Table 4.

Multivariable associations^a of alpha diversity estimates with breast cancer by participant characteristics in the Ghana Breast Health study (N=379 malignant cases and 414 controls)

	Age		Menopausal status		BMIb
	< 50	≥ 50	Pre-menopausal	Post-menopausal	Normal	Overweight	Obese
N cases	184	195	213	166	118	119	109
Shannon Index
Tertile 1 (1.91 – 4.11)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)
Tertile 2 (4.12 – 5.02)	0.57 (0.30, 1.10)	0.67 (0.31, 1.43)	0.71 (0.37, 1.36)	0.50 (0.23, 1.07)	0.53 (0.22, 1.22)	0.43 (0.15, 1.14)	0.88 (0.34, 2.30)
Tertile 3 (5.03 – 7.40)	0.46 (0.23, 0.91)	0.25 (0.11, 0.53)	0.51 (0.26, 0.98)	0.26 (0.11, 0.58)	0.39 (0.17, 0.88)	0.26 (0.10, 0.69)	0.28 (0.10, 0.75)
Ptrend	0.02	0.001	0.04	0.00	0.02	0.01	0.02
P-interaction	0.26		0.28		0.94
Observed sequence variants
Tertile 1 (26 – 94)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)
Tertile 2 (95 – 139)	0.53 (0.27, 1.04)	0.25 (0.11, 0.54)	0.52 (0.26, 1.02)	0.22 (0.09, 0.48)	0.34 (0.14, 0.81)	0.70 (0.26, 1.88)	0.45 (0.17, 1.16)
Tertile 3 (140 – 338)	0.31 (0.15, 0.63)	0.12 (0.05, 0.28)	0.34 (0.17, 0.68)	0.12 (0.05, 0.28)	0.17 (0.07, 0.42)	0.19 (0.06, 0.52)	0.20 (0.07, 0.58)
Ptrend	0.001	<0.001	0.002	<0.001	<0.001	0.002	0.004
P-interaction	0.05		0.06		0.56
Faith’s PD
Tertile 1 (8.13 – 21.56)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)
Tertile 2 (21.66 – 28.90)	0.43 (0.22, 0.85)	0.23 (0.10, 0.49)	0.47 (0.24, 0.91)	0.22 (0.10, 0.48)	0.35 (0.14, 0.84)	0.40 (0.16, 1.00)	0.59 (0.22, 1.55)
Tertile 3 (28.97 – 86.36)	0.23 (0.11, 0.47)	0.15 (0.06, 0.34)	0.25 (0.12, 0.49)	0.15 (0.06, 0.35)	0.19 (0.07, 0.44)	0.28 (0.09, 0.82)	0.06 (0.02, 0.22)
Ptrend	<0.001	<0.001	<0.001	<0.001	<0.001	0.01	<0.001
P-interaction	0.17		0.27		0.27

Abbreviations: BMI, body mass index

^aFully adjusted unconditional logistic regression models include age (continuous), study center (Komfo Anoyke Teaching Hospital, Korle Bu Teaching Hospital, or Peace and Love Hospital), and collection method (home or hospital), body mass index (kg/m²), education (junior secondary school or lower, senior secondary school/Some college or technical school or more, other or unknown), family history of cancer (yes, no, unknown), antibiotic use (missing, ≤ 30 days ago, and >30 days ago, this year, or never), number of full-term pregnancies (0, 1–2, 3–4, 5+ pregnancies), and current hormonal contraceptive use

^bNormal BMI: 18.5 −24.99 kg/m²; Overweight BMI: 25–29.99 kg/m²; Obese: 30+ kg/m²