assess the relationships of obesity and body fat distribution to different subtypes of breast cancer, including triple negative (TN) cancer, which occurs more commonly in Black women. Relationships differed according to the subtype of cancer and menopausal status. Higher body mass index was associated with decreased risk of postmenopausal estrogen receptor positive (ER+) cancer and with decreased risk of postmenopausal TN cancer. Higher body mass index around the age of 18 was associated with increased risk of premenopausal ER+ cancer and all subtypes of postmenopausal cancer. High waist-to-hip ratio, a measure of body fat distribution around the waist, was associated with increased risk of ER+ tumors. Different biologic mechanisms may be at work and more research is needed to understand the interplay between weight, body fat distribution, and breast cancer.  link to online article

Previous studies have found that women who have recently used oral contraceptives have a higher risk of breast cancer, which dissipates after use ceases. This large study, based on the BWHS and three other studies, examined the association between oral contraceptive use and specific subtypes of breast cancer, namely estrogen receptor positive, estrogen receptor negative, and triple negative breast cancer. Long-term and recent oral contraceptive use were associated with increased risk of all subtypes of cancer. The risk decreased over time after use was halted.  link to online article

In an assessment of whether dietary intake is associated with risk of dying, information on food intake provided by Black Women’s Health Study participants in 1995 and 2001 was used to define several dietary patterns, such as the “Western” pattern. The Western pattern is a common pattern in the U.S., characterized by high intake of meat, fats, and sweets. The death rate was higher among BWHS participants with a Western type of diet whereas it was lower among women whose diets were high in whole grains, fruits, and vegetables. These findings are similar to results in other populations and strengthen the evidence that type of dietary intake can increase or decrease the risk of dying.  link to online article

In 2005 BWHS participants reported information on whether and how long they had worked night shifts. Based on follow-up through 2013, the incidence of type 2 diabetes in the BWHS was greater among women who had worked a night shift for at least 10 years than among women who had not worked night shifts. The relationship was present in women who were overweight or obese as well as in thinner women, indicating that the mechanism for the increase was not through weight. A possible mechanism may involve sleep disturbances, which are increasingly being associated with adverse health effects.  link to online article

With BWHS data on smoking (“active”) and exposure to the smoke of others (“passive”), we examined the development of adult-onset asthma among  past smokers, current smokers, non-smokers who were exposed to the smoke of others (passive smokers), and non-smokers  never exposed to the smoke of others. Current active smoking was associated with the greatest increase in risk of adult-onset asthma. Passive smokers also experienced a higher risk but less than that of active smokers. These results suggest that avoiding smoking and reducing exposure to tobacco smoke could help to prevent the development of adult-onset asthma.  link to online article

Depression can affect the production of female hormones, which are thought to be involved in the development of uterine leiomyomata. In a study in the BWHS, the incidence of uterine fibroids was a little higher among women who reported more depressive symptoms than in women with fewer symptoms. This finding supports the idea that disruption of female hormones can influence risk of uterine fibroids.  link to online article

Breast cancer prediction models that are currently used underestimate risk of breast cancer for African American women, resulting in lower rates of recruitment into breast cancer prevention trials. Based on data collected from Black Women’s Health Study (BWHS) participants from 1995 to 2005, BWHS developed a prediction model that includes more factors than used in previous models.  The model was then tested in BWHS data from 2006-2011. The results suggested an improvement on current prediction models among African American women. Use of the new model could result in an increase in the number of Black women eligible for breast cancer prevention trials, which in turn would ensure that new prevention methods are applicable to African American women.  link to online article

The BWHS and other studies have previously shown that childbearing is associated with weight gain in the years following a pregnancy. In an analysis of the association of breast feeding with weight gain after pregnancy, BWHS participants who had a body mass index less than 30 before pregnancy and who breastfed their babies after the pregnancy gained a little less weight than similar women who did not breast feed, but this was not the case among heavier women who breast fed their babies. While the beneficial effect of breastfeeding on the health of babies is clear, the effect of breastfeeding on weight gain is likely very small.  link to online article

Sarcoidosis, an inflammatory autoimmune disease that can affect the lungs and other organs, disproportionally affects Black women. Overweight and obesity causes inflammation. BWHS data was used to examine whether there is an association between weight and sarcoidosis. Weight gain and obesity were both associated with increased incidence of sarcoidosis. While plausible, this is the first report of such associations and they need to be confirmed in other studies.  link to online article

The Endometrial Cancer Consortium combines data from 18 separate studies, including the BWHS, to assess risk factors for endometrial cancer. Based on 8,801 cases of endometrial cancer, use of IUDs of various types was associated with reduced risk of endometrial cancer. To fully understand the biology of the decrease in risk, additional study is needed. In addition, further study of the types of IUDs currently available in the US is needed.  link to online article