Research Papers: Breast CancerAssociation of Epstein–Barr virus and passive smoking with the risk of breast cancer among Chinese womenQi, Mei-Linga,*; Xi, Jinga,*; Chen, Li-Juana; Su, Yia; Cen, Yu-Linga; Su, Feng-Xic; Lin, Yingd; Zhuang, Zhi-Xionge; Tang, Lu-Yinga,b; Ren, Ze-FangaAuthor Information aSchool of Public Health bThe Third Affiliated Hospital cThe Second Affiliated Hospital dThe First Affiliated Hospital, Sun Yat-sen University, Guangzhou eShenzhen Center for Disease Control and Prevention, Shenzhen, China * Mei-Ling Qi and Jing Xi contributed equally to the writing of this article. All supplementary digital content is available directly from the corresponding author. Correspondence to Ze-Fang Ren, PhD, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China Tel/fax: +86 20 87332577; e-mail: [email protected] Received May 13, 2013 Accepted September 11, 2013 European Journal of Cancer Prevention: September 2014 - Volume 23 - Issue 5 - p 405-411 doi: 10.1097/CEJ.0000000000000071 Buy Metrics Abstract Reactivation of Epstein–Barr virus (EBV), as indexed by the higher immunoglobulin A (IgA) antibody titers, was reported to be associated with an increased risk of breast cancer. Passive smoking plays a role in host immune responses and may modify the association of EBV with breast cancer. We carried out a case–control study using data from 349 incident breast cancer cases and 500 age-matched controls in the Guangzhou Breast Cancer Study to investigate the interactions of EBV antibodies and passive smoking on breast cancer risk. A higher risk of breast cancer was observed in passive smokers who were seropositive for EBV viral capsid antigen IgA or nuclear antigen-1 IgA in serum compared with those with the seronegativity and no passive smoking [odds ratio 3.13 (95% confidence interval, 1.76–5.56)]. There was a significant linear trend for the risk of breast cancer from IgA seropositivity with passive smoking, only IgA seropositivity, only passive smoking, to seronegativity without passive smoking (P<0.001), but the interaction in either multiplicative or additive models was not significant. No significant association was found between passive smoking and EBV IgA seropositivity. The present study confirmed the associations of EBV IgA antibodies and passive smoking with the risk of breast cancer and suggested that there was no synergic action between passive smoking and EBV IgA seropositivity on the risk of breast cancer. © 2014 Lippincott Williams & Wilkins, Inc.